Abstract
Aim. The purpose of this study was to investigate the key performance indicators in the emergency department.
Background. Health care organizations are confronted with various phenomena such as the rapid promotion of technology, changing demographic factors and changing lifestyles. On the other hand, the health care system has become one of the largest and most expensive industries in the world. These factors have led hospital management to require fundamental changes, including for organizations to measure performance to achieve organizational goals. Evaluation and monitoring of emergency department performance is one of the most important processes in health centers.
Methods. In this review study, the articles were searched out using the keywords “key performance indicators” and “emergency department” and their Persian equivalent in Jahad Daneshgahi Database, Iran Scientific Research Institute, Database of Iranian Journals, Springer, Medline, PubMed, and Google Scholar. Forty eight articles were found. These articles were reviewed and refined step by step and finally, 16 related articles were selected. Then, selected sources were included in the data collection form according to the purpose of the study and narrative analysis was performed.
Findings. Based on the results of this study, the articles have addressed three aspects of the importance of performance appraisal in the emergency department, key performance indicators and their types (input indicators, process indicators, outcome indicators) that are explained in detail.
Conclusion. Managers and decision makers are always faced with the problem of choosing the best index from a diverse set of indicators, and often because of data aggregation, not all of them can be used. For this reason, managers and employees have a negative view of performance evaluation systems, and it is necessary to identify a limited number of key indicators that can meet an organization's management goals.

Abstract
Aim. This study aimed at investigating the obstacles to the implementation of evidence-based care from the perspective of the staff nurses in Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
Background. Evidence-based care plays a crucial role in enhancing the nursing care quality due to the up-to-date care measures and procedures, and the cost-effectiveness for patients. However, there are some obstacle to implement it that should be addressed.
Method. This is a descriptive cross-sectional study conducted on 215 nurses from different departments of Rajaie Cardiovascular Medical and Research Center, Tehran, Iran. They were selected using simple random sampling method. The data collection tool was a questionnaire measuring the obstacles to the implementation of evidence-based care. The collected data were analyzed using descriptive and inferential statistics in SPSS version 20.
Findings. According to the nursing staff, the obstacles to the implementation of evidence-based care in the management dimension were the insufficient number of staff (80 percent), the large number of patients (71 percent), and the lack of motivation in the staff (68 percent) and in the individual-care dimension the obstacles were the lack of enough time for nurses to study the conducted research (72 percent).
Conclusion. The obstacles to the implementation of evidence-based care are in both individual and managerial areas, so it is suggested to correct arrangement of human resources, holding training workshops and meetings, creating interaction with the centers implementing evidence-based care, and using their life experiences considering the available facilities.