workflow

The implementation of health information systems in hospitals not only ensures more accurate record-keeping but also improves workflow. The aim of this study was to examine the workflow in the surgical department of Khatam Al-Anbiya Hospital in Behshahr, Iran and to provide health information technology-based solutions for improving health care process.

This cross sectional study was conducted in 2022. The study included the following steps: mapping the workflow of surgical patients, time measurement and work measurement of processes, identifying existing infrastructure related to the processes, recognizing current issues, and proposing technology-based solutions. Data were collected using observation, interviews, and the Delphi method. Throughout different stages of the research, the participation of all stakeholders, including managers, staff, and patients, was secured. Additionally, a stopwatch was used for time measurement, and a data recording sheet was employed for work measurement. For quantitative data analysis, SPSS software and descriptive indices were utilized.

The existing problems in the workflow of the department included: "crowding of patients both in-person and via phone at the appointment scheduling section of the hospital," "delays in file formation," "retrieval of patient files," "confusion and delays in obtaining consent," "delays in providing paraclinical results," and "billing issues." To address these problems, IT-based interventions such as electronic scheduling, intelligent customer management systems, queue management, interactive voice response systems, and electronic health records were among the most significant recommendations provided.

Planning for the enhancement of infrastructure based on health information technology and creating a framework for improving workflow in the surgical processes of the hospital, according to the current working environment, is necessary and should be prioritized by hospital management.

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.

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.

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.

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.

The emergence of electronic prescriptions has transformed the methods of prescribing and distributing medications in pharmacies. The aim of this study is to explain the factors affecting workflow, patient communication, and medication safety within the electronic prescription system from the perspectives of pharmacists and pharmacy technicians.

This research is a descriptive and cross-sectional study conducted in 2023 in selected pharmacies in the city of Urmia. It was carried out in two stages. In the first stage, relevant studies were systematically reviewed and selected based on entry criteria to identify the influencing factors. In the second stage, the two-stage Delphi method was used with purposive and snowball sampling to finalize the identified factors.

The results of this study consisted of two stages. In the first stage, the factors affecting workflow, patient communication, and medication safety in pharmacies within the electronic prescription system were identified. In the second stage, the validity of the factors identified in the first stage was determined using a two-stage Delphi method. After two rounds of Delphi, 11 items related to workflow variables, 6 items for patient communication, and 11 items for medication safety were confirmed.

This study has identified the factors that can be utilized by health policymakers and developers of electronic prescription systems to improve efficiency and serve as a framework for formulating both long-term and short-term plans.

One of the most effective ways to improve the management of asthma in primary care is using guidelines in the patient management process; but due to lack of time, their use is very limited. One way to solve this problem is mechanized guideline in a form of decision-support system that requires computer-interpreted guideline (CIG). In this study, a CIG was developed for asthma management in primary care.

This qualitative study was performed using mini-Delphi method uses a workflow-based approach to develop a CIG. The workflows and data components were extracted through Business Process Model and Notation (BPMN) language and Enterprise Architecture (EA) software. Afterwards, they were confirmed through an expert panel of five asthma specialists.

The developed CIG included three major workflows, four sub-workflows, and 21 data components. Main workflows included treatment, drug interaction, and follow-up time. Sub-workflows were related to treatment workflow that were developed based on the patient visit number and age.

Because the accuracy of this workflow was confirmed by asthma specialists, it is expected that the design of this CIG will lead to development of a cost-effective software for the management of asthma and better detection of drug interactions.

In recent years, the dentistry workflow has developed considerably. By the introduction of computers and their various applications, the effectiveness and efficiency of treatment has increased enormously. Considering engineering concepts in the workflow, it is necessary for participants to assess different steps and data transferring between various software and hardware devices. This research investigated the interaction between dentists, laboratories and production centers through the required steps for accomplishing treatment by different applications of software and digital hardware devices.
Review in this article was based on searching Google scholar database considering key words: digital dentistry, workflow, computer aided design and manufacturing, dental CAD/CAM. This search was limited to the English articles published after the year 2000.
It is necessary in dentistry to use digital technologies to improve the efficiency of treatments. Thus, the participants in this field must have appropriate knowledge to choose and apply these tools. Moreover, the participant should help providers of digital solutions for better development of software packages and related hardwares.a

Emergency department (ED) is one of the most important wards in a hospital and its function can deeply affect the function of other wards and patient satisfaction. Therefore, the speed of providing services in ED is of great importance in order to decrease mortality and disabilities. Thus, the present study was done with the aim of evaluating timing of services in 2 teaching hospitals in Arak.
In this crosssectional study, researchers were present in the hospitals for 3 months in various working shifts and recorded the time of the patients’ presentation to triage unit. They also recorded the times of physician’s visit, sending samples to laboratory and receiving their results, radiography performance, and decision making in a checklist using a chronometer.
In the present study, 200 patients with the mean age of 45.8 ± 2.5 years participated (53.5% male). The findings of the study showed that mean time interval between triage and physician’s visit was 8.1 ± 4.3 minutes, time between visit and the first treatment measure was 8.7 ± 2.3 minutes, time between ordering a test and receiving results was 60.9 ± 17.5 minutes, time between ordering radiography and getting the results was 55.4 ± 18.1 minutes, time between ordering electrocardiography and getting the results was 5.4 ± 2.3 minutes and the patient’s length of stay in ED was 6.9 ± 3.3 hours.
It seems that although the timing of providing the studied services is less than similar studies in some cases, it is still far from the international standards.

Emergency department has the responsibility to provide healthcare services for the patients day and night all through the year. The present study aimed to investigate the patients’ waiting time in the emergency department of an educational hospital in Shiraz.
This cross-sectional study was conducted in an educational hospital in Shiraz in 2011. For timing the workflow in the hospital emergency department, a 180-patient sample size was selected for the study. Besides, emergency workflow form was used for data collection. The validity of this form was confirmed through several expert meetings. After all, the data were entered into the SPSS statistical software and analyzed using descriptive statistics and T-test.
The findings showed that the mean interval between patient arrival and the first doctor visit was 4.73±5 minutes. Besides, the mean interval between patient arrival and triage and referral to internal, surgical, and gynecology emergency departments or discharge was 48.13±55 minutes. Also, the mean interval between referral to internal and surgical emergency departments and the first visit by a specialist was 10.45±9 and 39.10±20 minutes, respectively and the difference was statistically significant (P=0.002). Considering the diagnostic procedures, the mean interval between referral and receiving the laboratory test results, radiology results, and ECG was 104.91±33, 24.50±11, and 11.83±4 minutes, respectively.
The results indicated that the waiting time was long in the emergency department of the study hospital. Thus, employing expert residents in each department, expansion of the space and facilities of the emergency department, and modification of service delivery processes are essential.