Showing 10 results for Risk
A Akbari Sari, L Doshmangir,
Volume 8, Issue 2 (6-2009)
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.
Ali Ardalan, Arezu Najafi, Anita Sabzghabaie, Vahid Zonoobi, Saeed Ardalan, Hamidreza Khankeh, Gholamreza Masoumi , Mohsen Abbasi, Amir Nejati, Mehdi Zahabi,
Volume 9, Issue 3 (2-2011)
Abstract
Background: vulnerable events could damage structural, non structural and functional components of hospitals that might lead to community crisis, accordingly. Risk assessment is the first step to develop of a hospital disaster plan. In this study, a primary phase of developing a local tool for Iran's hospital disaster risk assessment entitled "Hospital Safety Index (HSI)" was conducted by World Health Organization originally.
Materials and Methods: First, the original index was translated into Farsi in five forms and 145 items. Then a group of four experts from the fields of medicine and engineering assessed the items one-by-one for their relevance and applicability. Revised edition tested three times at Shariati hospital in Tehran. An expert panel also evaluated the feature and content validity of the index. They also weighted the items as well.
Results: Test-retest of the index by two independent research groups found 93% of agreement. Furthermore, 244 points were revised or added to the original edition. The most important changes included: Combining instruction parts with related items for increasing educational properties, completing the list of hazards, developing a plan to analysis, and to present a quantitative and graphic of the model and finally to prepare an educational package as well.
Conclusion: Persian version of HSI, in response to needs of Iranian's health system, represents a rapid no-expensive tool for screening disaster risks at hospitals based on an international template that was tested in several countries. Based on this study, the Farsi index would be evaluated in more hospitals around the country. The assessment results will provide Iranian's health system with evidence-based information for more effective allocated resources and interventions evaluating.
Zh Agharezaei , Sh Tofighi Sh, A Nemati , L Aagharezaei , K Bahaadinbeigi ,
Volume 12, Issue 2 (9-2013)
Abstract
Background: This research aims to design and implement a software with the ability to identify patients who are facing the risk of pulmonary embolism and deep venous thrombosis instantly as well as the ability to send timely reminders for any prophylactic action. The main target is introduce a clinical decision- support system which could finally lead to preventing mortality and handicap cases caused by embolism and thromboses in patients who are confined to bed in hospitals. Materials and Methods: The software was designed using the Visual Basic.Net and SQL Server database. Afterwards the software was installed in the largest educational hospital of Kerman and a survey was conducted amongst the physicians using multiple questionnaires and interviews. Finally, the data were analyzed using the SPSS software. Results: The average score was 21.16 for the physicians and 20.76 for the nurses. T-Test results show that there is no significant difference between the total average score of the physicians and that of the nurses. Conclusion: The results have shown that both groups (physicians and nurses) have a positive viewpoint about the software therefore using the clinical decision support system can be effective in reducing the occurrence of pulmonary embolism and deep venous thrombosis through sending timely electronic alerts to the medical staff.
Farnaz Attar Jannesar Nobari, Taraneh Yousefinezhadi, Faranak Behzadi Goodari, Mohammad Arab,
Volume 14, Issue 2 (8-2015)
Abstract
Background: The goal of clinical risk management is to improve the quality of health care organization’s services and to ensure patients' safety. Thus, this study has identified and evaluated the potential failures by Failure Mode and Effects Analysis (FMEA) approach to eliminate errors occurrence of an Intensive Care Unit (ICU) in a hospital in Tehran city.
Materials and Methods: This study is a descriptive one in which data were gathered qualitatively by direct observation, document review, and Focus Group Discussion (FGD) with the process owners in an Intensive Care Units (ICUs) of a Tehran non-governmental hospital in 2014. According to FMEA method, quantitative data analysis was carried out based on failures’ Risk Priority Number (RPN).
Results: By FMEA, 378 potential failure modes in 180 ICU tasks were identified and evaluated. Then, with 90% confidence, 18 failure modes with RPN≥100 are identified and analyzed as non-acceptable risks totally.
Conclusion: Identifying 18 failures as non accepted risk from identified 378s, and identifying causes, analyzing and then suggesting correction actions reveals the FMEA high capability to identify, evaluate, prioritize and analyze potential failure modes in a such complex and critical hospital ward(ICU).
