Showing 14 results for Akbari Sari
A Akbari Sari, L Doshmangir,
Volume 8, Issue 2 (23 2009)
Abstract
Background: A variety of methods are available for identifying and measuring adverse events and medical errors in healthcare. The aim of this study is to review these methods with their strengths and weaknesses.
Methods: Electronic databases including Medline, Embase, Google Scholar and Iran Medex were searched to identify and summaries relevant studies.
Results: Different methods have been used to identify adverse events and their nature, causes and consequences. Record review seems to be the most common and the best method for measuring the rate and consequences of adverse events. However, this method is relatively expensive and time consuming and still underestimates the rate of adverse events. It is also not suitable for identifying the underlying causes of adverse events. The other method commonly used is reporting system including critical incident reporting system. This method is relatively cheap and more suitable for exploring the underlying causes of adverse events, but it is not suitable for identifying the rate of adverse events as it may underestimate many adverse events. Other methods include critical incident technique, interview, questionnaire, direct observation and review of claims and none of them are suitable for identifying the rate of adverse events but they might be useful for other purposes including assessment of the causes of adverse events.
Conclusion: Several methods can be used for study of adverse events. No single method can serve all purposes. Each method has some strengths and weaknesses. Using a combination of methods is more suitable, but this approach is more expensive and time consuming. Which combination of methods are more appropriate, depends on several factors including the aim of the study and resources available.
M Mokhtari Payam, A Akbari Sari, Mr Aye, M Mobinizadeh, S Manavi,
Volume 9, Issue 1 (9 2010)
Abstract
Background: The aim of this study is to explore the safety and diagnostic performance of dual-source CT scan in comparison with single source CT scan and conventional angiography in patients with coronary heart diseases.
Materials and methods: A systematic review was performed using CRD standard methods. The Cochrane Library, MEDLINE, EMBASE، Google Scholar and TRIP were searched up to April 2009. The references of the marked studies and gray literature were also searched.
Results: 17 articles were included. 9 articles reported the safety and 12 articles reported the diagnostic performance of DSCT. Generally DSCT was a non-invasive and safe procedure. Using DSCT the exposure of patient to X-ray was less than 64-slice single source CT (SSCT) and more than conventional angiography. For the DSCT the mean sensitivity was 90.4%, mean specificity was 82%, mean PPV was 83% and mean NPV was 96%. For the SSCT the mean sensitivity was 90.4%, mean specificity was 82%, mean PPV was 83% and mean NPV was 96%. The mean sensitivity, specificity, PPV and NPV of DSCT were slightly higher than SSCT.
Conclusion: DSCT is a noninvasive and relatively safe technology. The diagnostic performance of DSCT is higher than SSCT, but its performance is not so much high to be able to substitute the conventional invasive angiography which is still the gold standard test.
Movahed Kor E, Arab M., Akbari Sari A, Hosseini M,
Volume 11, Issue 1 (20 2012)
Abstract
Background: Focusing on making opportunities to participate of patients in all levels of health care system is important in order to develop of system capability that could make improving of patients’ safety and quality of care services. The aim of this study was to determine inpatient perceptions in general hospitals of Tehran medical university regarding patient participate in treatment decisions and safety.
Material and methods: This was a cross-sectional study in 1390. First, the list of eight general hospitals affiliated to Tehran University of medical sciences and all clinical wards were obtained through the university website. Then, stratified random sampling method applied to collect 300 patients as a sample size. Data were collected by using a structured questionnaire that validity and reliability were accepted. Descriptive statistical methods, linear regression and multivariate logistic regression were applied to analyze.
Results: From total of 300 patients, 60% of them were female. The level of participating by patients in cure decision making were at high level (59.7%) and 27% in low level. The range of patients’ safety was at high (60%) and low (26%). The level of participate in decision making of cure process had high rate among young people and employed participants. The patients who were unmarried, educated, and employed had lower score in patients’ safety. The participants’ perception had no effect on the patients’ safety perceptions.
Conclusion: The symptoms that might be interpreted as an abnormal could be interpreted in different ways by the others. These unusual results could come from dissimilarities in demographic features
J Moghri, A Ghanbarnezhad, M Moghri, A Rahimi Forooshani , A Akbari Sari, M Arab,
Volume 11, Issue 2 (22 2012)
Abstract
Background: Patient safety is one of the most important components of health care quality. Given that assessing the current culture of patient safety is the first step in improving patient safety, we decided to translate and validate one of the most used patient safety culture assessment tool (HSOPS questionnaire) for the first time in Iran, and in this way take a step toward improving patient safety in our hospitals.
