Showing 23 results for Emergency
M.a Afshar Kazemi , N Bigdeli , J Manoochehri , Y Jenab ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: Emergency department (ED) is the first place for providing diagnostic and therapeutic services to emergency patients. Due to importance of speed and accuracy in providing services the proper allocation of resources, the department must consider this matter in a particular way. Planning Emergency resources implements regardless of patient overcrowding which occurs at different times. In conclusion the emergency department may faces lack of resources and it results in delay of providing services, a whole mess in functions and decreasing in quality of services. This study is aimed to overcome these problems by suggesting a model for predicting the number of arrival patients at ED.
Materials and Methods: The number of arrival patients is predicted based on the data colleted by counting arrival patients and using the data mining technique and neural network model (Multi-layer Perceptron).
Results: The number of arrival patients during whole days of a week and 24 hours a day were calculated by sorting out 1, 2 and 3 priorities . The highest number of arrival patients counted was for Saturdays and the lowest for Fridays. Holidays and non-holidays` number of arrival patients differ . The number of arrival patients on formal holidays was similar to Fridays. The highest number of arrivals was between 9 am and 11 and also between 20 pm and 23 pm and the lowest arrivals was between 2 am and 7 am.
Conclusion: prediction the number of ED arrival patients can be used for estimating required sources and distributing them appropriately and improving quality of services.
Dr. Khodakaram Salimifard, Leyla Keshtkar, Mohammadsadegh Moradi,
Volume 13, Issue 3 (12-2014)
Abstract
Background: Emergency department performance can be evaluated in quantitative and qualitative criteria. Some quantitative criteria are considered such as length of stay, patient waiting time, the percentage of patients that treat in a specific time and etc. In this paper the performance of emergency department was evaluated in terms of these criteria. Then four scenarios by using simulations was proposed.
Materials & Methods: patient flow was modeled by discrete event simulation (DES) and the simulation was done by Arena software. Data was gathered randomly and patient waiting time, length of stay and the percentage of patients by noticing 6-hour boarding limit for EDs were performance criteria.
Result: The result show 70% of patients were hospitalized in ED over 6 hours and it is an important bottleneck. The fourth scenario is that best of the scenarios, that improve in waiting times for hospital admission (85%), total waiting time before hospitalization (63%) and the percentage of the beds utilization (15%).
Conclusion: the findings of this paper show that the fourth scenario has greatest improve in the process. In this scenario, to reduce waiting times for patients admitted to the emergency department as well as to reduce the high percentage of occupied beds, 3 beds and 1 nurse were added.
Neda Vaziri, Ali Ardalan, Elham Ahmadnezhad, Abbas Rahimi Foroshan,
Volume 14, Issue 1 (6-2015)
Abstract
Background: Emergency operation centers (EOC) have been established in recent years aimed to organize and coordinate through disasters. These centers are responsible for decision-making in response and recovery phases after events. This study is aimed to develop a standard function evaluation criteria for EOC.
Materials and Methods: This mixed method study with sequential triangulation approach had been conducted in 1391 among employees of EOCs which have been running experience for minimum of one year . validity and reliability of questionnaire had been confirmed by face and content validity and Cronbach's alpha respectively. The most important factors have been determined by an Explanatory factor analysis which also helped reducing number of questions.
Results: Final tool by six domains had 38 questions. All content validities were higher than +0.6 apart from one at +0.1. Only the activation domain had inappropriate Cronbach at 0.337 and all others were higher than 0.7. Factor analysis reduced number of questions in each domain. Explanatory factor analysis reduced number of questions from the views of information assessment, activation and coordination and other domains to 5 ,2 and 1 respectively.
Conclusion:It seems that mentioned questionnaire could be an appropriate criteria for assessing performance of EOCs due to its validity and reliability according . The high reliability was resulted from closed correlation of. Appropriate quantity of validity implied EOC personnel great depth of knowledge on all questions asked.
Mohammad Arab, Elham Movahed Kor, Mahmood Mahmoodi,
Volume 14, Issue 1 (6-2015)
Abstract
Introduction: Major consideration on hospital emergency services had been taken into account in recent years. This study is aimed to analyze contributory factors of clients' satisfaction in services provided in emergency unit of selected hospitals affiliated with Tehran and Shahid Beheshti University of Medical Sciences.
