Features and results of conducted studies using a lean management approach in Emergency Department in hospital: a systematic review

Objective: To perform a systematic review of the properties and results of the studies that their approaches are lean management in emergency departments and the factors which influence on their performance

Method: The necessary information in the first stage was collected by searching these keywords: "Lean principles" "Lean Six Sigma", "Lean Process", "Lean thinking", "Lean Methodology", "Toyota Production System lean processing", "lean techniques", "emergency department", "emergency medicine", "emergency room" and "emergency care". And in the next stage the keywords such as "lean management" and "emergency" was collected from SID, Medlib, IranDoc, Google Scholar, MagIran, IranMedex data bases. For extracting the data data-extracting forms was prepared. The information we got from the forms was organized in information-extracting forms and was analyzed manually. The diagrams were drawn in Excel: 2010

Results: Finally, 26 essays have been included. Most of the studies were accomplished in Canada and U.S.A. only in one of the cases, the authors used the control group. Each of these terms, "lean techniques" and "lean principals", with five times repetitions had the highest frequency. The most important team of implementation of lean management included: hospital management team or the manager of Emergency department, physicians, nurses, staffs and external counselors. Generally, 51 indicators were studied which among them the length of stay and the timing had the most frequency. After implementation of lean management, almost all studied indicators have significantly improved. 14 barriers, 14 facilitators and 10 effective factors were recognized in implementing the lean management

Conclusion: According to the studies, responsibility of organization's senior management and his/her supports; increasing the knowledge of the characteristics and dimension of lean among the providers of health service; and decreasing the resistance and consulting with external counselors can have great effect on the success of lean management

Communicable diseases management in disasters: an analysis of improvement measures since 2005, Islamic Republic of Iran

Background: due to the importance of managing communicable diseases in disaster situations, the Centre for Communicable Diseases Management [CCDM] within the Iranian Ministry of Health and Medical Education has taken measures to improve routine communicable diseases management systems in normal and emergency situations

Aims: this study aimed to explore the improvement measures since 2005

Methods: a qualitative document analysis method was used to analyse all documents related to communicable diseases management from March 2003 to the end of 2014 in the CCDM and on official websites of related organizations

Results: seventy-two documents addressing communicable diseases management in disasters were included in the final analysis. The findings were summarized in 4 phases of the disaster management cycle corresponding to 5 core and support functions of the surveillance system

Conclusions: the findings highlighted improvements in communicable diseases management in disasters, including interorganizational collaboration, information flow and use of new technologies such as web-based or mobile phone-based systems

Disaster Health Literacy of Middle-aged Women

As disasters have been increasing in recent years, disaster health literacy is gaining more important for a population such as middle-age women. This is because they face developmental crises (menopause) and situational crisis (disaster). Due to the growing elderly population, it is imperative to seriously consider the issue of aging women's healthcare, and their educational needs relative to emergencies and disasters. The purpose of study was to clarify the importance of disaster health literacy for middle-age women. This study is a review of the literature using PubMed, ScienceDirect, Web of Science, Google Scholar, SCOPUS, OVID, ProQuest, Springer, and Wiley. Data was collected with keywords related to the research topic (“Women's health” OR “Geriatric health”) AND (“Health literacy” OR “Disaster health literacy” OR “Disaster prevention literacy” OR “Risk knowledge” OR “Knowledge management”) AND (“Disasters” OR “Risk” OR “Crises”) in combination with the Boolean-operators OR and AND. We reviewed full text English-language articles published November 2011 November 2017. Additional references were identified from reference lists in targeted publications, review articles and books. This review demonstrated that disaster health literacy is critical for elderly women, because they may suffer from physical and psychological problems triggered by developmental crises such as menopause and situational crises such as disasters. Disaster literacy could enable them to improve resiliency and reduce disaster risk. Education has vital role in health promotion of middle-age women. Policymakers and health managers should be aware of the challenges of elderly women as a vulnerable group in disasters and develop plans to incorporate disaster health literacy for preparedness and prevention in educating this group.