Zohreh Kalani, Zahra Pourmovahed, Ali Akbar Vaezi, Seyede Felor Vaziri,
Volume 14, Issue 3 (9-2015)
Abstract
Background: Using vein by Peripheral Catheter is one of the important ways to provid water, electrolytes, medications and nutrients to patients in hospitals and other therapeutic centers. Phlebitis is an important complication of using peripheral cannula. This study performed to determine the incidence of phlebitis related to peripheral cannulae, and its effecting factors.
Materials and Methods: This prospective and analytical study was conducted in adult's medical- surgical units of Shahid Sadoughi Yazd. Two hundred ninety seven cannulae of 297 patients were assessed. Phlebitis was identified by the presence of at least two following symptoms including local pain, redness, swelling, warmth and palpable venous cord.
Results: The mean of patients' age was 40.82±19.48 (12-91 yrs.). The phlebitis incidence rate was 14.1%. Some factors such as smoking (P=0.007), diabetes (P=0.001) had positive and significant association with phlebitis incidence rate. Odd Ratio for smoking and diabetes were 3.107(CI=1.310-7.372, 95%) and 3.736(CI=1.736-8.039, 95%) respectively.
Conclusion: Study findings revealed that overall incidence rate of phlebitis compare with other similar studies was low. Study results indicated high phlebitis incidence in smokers, diabetic patients, and elder patients which can be prevented by considering phlebitis incidence in impatiens.
Maryam Zahedi, Seyed Mohsen Banihashemi, Sedigheh Mohammadesmaeil, Mansour Sharifi,
Volume 19, Issue 2 (8-2020)
Abstract
Technological progress and changes have affected the field of medicine and health. Also, the electronic health record is used for convenience of treatment, prevention and diagnosis, but it has advantages and disadvantages that we have studied them in this research.
Method: Qualitative research methods and Grounded theory were used for the sociological study of electronic health record, and in order to achieve a comprehensive theory in this field by using the theoretical saturation method, twenty experts in the fields of medicine, policy, sociology and informatics that They were familiar with electronic health records, were selected from the community of experts as the statistical population and by using the three stages of open, axial and selective coding, important concepts and categories were extracted in each stage.
Results: The most important result of the research is multidimensional effects of electronic health record. Electronic health record by reducing emotional interaction and prioritizing registered data reduces the intimacy in the patient- physician relationship, and recording data in the specific political and economic environment of the country bring a fear of social stigma and disclosure, especially when system security, investing, and training employees face some problems, and the constant changes of managers reduce their risk-taking and positive effects.
Conclusion: In order to have a proper system and comprehensive and pervasive use of electronic health record, cultural, managerial and technological changes are necessary. Cultural contextualization in the society and among individuals, risky and efficient management and the use of integrated information systems along with system security can increase efficiency. Moreover, this efficiency will lead to research, development and progress.
Neda Vahedi Nezhad, Farzad Firouzi Jahantigh,
Volume 20, Issue 1 (5-2021)
Abstract
Introduction and purpose: Risk assessment is a necessity in high-risk work environments like hospitals. During epidemics, the need to maintain the health of healthcare staff increases as they are effective people in controlling the spread of the disease. The purpose of this study was to assess the occupational safety of healthcare staff against coronavirus using FMEA in
infectious diseases ward of Bu
-Ali Hospital in Zahedan.
Methodology: Failure modes were identified using brainstorming technique. After scoring them with S, O and D, they were prioritized by calculated RPN. To improve the traditional FMEA, failure modes were prioritized with weighted FMEA and MCDM techniques. After identifying the critical failure modes, the root causes of them were identified and categorized. Finally, corrective solutions were provided to handle them.
Results: Three processes including emergency admission, patient visit, and sampling were identified as priority processes. 58 failure modes and their effects were identified in 6 categories. 13 critical failures modes (RPN above 100) equivalent to 22% were identified. Then 42 root causes of them were identified by brainstorming technique and their classifications were done by Eindhoven. Finally, 49 corrective strategies were presented to handle critical risks.
Conclusion: Identifying 58 risks and their effects, identifying and classifying root causes and providing corrective solutions indicate the capability of the FMEA to assess the risk of critical departments such as hospitals. As a result, the FMEA is able to detect risks, reduce their consequences and improve quality. Risk assessment techniques along with the commitment of managers and the renewal of organizational policies can ensure the effectiveness of these activities
.
Rahele Panjekoobi, Farzad Firouzi Jahantigh,
Volume 20, Issue 4 (12-2021)
Abstract
Background and Aim: As difficulties increase, the level of uncertainty and risk in the supply chain increases. Medicine is a strategic product and is directly related to community health. The aim of this study is to evaluate the risk factors of pharmaceutical supply chain with artificial intelligence methods.
