ABSTRACT
Introduction: In Emergency Departments [ED], seconds and minutes are vital for the patients. Therefore, a logical decision making is crucial to manage the patients' waiting time. Simulation, a decision supporting technique, is used to analyze risk factors and strategies in decision making. The purpose of this research was to apply this method to reduce patients' waiting time in the ED at Ayatollah-Kashani Hospital
Methods: The population of this applied- analytical study included the patients referred to the ED at Ayatollah-Kashani Hospital in Isfahan during May 2008. Having recognized the patients' workflow, the researchers gathered the required data concerning the time of patients' arrival and service delivery at various stations for 663 patients during 2 weeks. The data were used to design a simulation model for the ED using simul8 software. The validity of the model was verified through comparing the results obtained from the manual system with those from the simulation model which led to the formation of the finalized model
Results: The results showed an increase in the waiting time when implementing alternatives 2, 9, 10 and 12 while a decrease was observed in other alternatives. In alternatives 6 and 13-17, the total waiting time decreased more than the other alternatives. The most amount of reduction was observed in alternative 15, so much so that the waiting time of receiving emergency services reduced from 112.19 to 99.24 minutes. This could be due to the placement of an intern student at Eye- Nose-Throat [ENT], Neurology, and Orthopedic stations which caused reduction in the waiting time from 38.89, 13.31 and 12.13 to 26.54, 6.58 and 5.98 minutes, respectively
Conclusion: Since health care managers, especially in the ED, are mostly physicians not experienced enough in statistical analysis, it is essential to provide them instruments with which they can readily achieve scientific approaches to reduce costs and patients' waiting time. Applying various research methods such as simulation can satisfy these goals
ABSTRACT
Background: Despite occurrences of several earthquakes in Iran, there aren't no document data from clinical and demographic findings of patients. The aim of this study was to analyze the demographic and clinical findings of pediatric trauma patients referred to Tehran University of Medical Sciences Hospitals after Bain earthquake in 2003
Methods: Medical records of all of pediatric trauma patients with age lower than 18 year old who were admitted in Imam Khomini, Shariati and Sina hospitals were reviewed retrospectively
Results: From 440 total number of patients, 25.4% [51 boys and 61 girls] were pediatrics. Eighty-two percent patients were transported to our hospitals within the first 3 days after earthquake. The limbs were the most common organs injured [61.6% alone and 14.3% together with other organs]. Of these patients, 34.5% had operative surgery and there were no tetanus n our subjects. Thirty percent patients suffered from infectious disease and the most common infectious disease was urinary tract infection. Acute renal failure developed only in 5 patients
Conclusion: The good management of our patients caused low rate of acute renal failure and any clinical findings of tetanus. The high rate of limbs injuries need appropriate management in future