Electronic medical record implementation in the emergency department in a low-resource country: Lessons learned.

Objective: There is paucity of information regarding electronic medical record (EMR) implementation in emergency departments in countries outside the United States especially in low-resource settings. The objective of this study is to describe strategies for a successful implementation of an EMR in the emergency department and to examine the impact of this implementation on the department's operations and patient-related metrics.

Methods: We performed an observational retrospective study at the emergency department of a tertiary care center in Beirut, Lebanon.

Improving Emergency Department radiology transportation time: a successful implementation of lean methodology.

Background: Emergency Department overcrowding has become a global problem and a growing safety and quality concern. Radiology and laboratory turnaround time, ED boarding and increased ED visits are some of the factors that contribute to ED overcrowding. Lean methods have been used in the ED to address multiple flow challenges from improving door-to-doctor time to reducing length of stay.

Nurse-Led Competency Model for Emergency Physicians: A Qualitative Study.

Study Objective: To develop a competency model for emergency physicians from the perspective of nurses, juxtapose this model with the widely adopted Accreditation Council for Graduate Medical Education (ACGME) model, and identify competencies that might be unique to the nurses' perspective.

Methods: The study relied on secondary data originally collected as part of nurses' assessment of emergency physicians' nonclinical skills in the emergency department (ED) of an academic medical center in the Middle East. Participants were 36 registered nurses who had worked in the ED for at least 2 years and had worked for at least 2 shifts per month with the physician being evaluated.

Improving Emergency Department Door to Doctor Time and Process Reliability: A Successful Implementation of Lean Methodology.

The aim of this study is to determine the effectiveness of using lean management methods on improving emergency department door to doctor times at a tertiary care hospital.We performed a before and after study at an academic urban emergency department with 49,000 annual visits after implementing a series of lean driven interventions over a 20 month period. The primary outcome was mean door to doctor time and the secondary outcome was length of stay of both admitted and discharged patients.

Nurses' evaluation of physicians' non-clinical performance in emergency departments: advantages, disadvantages and lessons learned.

Background: Peer evaluation is increasingly used as a method to assess physicians' interpersonal and communication skills. We report on experience with soliciting registered nurses' feedback on physicians' non-clinical performance in the ED of a large academic medical center in Lebanon.

Methods: We utilized a secondary analysis of a de-identified database of ED nurses' assessment of physicians' non-clinical performance coupled with an evaluation of interventions carried out as a result of this evaluation.

Acute allergic reactions in the emergency department: characteristics and management practices.

Objective: The objective of this study is to determine the incidence of emergency department (ED) visits for acute allergic reactions, identify the triggers, assess the severity, evaluate the management practices, and examine patient outcomes at a single-center ED in Lebanon.

Patients And Methods: A retrospective review of all patient charts presenting with a final diagnosis of acute allergic reaction to a single ED within a 6-month period (July-December 2009) was carried out. Age, sex, triggers, management in the ED and at discharge, disposition, and return visit were determined.

The discrepancy rate between preliminary and official reports of emergency radiology studies: a performance indicator and quality improvement method.

Background: At teaching hospitals, radiology residents give preliminary reports for imaging studies requested from the Emergency Department (ED). Discrepancy rates between preliminary and final reports represent an important performance indicator.

Purpose: To present a system for feedback and follow-up of discrepancies, identify the variables associated with the rate and severity of such discrepancies, target the weaknesses, and suggest the need of a standard reference value for comparison among institutions.

Integrating quality and patient safety concepts in medical curricula. Baseline assessment in Lebanon.

Purpose: Hospital accreditation places emphasis on the role of health professionals in quality of patient care. Training physicians in quality and patient safety influences quality improvement efforts in healthcare. Little is known about the attitudes and knowledge of medical students towards the concepts of quality of care, patient safety and accreditation.