Journal of

Background: Priority Setting is necessary. There are different ways of priority Setting. How they are used depend on the situation of the country.

Material and Methods: This research is literature review. Google Scholar, Medline, Iranmedex, SID, Irandoc data base are used to gathering data.

Results: According to this study, there are various standard ways to priority setting such as Essential national health research ( ENHR), combined method, The commission on health research for Development (COHRED), Five-Step Process of the Ad Hoc Committee on Health Research. These methods have their own characteristics. These methods vary from one country to another . However the final impact is the same.

Conclusion: The result shows that it is useful to know about priority setting and strength and weakness of them. Combined method is the best way because it has the strength of other methods and corrects weakness of them. 

Background: Process of discharging patients affects patient’s satisfaction .This is one of the serious challenges that hospital managers face. This study is aimed to determine the average waiting time of patient discharge process and identify influential factors of this process in Imam Reza Hospital in Mashhad in the year of 2014.

Materials & Methods: This is a cross-sectional survey in which waiting time of patients who had discharged from clinical wards of the Imam Reza hospital in Mashhad had been studied. 455 of patients had been selected as samples. The amount of  time spent during discharge in six different departments  such as inside each ward, from each ward to the medical records unit, inside the medical records unit, from medical records unit to  accounting department , during cost calculation and also from  cost accounting to cost payment unit) had been determined by using stop-watch method. The data had been analyzed by descriptive and analytical statistics in significant level of 0.05  using SPSS16.

Results: Results showed that waiting time was 504.26± 362.96 Minutes. Patients spent most and least proportion of their waiting time in ENT and Burns wards during discharge.

Conclusion:   As noticeable number of minutes spent inside wards and cost payment unit by patients, calls for corrective interventions such as changing visit time and predicting schedules for sending medical record to accounting department could  reduce waiting time.

Background: Pre hospital emergency medical service (EMS) as the first line of emergency care and treatment in the out- of -hospital has a considerable importance in the health care system. Planning on finding about strengths and weaknesses and improve the quality of EMS by exploring the problems of this section has considerable important.This study aimed to explore the challenges of pre hospital emergency medical service in Mashhad.

Materials and methods: A qualitative study was done with 14 personnel working in EMS sites in Mashhad using purposeful sampling. Data was collected by semi structured interview and analyzed using conventional content analysis approach according to Graneheim and Lund man 2004 with ATLAS.ti  software.

Results: Three general themes were identified including 1) "challenges in Human resources"( Individual characteristics of human resources and personnel's dissatisfaction 2) "challenges in organization" (Structural challenges, lake of equipment and human resource limitation 3) "socio-cultural challenges"(Environmental-social challenges and cultural challenges) were determined.

Conclusion: personnel's dissatisfaction, structural challenges, human resource limitation, lake of equipment   and Environmental-social challenges were the most important challenges in pre-hospital emergency system. Organizational independence , create organizational rows, regulation of laws and administrative regulations reform in relation to the range of services offered by emergency personnel, attention to the facilities and cooperation And the participation of other organizations, such as media and traffic to enhance pre-hospital emergency services at the community level can be effective in reducing the challenges in hospital emergency system.