[Conceptual model designing of clinical staff's information needs of emergency information system]

To optimize emergency services depends on appropriate management structures and efficient and effective information system design. This study aimed to investigate emergency department staffs information needs of emergency information system and to design a conceptual model of these needs. This descriptive study was performed among nurses and emergency medicine professionals working in emergency units of 9 hospitals affiliated to Tehran and Shahid Beheshti Universities of Medical Sciences. Data were collected by interviewing 25 staff members in the emergency department, model design by RUP method and UML language and questionnaire distribution among 315 staff members in the emergency department. Data collected were analyzed by descriptive statistics and SPSS. Most nurses and emergency medicine physicians believed that multiple data elements such as time of patient's first visit and procedure, the latest status of patient, medical procedure taken, and paraclinical procedure taken must exist in the emergency information system. Also 68.3% [108] of them agreed with the relationship between data elements required in the clinical practice process. It is concluded that the presence of identity, clinical, and paraclinical data in emergency information systems can produce an electronic medical record. According to these data, elements can improve the coordination between the hospital emergency and pre-hospital rescue teams, controlling of victim status, access to patient reports and quality of service to patients

[Study of patients'safety culture in Selected Training hospitals affiliated whith Tehran university of medical sciences]

Patients' safety is a critical component of health care quality. As health care organizations continually strive to improve, there is important growing recognize of establishing a culture of patients' safety. To establish a safety culture in a healthcare organization, the first step is measuring the current culture. The aim of the study was to measure physicians, nurses and Para clinical personnel perceptions in patient safety culture in Tehran's selected hospitals, and to compare findings with U.S. hospitals. Physicians, nurses, and Para clinical personnel who worked in training hospitals affiliated with Tehran university of medical sciences were asked to complete a self-administrated patients' safety culture survey [n = 145]. Data collection was carried by using the Persian version of HSOPS, developed by Agency for Healthcare Research and Quality [AHRQ]. Cronbach's alpha and chi-square tests were employed in statistical analyses. Among the dimensions of patients' safety culture with the highest percentage of positive responses the teamwork within units [67%] was higher, whereas that with the lowest percentage of positive responses was non-punitive response to error [51%]. Except to Handoffs and transitions dimension the entire dimension scores were lower than the benchmark scores. The study revealed that more than half of the participants were not reported the errors. Improving patients' safety culture should be a priority among hospital administrators. Meanwhile, Healthcare staff should be encouraged to report errors without fear of punishment action

[Study of payment methods to doctors in the referral system in selected countries and suggestions for Iranian social security organization- direct medical service provision]

Payment method is one of the most important control knobs in the health system. All organizations that mobilize funds for health sector must be decided: who should be paid? Why this money should be paid to them? And how much should be paid? So the main purpose of this study is to identify different methods of paying to the doctors in referral system of selected countries, and ultimately providing some suggestions for Iranian social security organizations- direct medical service provision. This was a comparative study designed in 2008. First we studied theoretical issues and analyzed them within the framework of the current situation. Then we conducted a comparative study to find some solutions for it. Then we validated selected suggestions using by Delphi technique. Most selected countries use a combination of methods to pay to the physicians. Usually for employed physicians in insurance organizations, salary makes a large part of doctor`s income. In countries where GPs play the role of gatekeeper, the per capita payment method has a special room. In American Health Maintenance Organizations [HMOs], based on employment or contractual relationship, they pay physicians by one of three "Per Capita", "Salary Monthly" or "Prepayment". In addition to Salaries [if any employment relationship], specialists usually receive some fees for their Services widely. Bonus payment in exchange for quality indicators is considered as a recently developed payment method for both GPs and specialists, but due to wide infrastructures, it needs accurate designing and plenty of arrangements

Understanding Interns' information needs in emergency departments

Objective: In teaching hospitals, the clinical encounter is an increasingly significant component of interns' curriculum and one of the clinical experiences of interns is emergency medicine. This research was conducted to provide new insights on interns' information needs in emergency departments.  Methods: This study examines the information needs of interns in the emergency departments of teaching hospitals in Iran University of Medical Sciences. Questionnaires and observations were used to collect data from seventy interns. Chi-square, two-tailed and bi-variation correlation tests were used to investigate the relationship among the data.    Results: It was observed that the most commonly asked questions related to patient specific information and fewer questions related to organizational questions such as hospital policies and procedures. The analysis revealed a statistically significant relationship (0.576, P