Materials and Methods: This is a descriptive-analytical and cross-sectional study. 768 clients of emergency departments of selected hospitals had been chosen during last year as samples . 3 general and 3 specialized hospitals had been chosen randomly among total hospitals affiliated with mentioned two universities . A questionnaire consisted of 54 questions in 2 sections had been used for data collection . Reliability and validity were confirmed by professors and 50-sample pilot study respectively. The alpha-cronbach was calculated at 0.87.Responsible rate had been determined at 97.66 % . The data had been analyzed by independent sample t-test, simple linear regression and linear multi-regression.
Results: The demographic characteristics of attendants were as follows: 57.3% women, 56.8% over 45 years old , 63.1% social insurance coverage, 92.7% urban residents , 56% married, 58.7% low education ( below high school level) and 68.4% complementary insurance coverage. Clients had to pay more for services provided by Shahid Beheshti University. Moreover, majority of the clients paid their expenditures by out-of-pocket and insurance. Clients were more satisfied with admission unit , gaurds, physicians, nursing cadre and environment provided by hospitals of Tehran university. On the other hand , in terms of management , clients were more satisfied with management approach provided by hospitals of Shahid Beheshti university . Totally , women , elderly people , urban residents , individuals who visited physicians out of referral system and also ones who came during physician presence felt more satisfaction .Generally , patients were more satisfied with services delivered by hospital affiliated with Tehran university .
Conclusion: Evaluating viewpoints of patients about quality of services result in promoting current trends of providing services.
Mohammad Arab, Mostafa Hoseini, Mohammad Panahi, Ziba Khalili,
Volume 14, Issue 2 (8-2015)
Abstract
Background: Nurses are the largest group of health care providers and emergency department is known as a high risk ward in terms of occupational injuries. The aim of current study is to make out nursing occupational hazards in the emergency department among teaching hospitals affiliated to Tehran University of Medical Sciences.
Materials and Methods: The study carried outed on 250 emergency department’s nursing staff of hospitals affiliated to Tehran University of Medical Sciences. A valid and reliable questionnare used for data gathering by Simple random sampling method. Data analysed using descriptive snd inferential statistics.
Results: The level of mean and SD of occupational injuries (2.87 ± 0.55) was assessed moderate. Among occupational hazzards, Psychosocial and institutional (3.58 ± 0.47) and Ergonomic (3.57 ± 0.71) ones were the most prevalent occupational hazards respectively and chemical hazards were the least important source of occupational injury. There was a statistical significant association of occupational injuries and variables such as hospital, years in practice, educational level, type of employment and training courses in occupational hazards (P<0.05).
Conclusion: Nurses exposes a range of risk factors in different domains regarding occupational injuries. With the purpose of eliminating the risk factors, it needs to run various strategies in different domains. Applying ergonomic approaches, developing appropriate educational programs, providing adequate training in this area, etc., can result in reduceing occupational injuries and increasing their productivity.
Mahdi Kouchakzadeh, Zohreh Sohrabi, Ali Mohamad Mosadegh Rad,
Volume 14, Issue 3 (9-2015)
Abstract
Background: The emotional intelligence of nurses has several effects on their behavior skills. In this study, the relation between Emotional Intelligence (EI) and Communication Skills (CS) among emergency unit nurses was assessed.
Materials and Methods: In the descriptive analytical study, 253 nurses of fifteen IUMS hospitals were selected using census sampling method. The Golmans instrument for EI assessment and self -administered CS questionnaire filled by study participants. Validity and reliability of the questionnaire confirmed. SPSS software version 18 utilized to analysis using ANOVA, Spearman correlation test and Pearson correlation coefficient.
Results: mean of total EI estimated 78.31 which the highest and lowest score were in self-cognitive dimension (20.83) and self-management dimension (18.19) respectively. The total mean of CS was 70.90. There was a significant statistical correlation between EI and CS (r=0. 775, p<0.001). Moreover, there was a significant statistical correlation between CS and four dimensions of EI.
Conclusion: Based on study results, emotional intelligence and its dimensions had positive effect on communication skills among emergency unit nurses. Hospital managers can reinforce emotional intelligence by providing educational sessions. They should promote communication skills in emergency unit nurses and provide improvement emergency services quality.
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Volume 14, Issue 4 (1-2016)
Abstract
Background: Emergency response of hospitals to deal with disasters is essential to success in providing qualified emergency services. The aim of current study was to evaluate emergency response of hospitals in Karaj against disasters.
