Journal of

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Introduction: Intensive Care Unit (ICU) in hospitals is one of the most sensitive and costly units which is really important due to safety and health of patients during their stay in these units. Hence, considering the potential risks in this unit, treatment operations for eliminating or decreasing risks are very important. Among these intensive care units, the most important one is the open-heart surgery unit which may have irreparable damages due to vulnerability of these patients in the process of their transfer, care, and discharge. The present study aims to identify the potential risks and offer solutions for eliminating or decreasing them.
Method: In this research, we used Failure Mode and Effect Analysis (FMEA) method, which is a very useful method for evaluating and managing the risks, to prioritize risk factors. Due to some limitations of the method, fuzzy FMEA and fuzzy TOPSIS methods were also used in order to have more precise results and then the results were compared with each other.
Results: The suggested approach was implemented in ICU-OH (open-heart) unit of Kowsar hospital in Semnan. Finally, nineteen factors were recognized as major risk factors. Also, corrective actions were determined for all detected risks that can be pursued according to their priorities.
Conclusions: Factors including not observing hemodynamic signs, not considering patient safety and security, and inability to interpret arterial gas valve abnormalities are the three top risk factors that can be addressed through training and having more control on nurses.

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Background: Achieving goals and developing hospital services depends on competence and optimal management. There will be competent managers who can be successful in performing managerial roles. Playing the roles supports the management in the direction of efficiency, administration and optimal management of the hospital. The purpose of this study is to evaluate and prioritize the roles of management in the hospital from the experts' point of view.
Materials and Methods: This research has a practical purpose and a descriptive and analytical approach. The statistical sample of the research included 65 experts from Imam Khomeini (RA) Al-Shatar Hospital, who were identified based on the snowball and selective sampling method. In this study, a self-made matrix questionnaire whose validity has been confirmed by experts was used to collect data. TOPSIS technique was used to analyze the data. In this study, five criteria and three main roles, which include 10 secondary roles, were identified
Results: The data analysis showed that the promotion of organizational commitment with the percentage of importance (23.2%) with the most important criterion, followed by organizational improvement criteria (20.9%), coordination and coherence (19.4%), promotion of employees' job motivation (7%) 18.00) and improvement of performance efficiency (18.4%) are ranked as effective indicators respectively. Also, the sub-role of analyst supervisor (0.926) was introduced as the most important role among the sub-roles of management in the hospital.
Conclusion: Considering that the role of decision-making was introduced as the most important role, as well as the consequences of decisions on the present and future of the hospital, it is necessary for the hospital management to pay more attention and importance to the role of decision-making in order to make optimal decisions.