Risk assessment of drug management process in women surgery department of qaem educational hospital [QEH] using HFMEA method [2013]

Evaluation and improvement of drug management process are essential for patient safety. The present study was performed whit the aim of assessing risk of drug management process in Women Surgery Department of QEH using HFMEA method in 2013. A mixed method was used to analyze failure modes and their effects with HFMEA. To classify failure modes; nursing errors in clinical management model, for classifying factors affecting error; approved model by the UK National Health System, and for determining solutions for improvement; Theory of Inventive Problem Solving, were used. 48 failure modes were identified for 14 sub-process of five steps drug management process. The frequency of failure modes were as follow: 35.3% in supplying step, 20.75% in prescription step, 10.4% in preparing step, 22.9% in distribution step and 10.35% in follow up and monitoring step. Seventeen failure modes [35.14%] were considered as non-acceptable risk [hazard score = 8] and were transferred to decision tree. Among 51 Influencing factors, the most common reasons for error were related to environmental factors [21.5%], and the less common reasons for error were related to patient factors [4.3%]. HFMEA is a useful tool to evaluating, prioritization and analyzing failure modes in drug management process. Revision drug management process based focus-PDCA, assessing adverse drug reactions [ADR], USE patient identification bracelet, holding periodical pharmaceutical conferences to improve personnel knowledge, patient contribution in drug therapy; are performance solutions which were placed in work order

Imbalance between goals and organizational structure in primary health care in Iran - a systematic review

In recent years, the main focus of health sector reforms in Iran is the family physician and referral system plan. Fundamental changes in the goals and strategies, has increased the necessity of the need to reform the organizational structure. This study tries to review and summarize all cases about the organizational structure of Iran and its challenges in primary health care system. This study was a systematic review of published and grey literature. We searched the relevant databases, bibliography of related papers, and laws, using appropriate search strategies and key words. The CASP tool was used by two experts to evaluate the quality of retrieved papers and inconsistencies were resolved by discussion. After removal of duplicate citations, a total of 52 titles were identified through database searching, among which 30 met the inclusion criteria. Considering the research quality criteria, 14 papers were recognized qualified, which were categorized into two groups of: articles and policies. The results showed ineffectiveness of the current organizational structure at different level. The majority of the papers recommend performing reforms in the system because of changes in goals and strategies. Also, some suggest an appropriate information system to be designed in the current structures. Centralization and delegation process are the main discussions for the studies. Because of fundamental changes in goals and strategies, reforms in the organizational structure of primary health system in Iran especially in peripheral levels are highly recommended

Provincial human development index, a guide for efficiency level analysis: the case of Iran

Human Development Index [HDI] is a composite indicator that can show the impact of economic strategies on human life standards. The index is calculated by three main factors of income, education and health. This research studies the status of HDI across the Iranian provinces, its changes over time and the efficiency of provinces in using resources. The data for 2001 and 2009 was obtained from the Iranian Center of Statistics. Data envelopment analysis technique was used to analyze the data. To calculate the efficiency, Banker, Charnes and Cooper's model was used. The national mean for the HDI in 2001 was 0.717 while it grew to 0.747 in 2009. Except for one province, all others had an improved human development index. Low ranked provinces such as Sistan and Baluchistan and Kurdistan stayed at the bottom in 2009 as well. Some provinces such as Bushehr with developing oil industries, or those purposively benefited from national oil income showed good growth. In some provinces, such as Hormozgan, out-migration of manpower to its neighboring province, Bushehr, was associated with decrease of the provincial income level. The number of efficient provinces increased from 5 to 13 in 2009. Iran falls among countries with high human development index based on the 2009 data. However, the distribution of HDI status across provinces was highly varied and the difference between high- and low-developed provinces increased in 2009. The government needs to revise policies concerning distribution of resources among the provinces

[ effectiveness of contact thermography in the diagnosis]

Making decisions on buying and using different diagnostic and therapeutic equipments, require collection and analysis of appropriate information and performing a comprehensive systematic studies considering the safety, effectiveness and cost effectiveness of the technologies. The current study was designed to evaluate the effectiveness of contact thermography technique in the diagnosis of different diseases. This study was conducted as a systematic review. All of the relevant databases, bibliography of related papers, and companies' websites were searched using appropriate search strategies and keywords. To evaluate the quality of selected papers, CASP tool was applied by two experts and their choices were discussed to reach the final decision. In this study, 308 papers were recovered in total using different databases and search techniques. Considering the research selection criteria, 14 papers were recognized as suitable and categorized into three groups of: papers related to the breast cancer, DVT and others. The results show although contact thermography is a safe, rapid and cheap technique to be used in screening and diagnosis of different diseases, current studies do not show any acceptable diagnostic value compared to other diagnostic techniques. It is recommended to use the contact thermography as a complementary technique. More research is proposed to be performed in this area