Materials and Methods: This study was a cross sectional one which performed among 13 Karaj hospitals in 2013. To collect data, emergency response Checklist WHO (2011) was utilized with 90 questions prepared in 9 domains (Command and control, Communication, Safety and security, Triage, Surge capacity, Continuity of essential services, Human resources, Logistics and supply management and Post-disaster recovery). Data analysis carried out using SPSS version 20 with descriptive tests.
Results: mean score of emergency response was 44.17%. The most and the worst dimensions were hospital triage 70.30% and accident reconstruction after the emergency 24.84% respectively.
Conclusions: Based on WHO checklist, only 44.17% of studied hospitals were able to respond disaster events. Planning and providing a systematic framework to deal with disasters is a necessity, and the major role of hospitals should not be ignored in providing services considering its priority in plans and budgets in disasters conditions.
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Volume 16, Issue 1 (4-2017)
Abstract
Background: The emergency department is as heart of hospital and is one of the first points of contact for patients with health care system are facing a variety of challenges. This study aimed to explore the challenges of emergency departments in teaching hospitals of Mashhad University of Medical Sciences.
Materials and Methods: This study was carried out through a qualitative approach and phenomenology method in 2013 in Mashhad, Iran. Twenty nurses and two emergency medicine specialists were recruited from four teaching hospitals in Mashhad Iran using purposive sampling. Data were collected through semi-structured in-depth interviews. Interviews were transcribed verbatim and analyzed using conventional content analysis approach according to colaizzi with MAXQDA 3 software.
Results: The results of this study indicated that challenges of emergency department lay in
Three main aspects including: "challenges in Human resources"(personal characteristics, professional characteristics and human resource limitations), "nurses' dissatisfaction"(less quality hospital hoteling and services for staff, disproportion between the workload and salaries, Lack of support from nurses) and " challenges in human resources management "(Structural challenges, the performance challenges and challenges in human resource management). Each theme included several category and subcategory that explain various aspects of the challenges in emergency department.
Conclusion: Human resource limitations, nurses' dissatisfaction and poor management were the most important challenges. Providing adequate human resources, support of nurses and determination guidelines and process for nursing care can reduce these challenges in hospital emergency departments.
Dr Roghieh Bayrami, Dr Hossein Ebrahimipour, Alireza Rezazadeh,
Volume 16, Issue 2 (7-2017)
Abstract
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.
Dr Faramarz Pourasghar, Nesa Kavakebi,
Volume 18, Issue 4 (1-2020)
Abstract
Background: Information technology application in health care is increasing. The aim of this study, is to introduce a scientific model for designing an electronic system for managing patient transfer.
Materials and Methods: This study is an exploratory qualitative study. At first a review of literature was carried out for identifying clinical, managerial and process indicators necessary for patient transfer. Then 30 experts, who had vast experiences on patient transfer, were selected using purposive sampling approach and their informational needs were extracted using focus group discussion and semi-structured interviews. Then clinical indicators extracted from literature review and informational needs collected from interviews were distributed among 51 experts in the form of Delphi questionnaires. Process indicators were also distributed among 35 experts to summarize all necessary indicators for designing patient transfer system. At the final step an expert panel approved the model.
Results: Thirty eight process indicators and 249 clinical and managerial components were finalized for designing the system. The process indicators were used for designing “monitoring and reports sections” of the system. The clinical indicators were used for designing “main sections” of the system including request for patient transfer, automatic algorithm for selecting destination hospital, information flow cycle, communicating clinical data and documentation. Final model also includes user interfaces relevant to responsibility of the user.
Conclusion: The proposed model, which contains necessary indicators for patient transfer, can communicate clinical information among hospitals and by providing proper infrastructure, will be able to improve patient transfer process.
Ali Akbarisari, Farhad Habibi, Bahman Khosravi, Pejman Hamouzadeh, Mani Yousefvand,
Volume 19, Issue 1 (4-2020)
Abstract
Background: Performance appraisal and quality evaluation of the services provided will achieve the organizational goals and improve the level of staff capability. In order to evaluate accurately and efficiently, we need to use standard indices, to compare the quality and quantity of work with standards, to know the current conditions and to solve its problems
Methods: This study is an applied study. This was done through a combined method of reviewing the texts and consensus of experts. Initially, the literature review and emergency evaluation indices were extracted, then the duplicate indices were removed and similar indices were merged, then weighted experts and questionnaires were compiled with the indices. Content validity, Cronbach's alpha coefficient and test-retest were used to assess the validity, internal consistency and reproducibility of the questionnaire, respectively. Data were analyzed using Excel and SPSS 20 software.