Materials & Methods: This cross sectional study was done among four general hospitals of Tehran University of Medical Sciences (TUMS), which were selected purposefully. Questionnaires randomly distributed among 420 members of the study population, and were collected after completion. Results were analyzed using Confirmatory Factor Analysis (CFA), internal Consistency and correlation.
Results: The value of Fitness function (FF) was 14.25 and according to that, the value of Goodness of Fit Index (GFI) was 0.96. Almost in all of the dimensions, the internal consistency of items in the translated Persian questionnaire was lower than the original one and ranged between 0.57 to 0.8.
Conclusion: Regarding to the findings of this study the Persian translation of the HSOPS questionnaire is a valid tool for the assessment of patient safety culture in Iran's hospitals.
M Mohegh, A Pourreza, A Rahimi, A Akbari Sari, M Nekouymoghadam,
Volume 11, Issue 3 (20 2012)
Abstract
Background: People give you an idea about variety of behaviors when confronting diseases. Different factors such as age, sex, economic and social situations have effect on its. Recognition of these behaviors helps politicians to deliver better services. This study aimed to identify health seeking behaviors of Zoroastrian residing in Yazd province due to advanced number of them in comparison to the other provinces.
Materials & Methods: This study is a cross sectional. The sample size was 196 cases which selected by using simple sampling method. The data was collected via the questionnaire, then data were analyzed by spss.11 software with two test of chi square and exact test of Fisher.
Results: The findings showed that 64.3% of the population was female whereas remaining 35.7% were male. 15.58% of participants were single, 76.5% married and the rest of them (7.7%) were widow. Data indicated that 4.1% of individuals were illiterate, 17.3% were high school , 51.3% had diploma, 23.5% had Bachelors degree and 3.6% had Masters Degree or Ph.D. 43.4% of studied population were unemployed and the rest of them (46.7%) were employed. 94.4% of participants had health insurance whereas 5.6% did not had uninsured card. The results showed that the following direct variables had relation with the following mentioned indirect variables sex with the action during the period of being sick, Place of born with reasons of neglecting sickness, marital status with action during the period of being sick, educational status with action during the period of being sick and referring to practitioner in different stages if sickness and using consultation of different groups, occupational status with the first place to get medical treatment, economical status with reasons of neglecting sickness and completion of treatment period and having health insurance with action during the period of being sick and using consultation of different groups.
Conclusion: Considering the fact that educational, occupational and economic status have relation with health seeking behaviors in individuals, developed in education and occupation status could be lead a chance to choose a better health behavior in people.
M Arab, H Ghiasvand, Ra Darroudi, A Akbari Sari, M Hamidi, J Moghri,
Volume 11, Issue 3 (20 2012)
Abstract
Background: Regarding to the escalating costs of health care and limited resources in this field, the appropriate identification and control of costs is inevitable. This Study aimed to determine the unit cost of radiology services, in selected hospitals of TUMS.
Materials & Methods: This was a descriptive retrospective study. At first, we selected two hospitals (Shariati and Sina) out of general - teaching hospitals of TUMS randomly. After gathering data, using activity based costing method, the unit costs of radiography services in these centers in 1389 fiscal year (2010-2011) were calculated.
Results: The unit costs of radiography services in Shariati and Sina hospitals were 251255,5 and 334996,2 respectively. Building rent and human resources costs included the most share of total costs.
Conclusion: The unit cost of radiography services in this study is very different comparing with other studies. Calculated building rent costs in this study could be one of the possible reasons of this difference (other studies did not consider this costs). The other point is that, regarding the high share of human resources and building costs from total costs, special attention to these sources of costs and appropriate and adequate use of them, can be an important step toward improving the efficiency and cost savings in our national health system.
L Vali, A Pourreza, B Ahmadi, A Akbari Sari,
Volume 11, Issue 4 (17 2013)
Abstract
Background: aging is a very sensitive period of life and paying attention to the problems and requirements of this period seems to be a social necessity. Improving medication for old patients is challenging and sometimes medication`s benefits are less than its disadvantages for the patient.Because of the numerous evidences of problems caused by medication in the elderly in the recent decade, many specialists and physicians have introduced tools and techniques for identifying these problems which are caused by medication and prescription of risky medicines.
Materials and Methods: Several methods, tools and criteria for assessment of quality of medication and medicine prescription in elderly have emerged since 1990.. We found out two categories of criteria reviewing the literature which are generally named as distinct criteria (criterion based) and implicit criteria (judgement based).
Result:The distinct category including Beers, Zhan, McLeod, Laroch and STOP/START criteria are all developed by a panel of experts and consensus in several stages. The second category of criteria concentrates on evaluation of clinical information.
