Mohammad Mehdi Sepehri, Sara Naderi , Mansoureh Naderi ,
Volume 11, Issue 2 (7-2017)
Abstract
Background and Aim: Throughput improvement is a process that simultaneously increases the volume of services provided to patients, while decreasing the operating costs. The aim of the present study was to extract and prioritize the factors affecting throughput in an emergency department for heart disease patients.
Materials and Methods: This is a descriptive case study conducted through: interviews with experts, and the design of a questionnaire based on the emergency management criteria specified by the Ministry of Health and Medical Education (MOHME), and the completion of the questionnaire by academic experts in a teaching hospital in Tehran.
Six indicators and 26 sub-indicators were extracted and the data was analyzed using multi- criteria decision analysis methods including ANP and DEMATEL.
Results: Among the 26 sub-indicators, six sub-indicators were identified as the top priority ones with a 72 percent impact on throughput. And out of the six top indicators, cardiac emergency clinical guidelines were identified as the most important in maximizing throughput for patients with chest pain in the emergency department under study.
Conclusion: This study identified the priorities in enhancing throughput in an emergency cardiac unit. For the first time in Iran the study used a hybrid
ANP-DEMATEL method. This study can provide insights for health system planners and policy-makers on the enhancement of throughput in care delivery
organizations, especially teaching hospitals.
Hamed Basir Ghafouri, Mohammad Hosseini Kasnavieh, Marziye Alsadate Sharifi, Milad Amini, Amirreza Darzi Ramandi ,
Volume 11, Issue 3 (7-2017)
Abstract
Background and Aim: Hospitals should be able to satisfy their clients’ needs in less time and with best quality possible. Length of Stay (LOS) in hospitals is considered as a key performance indicator, especially in emergency departments. In this study, the analysis of LOS in emergency departments was performed so that some of the factors affecting patients’ length of stay could be found.
Materials and Methods: This descriptive-analytical and cross-sectional study was performed in the emergency departments of two teaching hospitals of Tehran University of Medical Sciences (TUMS). Seventy-two patient samples were included. The patients’ length of stay in emergency ward was measured from the entrance time until the time they left the emergency department. Data on both descriptive (mean and standard deviation) and analytical statistics (one-way ANOVA, independent sample t-test and linear regression) were analyzed with SPSS software.
Results: Patients’ average LOS in emergency departments was estimated at around 3 hours and 13 minutes (SD=1.52). Such variables as patients’ marital status, days of the week (holidays or regular days) and admission time (day or night) were determined as the factors affecting LOS.
Conclusion: The time spent to give services in hospital emergency rooms is at an appropriate level and items such as marital status, holidays of a week, and time of the day can be referred to as factors affecting patients’ length of stay. With regard to these findings, health managers can rely on the results for the effective planning and management of hospital emergency departments.
Mohammadreza Asghariyan, Farzad Firouzi Jahantigh,
Volume 18, Issue 4 (10-2024)
Abstract
Background and Aim: The emergency department of the hospital is considered one of its main entrances; which has provided health care and treatment for critical and non-critical patients and faces various health and treatment restrictions, but the main emphasis is always on resource limitations. Many simulation projects were implemented in hospitals and first in emergency departments with the aim of increasing productivity. The present research is a general description of the patient’s movement flow and length of stay in the emergency department of a selected specialized hospital in Zahedan city. The aim of the current research is to prevent care complications, reduce waiting time and patient stay in the emergency department, present a simulation model and improve it based on discrete-event simulation.
Materials and Methods: Using the data bank of the emergency department system based on the required data and also through the in-person observation of the data related to the duration of the patient’s stay in the emergency department, including the arrival time, waiting time, The type of services provided to the patient, the time of service and the time of departure were collected and checked and confirmed by experts related to this field so that it has the highest level of reliability with the facts. The data were designed in Excel software, and then data analysis and simulation model creation were done using Aren V14 software, and according to the results, the effect of the proposed solutions was evaluated.
Results: The findings of the present research showed that the longest queue created in the emergency department of the selected specialized hospital in Zahedan city is related to medical examination and additional tests. By implementing the simulation model and testing different solutions, solution 3, which means adding one nurse to nursing consultation and one person to radiology, has the most optimizing effect on the performance of the system at different levels of the patient admission process. and the cost of its implementation is more than solutions 1 and 2. This solution created a 14% decrease in the average length of stay and a 28% decrease in the average duration of additional tests.
Conclusion: The use of queuing models and simulation techniques improve the performance of the system and their implementation has significant effects on reducing the waiting time and length of stay of patients in the emergency department, increasing the quality level of the process of monitoring patients. It leads to optimal management of resources and increased productivity.