Finding: Final questionnaire with 105 questions in 8 areas including management and leadership (15); human resources (22); physical space and facilities (18); medicine and medical equipment (6); guidelines and policies (17); patient-centered (10); documentation of patient records (5); quality and time indices in the emergency department (12). The results showed that the final questionnaire was reliable (0.89) and repeatable (ICC = 0.98).
Conclusion: The Hospital Emergency Performance Assessment Questionnaire is a valid and reliable instrument and can be used to evaluate the performance of hospital emergency services.
Mahmoud Mirakbari, Maryam Ooshaksaraie, Maryam Daneshmand Mehr, Hossein Amouzad Khalili, Seyed Ali Majidi,
Volume 19, Issue 2 (8-2020)
Abstract
Introduction : A large number of hospitals and medical healthcare centers catch fire every year. Nowadays, one of the most significant challenges that hospital designers and health providers faced with is fire safety. This study conducted to determine a comprehensive model for fire safety in hospitals by reviewing related studies.
Method: This study was conducted using a comprehensive review to find a research paper published on fire in hospitals. Electronic databases such as PubMed Scopus google were searched using the proper search strategy.
Results: Overall, 14 studies were obtained. The findings were analyzed qualitatively through thematic synthesis and divided into some main themes: essential sections and divisions of hospitals in the field of fire, emergency exit patterns, materials and construction status, Flammable consumables materials in hospitals, and appropriate firefighting equipment.
Conclusion: The dangers of medical equipment and flammable material, the types of firefighting equipment in the hospital building, architectural safety issues regarding the degree of fire resistance of structures, roofs, doors, walls, and emergency exit stairs are crucial points To protect staff and patients in hospitals that should consider simultaneously.
Elahe Amirahmadi, Mehdi Rezaie, Fatemeh Meshkini, Mohammad Hosseinikasnavieh,
Volume 21, Issue 3 (12-2022)
Abstract
Background and aim: Having weakness and lethargy and feeling the need for hospital emergency services is one of the most important reasons for patients to go to hospital emergency rooms. The aim of the present study was to investigate the relationship between morbidity and mortality of patients with weakness and lethargy.
Method: The present study was conducted in an observational and prospective manner in the emergency department of Rasool Akram and Firouzgar hospitals. The patients were divided into 5 groups by the evaluation team in the emergency triage unit using the international valid triage tool "Emergency Severity Index (ESI)". The patients were followed up for 2 months after the time of discharge and the patient's condition was examined in terms of illness, health or death.
Result: Between levels 1 and 2 (patients with high severity conditions) and 3 (patient needs two or more emergency facilities in case of no disturbance in vital signs), level 3 had the highest frequency of referrals (61.9%). 90.7% had an underlying disease and 66.1% of the patients were taking medication at the time of visit. 11% of patients died in the first visit. In the initial follow-up, 23.7% of people were still sick, 40.7% had recovered and 17.8% had died.
Conclusion: According to results in the final follow-up, 3.9% of people were still sick; the rate of recovered patients in the final follow-up was 44.1% and the percentage of deaths in the final follow-up was 24.6%. The high mortality rate indicates that the patients' concern was not due to weakness and lethargy, but due to a dangerous underlying disease that forced them to go to the hospital.
Homa Azadi, Ahmad Ghazanfari, Maryam Chorami, Tayebeh Sharifi,
Volume 21, Issue 3 (12-2022)
Abstract
Purpose: Considering the problems of nursing profession, it is very important to find the best method to improve the resilience of nurses. The purpose the present study was to compare the effectiveness and durability of treatment based on acceptance and commitment and paradoxical time schedule of resilience of emergency department nurses.
Methodology: To perform this quasi-experimental research, which was carried out with a pre-test-post-test design with a control group and a follow-up stage, 45 nurses working in the 5 emergency departments of Isfahan hospitals in the second half of 2019 were selected using convenience sampling method. They were randomly divided into three groups of 15 subjects: treatment based on acceptance and commitment, paradoxical schedule treatment and control. Subjects in the acceptance and commitment treatment experimental group participated in 8 sessions and the paradoxical schedule treatment group in 6 90-minute sessions but for the control group, there was no intervention. Participants completed the resilience scale by Connor and Davidson (2003) in three steps. The research data were analyzed using the variance analysis method with repeated measurements in SPSS-26 software.