Conclusion: All the tools and methods described in this study are used in Europe and in the USA which have limited market similarities with our country thereforedevelopment of tools for assessing prescription quality for the elderly in Iran is absolutely necessary.
M Soofi , A Rashidian , F Aabolhasani , A Akbari Sari, M Bazyar ,
Volume 12, Issue 2 (9-2013)
Abstract
Background: Achieving equitable financial contribution and removing the risk of households' exposure to catastrophic expenditures are the most important challenges for health systems all over the world. This study aimes to measure Iranian households' exposure to catastrophic health care expenditures and surveying the factors affecting this expenditure, based on the World Health Organization and the World Bank approach.
Materials & Methods: Sectional data of the World Health Survey in Iran in 2001 has been analyzed. This survey covered 10300 urban and rural households across the country. The catastrophic expenditure has been calculated based on the ability to pay in the thresholds of 40, 50, and 60 percent and the income at the threshold of 20 percent. Logistic regression model was used to examine factors influencing catastrophic health expenditures.
Results: The proportion of families confronting catastrophic health expenditures was estimated at 9-15 per cent. Facing catastrophic expenditures showed a statistically significant relationship with variables such as having a family member suffering from a chronic disease, family`s financial condition, and living in rural areas regardless of the thresholds used. The insurance coverage showed a statistically significant relationship with exposure of catastrophic health expenditure just in case it was measured using the 40% threshold.
Conclusion: Political interventions and policies of the government such as implementing fee exemptions for certain target groups, designing benefits packages, extending population coverage through prepayment mechanisms and protecting the poor and disadvantaged groups can protect households from experiencing catastrophic health expenditures.
M Arab , M Shafiee , M Iree , H Safari , F Habibi , A Akbari Sari , R Khabiri ,
Volume 12, Issue 3 (12-2013)
Abstract
Abstract
Background: Family physician plan is a form of health care delivery system which its correct implementation results in health promotion. Being aware of family physicians’ viewpoints towards their occupation would play an important role in its better implementation. The present study aims to to investigate family physicians` attitude who are working in health centers affiliated with Tehran University of Medical Sciences towards their profession.
Materials and Methods: This qualitative study was conducted in 2011. In order to reach information saturation , the data were collected by performing two singular interviews and four focus group discussions among all 33 physicians working at health care centers of Tehran University of Medical Sciences. Eventually, data were analyzed using conceptual framework method.
Results: Data analysis indicated three general concepts. The first issue is the factors that encourage physicians to choose family physician profession and continue doing it (including economical, cultural and environmental factors and work conditions). The second one is the study challenges (including preparation to implement the plan, work conditions and professional limits) and the final one is the reforms needed for its correct and proper implementation ( in policy making and administrative level).
Conclusion: Regarding the issue that economical, cultural and environmental factors and work atmosphere have the main role in motivating family physicians, the most important challenges the plan confronts are also related to these factors and major and minor reforms are needed to overcome these challenges. Moreover preparing society’s culture would surely result in better implementation of the plan.
M Keshavarz, A Akbari Sari, A Rahimi Foroshani, M Arab,
Volume 13, Issue 1 (6-2014)
Abstract
Abstract
Background: Accreditation is a program that is designed for evaluation of health care organizations and measured processes and structures according to predetermined standards. The purpose of this study is to survey the safety situation and quality of care in selected hospitals of Tehran University of medical sciences based on the Joint Commission International (JCI) standards and determination of their strengths and weaknesses.
Materials and Method: This descriptive, analytical and cross-sectional study was carried out in 5 hospitals. Translated Joint Commission International (JCI) questionnaire checklist with 14 standards was used as the study tool. Data entry and statistical analysis were performed using the SPSS.13 and K Independent Samples tests were used to compare hospitals.
Results: Highest quality and safety of care score belonged to the hospital B (84%) and then to hospitals C (83%), A (72.75%), E (72%) and D (70.5%). Central indices like patient and family rights, quality improvement and patient safety, infection prevention and control standards in the studied hospitals are completely different according to the statistical results.
Conclusion: Study results show that the status of hospitals in terms of safety and quality of care are almost appropriate but in some cases there is a large distance between JCI standards and their current status and the studied hospitals have to make appropriate and related policies in order to plan and implement proper programs to improve their situation in quality and safety of care.
M Arab , M Sharifi , M Mahmoudi , B Khosravi , R Hojabri , A Akbari Sari , B Ahmadi , F Eftekhar,
Volume 13, Issue 2 (8-2014)
Abstract
Background:In recent years, clinical governance introduced as amodel to determine continuous quality improvement principals in health services. This study considers assessing the readiness of selected hospitals clinical governance programsimplementation by using CGCQ instrument.
