Journal of

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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.

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Background: Priority Setting is necessary. There are different ways of priority Setting. How they are used depend on the situation of the country.

Material and Methods: This research is literature review. Google Scholar, Medline, Iranmedex, SID, Irandoc data base are used to gathering data.

Results: According to this study, there are various standard ways to priority setting such as Essential national health research ( ENHR), combined method, The commission on health research for Development (COHRED), Five-Step Process of the Ad Hoc Committee on Health Research. These methods have their own characteristics. These methods vary from one country to another . However the final impact is the same.

Conclusion: The result shows that it is useful to know about priority setting and strength and weakness of them. Combined method is the best way because it has the strength of other methods and corrects weakness of them. 

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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.

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Background:  Need to assess the health system performance, various models and frameworks have been developed by different groups and organizations. This study explores health system performance assessment frameworks using the comparative-analytical study.
 
Materials and Methods: This is a comparative-descriptive study conducted using descriptive-prescriptive method based on comprehensive comparative analysis. The scope of research includes health system frameworks. The study results compared and interpreted based on identified factors in comparative tables.
 
Results:  Overall, 11 frameworks out of 16 ones described, analyzed and compared to each other. Some of the frameworks in addition to providing insight about the health system have focus on assessment of health system performance. Each framework follows especial goals which focus on importance the health systems assessment.
 
Conclusion: During the time, health system frameworks have changed and developed according to the health systems changes. Developed Frameworks in recent years are more comprehensive than others which have been presented at first. Utilizing these frameworks in order to identify health system goals, assess based on responsibility (organizational actions or outside the organizations) and ways to reach them can be effective. Using the developed frameworks based on their domains and objectives can be considered in health system performance.