Results:The results showed that there is a significant difference between the resilience score in three stages of pre-test, post-test and follow-up measurements. It was also found that there was a significant difference between scores of two experimental groups and control group, but there was no significant difference between the scores of the two experimental groups.
Conclusion: According to the results, it is recommended that the authorities use these two types of treatment programs under expert supervision to improve the resilience of nurses.
Mohammad Ziaaddini, Mohamaad Sadegh Abolhasani, Mohamaad Zarezadeh, Elahe Salarikhah, Homa Khazaei, Farzaneh Ghorbani,
Volume 21, Issue 4 (1-2023)
Abstract
Background and purpose: Considering the dimensions of organizational bullying and the context of its creation in the emergency department of the hospital, the decrease in the quality of patient care and the increase in dissatisfaction with the services received and the limited research studies in this area, the research was conducted in the emergency department of a hospital of Yazd University of Medical Sciences.
Materials and methods: To carry out this descriptive-analytical research, the interpretive structural modeling method was used. The experts included 30 doctors, nurses, and nurses who were either working in the emergency department of a Yazd University of Medical Sciences hospital or had experience of service in this department. From the extraction of these factors, they were returned to them for scoring, and the effects of these factors were measured from their point of view, and the final analysis was done by MATLAB software.
Results: The results show that the greatest effect in reducing bullying is related to "adequate training for personnel to communicate" and "proper and courteous treatment in the face of clients" (with influence power of 5) and the least effect is related to "creating a suitable comfortable environment". and "Perform appropriate triage" (with penetration power of 1).
Conclusion: Considering the destructive effects of bullying, creating appropriate mechanisms to reduce this phenomenon shown in this research and using the factors identified by the people involved in bullying can prevent this phenomenon, which occurs frequently in the emergency room of the hospital.
Hasan Fatahi, Seyyed Mohammad Waziri, Mahyar Souri, Mohammad Hossein Askarian,
Volume 22, Issue 2 (9-2023)
Abstract
Background and purpose: The emergency department of a hospital is akin to its heart, where smooth operations can save many lives. This research aims to reduce patient waiting time in the emergency department using simulation techniques.
Methods: This descriptive-analytical study was conducted cross-sectionally in 2019 at the Qaim Hospital in Mashhad. The study focused on accurately modeling the patient flow process in the emergency department using simulation techniques and Arena software. Key performance indicators such as patient waiting time, number of discharged patients (system output), length of stay, resource efficiency, and improvements in the emergency department were evaluated.
Results: The simulation model's results indicated that the laboratory, specialist doctor examination, and pharmacy departments had the longest waiting times in this department, respectively.
Conclusion: To reduce patient waiting times and improve conditions, the most effective and cost-efficient solution is to add a laboratory technician to the laboratory department during the [15-23] shift at Qaim Hospital in Mashhad, which is projected to decrease patient waiting times by 66 minutes.
Leila Vali, Hojat Farehmandnia, Ahmadreza Mohammadpour,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose:
As people age, physical dysfunction often increases, leading to various challenges and a heightened need for urgent medical services. Elderly individuals are among the primary users of healthcare and pre-hospital emergency services. Their subjective experiences during emergencies are influenced by their need for timely and relevant information regarding emergency procedures and their clinical condition—a need that is also shared by their caregivers. This study aims to elucidate the experiences of elderly individuals who have used pre-hospital emergency services in Shiraz.
Methods:
This qualitative study was conducted in two phases. In Phase 1, semi-structured interviews were conducted with 21 elderly participants using purposeful and snowball sampling until data saturation was achieved. The interview transcripts were analyzed using Colaizzi’s method to extract key themes. In Phase 2, a panel of experts was convened to further discuss the findings and provide recommendations.
Results:
Analysis of the interviews revealed several themes related to the elderly’s experiences with pre-hospital emergency services. These themes were categorized into sub-themes including ambulance condition, performance of technicians, timeliness of emergency response, and issues related to emergency rules and regulations. In Phase 2, the expert panel offered practical solutions to address the identified challenges.
Conclusion:
The findings indicate that elderly patients face significant challenges when accessing pre-hospital emergency services, such as poor ambulance conditions, suboptimal technician performance, delayed emergency response times, and restrictive emergency protocols. The recommendations provided by the expert panel could inform policy development and lead to improvements in the quality of pre-hospital care for the elderly.