Material and Methods: The survey was conducted in 14 private and public Hospitals in order to assess hospitals’ readiness to clinical governance programs implementation in Tehrancity. In this regards, 800 health professionals including physicians and nurses were inquired. Collected data analyzed by SPSS17 using correlation coefficient, mean comparison and descriptive tests.
Results:Based on study results, both private and public hospitals had readiness to implement clinical governance program. Results of field survey revealed mean score of organizational climate of clinical governance (3.14) is higher than average score (2.5) in selected Hospitals.
Conclusion: This survey demonstrated the necessary readiness to implement clinical governance programs is in an acceptable rangein assessed hospitals. Moreover, there is a big effort to use a unique and comprehensive strategy with the intention ofcontinuous quality improvement in health services.
Dr Mohammad Arab, Farhad Habibi Nodeh, Dr Abbas Rahimi Foroushani, Dr Ali Akbari Sari,
Volume 13, Issue 4 (3-2015)
Abstract
Background: Hospital waste need a very sensitive and cautious attention due to holding hazardous, toxic, and pathogenic factors such as infectious, pharmaceutical, pathological, chemical and radioactive left-overs. Thus, this study aimed to evaluate the observance of safety measures by workers responsible for collecting hospital wastes in the public hospitals affiliated to Tehran University of medical sciences.
Methods and Materials: This cross-sectional and descriptive-analytic study was conducted in 1391. Data were collected through using a questionnaire. According to the frequency distribution, total score for participants was divided into three weak (<26), average (26-30), and high (>30) categories. Data were analyzed by the SPSS 18 software using T-Test, one-way ANOVA and regression analysis.
Findings: Based on the results, 33.3% of hospitals received suitable, 55.5% received average and the remaining (11.2%) received a weak score regarding safety measures. Moreover, there was a statistically significant correlation between cleaning staff’s characteristics (education, age, work experiences and their training) with their safety status score.
Conclusion: Implementing current national principles and standards and conquering shortages, proper planning, using young workers alongside with experienced ones, more training courses and respecting and paying enough attention to cleaning staff would help to improve the safety of collecting hospital wastes.
Leila Doshmangir, Fereshteh Torabi, Hamid Ravaghi, Ali Akbari Sari, Hakimeh Mostafavi,
Volume 15, Issue 1 (6-2016)
Abstract
Background: Medical errors and adverse events are the main reasons of many avoidable deaths and imposed expenditures in worldwide health systems. Hence, this study aimed to recognize some challenges, medical errors and adverse events, and to address the appropriate solutions in order to solve them in the Iranian health system.
Materials and Methods: This qualitative study had three main data resources including key informants, national documents and expert panel. Key informants (30 persons) and experts (12 persons) were selected purposefully from macro, meso and micro levels of health system and some other health related organizations. Data were interpreted and analyzed through a mixed (inductive/deductive) thematic framework.
Results: Although, most reasons of medical errors were in relation with weak patient security system and low level security culture in hospitals, other factors like manpower, physical and external agents of hospital environment induced these errors as well. The most considerable solutions to decrease the medical errors comprised identification of medical error reasons in different levels of heath system, errors documentation and generation a consolidated system for recognition and following the errors and their main causes.
Conclusion: Relieveing the reasons of medical errors and adverse events can be a great step to prevent them. In order to eliminate the medical errors and its challenges, it is necessary to develop the consonant programs in national level via conclusive will of organizations, groups and related individuals.
Ali Akbari Sari, Mahboubeh Bayat, Mohammad Arab, Mehdi Yaseri, Seyedeh Fatemeh Hosseini,
Volume 19, Issue 1 (4-2020)
Abstract
Background: equality in access of health care services is one of the most important goals of Health system .In this study, we provided a description of the distribution of Otorhinolaryngology Head & neck surgery specialists in the Provinces of Iran in 2017.
Materials & Methods: This descriptive-analytical study was conducted in 2017 to describe the distribution of Otorhinolaryngology Head & neck surgery specialists in the Provinces of Iran in 2017. Data were gathered through Ministry of Health and Statistical Center of Iran. Gini Coefficient, Concentration Curve ,Multiple Regression and Geographic Maps used by Microsoft R Version 3-6-0 for data analysis.
Results: The highest and lowest ratio of Otorhinolaryngology Head & neck surgery specialists per population in the year 2017 was reported in Tehran (2.31 per 100,000 populations) and Hormozgan (0.39 per 100,000 populations).
Conclusion: There was a considerable disparity between different regions of the country in terms of access to Otorhinolaryngology specialists.