Materials and Methods: By reviewing the texts and interviewed 6 adept experts who had a Master’s degree and Ph.D. and had experience between 7 and 15 years in the field of risk and pharmaceutical supply chain, risk factors were identified. Finally, using multilayered perceptron neural networks and support vector machines with polynomial linear kernel functions and radial base in two low-risk and high-risk classes were classified in Python software.
Results: 22 factors were identified and classified using neural networks in 5 categories: assets, network and transportation, government and market, strategy and supplier. Shift in interest and inflation, Changes in exchange rates, Inflexibility in production and disruption of customer service are the most important risks in the pharmaceutical supply chain, respectively. The results of evaluation criteria showed that the multilayer perceptron model had better performance than the support vector machines with linear, polynomial and radial basis functions.
Conclusion: The results showed that artificial neural networks are able to classify pharmaceutical supply chain risk factors with acceptable accuracy. As a result, classification of risk factors with an accuracy of 97/07% indicates the high ability of multilayer perceptron network in risk assessment of pharmaceutical supply chain.
Mohammadreza Shahraki, Hamidreza Esmaeili,
Volume 22, Issue 4 (1-2024)
Abstract
Background and Purpose: Artificial intelligence (AI) plays a crucial role in the optimal management of hospital waste, particularly in predicting the volume and type of waste generated. This study aims to identify and rank the risks associated with the use of AI systems in hospital waste management by employing a multi-criteria decision-making approach.
Methods: This descriptive, cross-sectional study was conducted in 2023 (1402 in the Iranian calendar) at two hospitals, Ali Ibn Abitaleb and Khatam al-Anbiah, in Zahedan. Ten hospital staff members were selected as expert participants for the Delphi panel. The Shannon entropy method was utilized for risk weighting, and the TOPSIS method was applied to rank the identified risks.
Results: Kendall's coordination coefficient was used to assess the level of consensus among the Delphi panel members, with the coefficient values for the first, second, and third Delphi rounds being 6.3, 7.1, and 7.3, respectively. The indicators were weighted using the Shannon entropy method, based on three criteria: impact intensity (0.3), probability of occurrence (0.4), and detection probability (0.32). The TOPSIS method was then employed to rank the identified risks, with the most significant risks being the need for necessary infrastructure (0.847), the requirement for accurate and complete data (0.751), and budget constraints (0.749).
Conclusion: By applying multi-criteria decision-making methods, healthcare managers can effectively identify and prioritize the risks associated with using AI systems in hospital waste management, enabling them to focus on strengthening waste management practices based on these priorities.
Seyed Rahim Safavi Mirmahalleh, Mohammad Rahim Ramazanian, Mahmoud Moradi, Mostafa Ebrahimpour Azbari,
Volume 22, Issue 4 (1-2024)
Abstract
Background and Purpose: Health status is undeniably one of the most critical indicators of social development and progress. Providing healthcare poses a significant challenge for human life, and managing the healthcare supply chain is of strategic importance. The aim of this research is to analyze and compare the results of meta-synthesis with thematic analysis in identifying the risks of the pharmaceutical industry's supply chain.
Methods: This research follows a qualitative approach, utilizing both meta-synthesis and thematic analysis to identify supply chain risks in the pharmaceutical industry. In the first step, a meta-synthesis and systematic review of related studies over the past twenty-three years were conducted, identifying one hundred articles, which were refined to twenty-six key articles for the research. In the next step, risks specific to Iran's pharmaceutical supply chain were identified through thematic analysis and semi-structured interviews with experts, using targeted sampling. Finally, the results from these two approaches were compared and analyzed.
Results: The meta-synthesis approach identified ten general supply chain risks in the global pharmaceutical industry. Similarly, the thematic analysis approach identified ten specific supply chain risks in Iran's pharmaceutical industry. Six risks were common to both approaches: low quality of raw materials, complexity and incompatibility of information systems, supply of foreign currency and financial payments, transportation and insurance issues, increase in the price of raw materials, and unavailability of medicines. These common risks are critical for both the global and Iranian pharmaceutical supply chains.
Conclusion: Stakeholders in Iran's pharmaceutical supply chain (including hospitals) should prioritize managing these six common risks to improve supply chain performance. Additionally, they should focus on the four unique risks identified through thematic analysis specific to Iran's pharmaceutical supply chain, applying appropriate control measures and activities.