Morteza Ghaderi Azarkhavarani, Mohammadreza Khajeh Aminian, Milad Ahmadi Marzaleh, Mohammad Hosein Yarmohammadian, Seyed Masood Mousavi, Hassan Nouri Sari,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: The Emergency Operations Center (EOC) is a centralized facility designed to coordinate disaster management activities across all phases of the disaster management cycle. EOCs play a vital role in facilitating efficient and effective responses by coordinating information and resources. This study aims to highlight the importance of establishing a standardized framework for EOCs in Iranian universities of medical sciences and to examine its key dimensions.
Methods: This study is a commentary article that compiles information from published literature on the framework of emergency operations centers. It focuses on two prominent global frameworks: the World Health Organization’s Public Health Emergency Operations Center Framework and the U.S. Federal Emergency Management Agency’s Emergency Operations Center Guidelines. The study emphasizes the necessity of creating a standardized framework for emergency operations centers in Iranian universities of medical sciences.
Results: EOCs across different countries vary in terms of their missions, authorities, and resources. Consequently, the frameworks used in these centers are not uniform, and are largely shaped by the governance and regulatory requirements specific to each country.
Conclusion: A standardized framework, tailored to the specific needs and conditions of Iran, is essential for EOCs at universities of medical sciences. Such a framework could enhance the operational capabilities of these centers during incidents and disasters, improving their responsiveness and effectiveness.
Shahrzad Rasekhi, Sedighe Sadat Tabatabaei Far, Abdosaleh Jafari,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: The aim of this study was to investigate the waiting time of patients referred to the emergency department and the factors affecting it in the country.
Methods: A search was conducted in the scientific databases PubMed, Science Direct, ProQuest, Scopus, Web of Science, Mag Iran and Civilica with the keywords waiting time, duration, emergency, Iran, etc. The Search period was up to 2024/02/06. After applying the search strategy, 26 studies were included in the study.
Results: The findings of the present review study (rapid review) showed that the average time from patient arrival in the emergency department to the first doctor's visit ranged from about 2 minutes to about 32 minutes, the average time from patient arrival in the emergency department to the first treatment ranged from 3.7 minutes to 262 minutes, the average time from request to the first test result was from 20.17 to 629.2 minutes, the average time from request to the first radiology result was from 5.85 to 1080 minutes, and the average time from request to the first ECG result was from 3.7 to 32.3 minutes. Also, the most important factors affecting the waiting time of patients referred to the emergency department included individual factors related to the patient, reason for referral, factors related to the hospital and emergency department, and factors related to human resources in the emergency department.
Conclusion: This study showed that patients' waiting time in the emergency department depends on various factors. To reduce it, improvements in triage, workforce management, the use of smart technologies, infrastructure enhancement, and patient education are recommended.
Alireza Rahimi,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: Pre-hospital Emergency Medical Services (EMS) play a pivotal role in managing life-threatening conditions. However, evidence suggests that the Iranian EMS system faces multifaceted challenges across human, managerial, and infrastructural dimensions. This study aimed to conduct a comprehensive meta-synthesis to identify and analyze the challenges characterizing pre-hospital EMS in Iran, based on research evidence published between 2014 and 2025.
Methods: This study employed a meta-synthesis approach utilizing the seven-step framework by Sandelowski and Barroso (2006). A systematic search of major domestic and international databases using relevant keywords yielded 414 initial records. Following a rigorous screening process based on inclusion/exclusion criteria and quality appraisal, 25 articles were selected for the final analysis. Data were synthesized and categorized using thematic analysis.
Results: The findings revealed that the challenges facing the Iranian pre-hospital EMS can be categorized into six main themes: human resources, logistics and infrastructure, organizational and managerial barriers, socio-cultural issues, and educational deficits. A deeper analysis highlighted the multifaceted and intertwined nature of these obstacles. The results indicate that these challenges do not exist in isolation but are interconnected within a complex network of cause-and-effect relationships.
Conclusion: The findings confirm that the challenges within Iran's emergency system mirror global trends and overlap significantly with issues reported in other low- and middle-income countries (LMICs). Addressing these problems requires a holistic and systemic approach that simultaneously targets human, logistical, organizational, and socio-cultural dimensions, while ensuring system preparedness for potential accidents and disasters.
