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Showing 2 results for Type of Study: Case Report

Sousan Rabihavy, Zhila Najafpour,
Volume 16, Issue 1 (3-2022)
Abstract

Background and Aim: Operation rooms have several specialty processes, a higher level of technology, complicated treatment protocols, and the need for skillful human recourses, which is one of the highest risk wards in the hospital. Therefore, this study was initiated to identify and evaluate potential errors by using the Failure Mode, Effects, and Criticality Analysis (FMECA) approach to recognize the potential errors in operation rooms of Golestan hospital of Ahvaz. 
Materials and Methods: This research was done with a qualitative approach in seven stages and it was based on the FMECA protocol. Data were obtained through direct observation, assessment of documents and interviews with the related staff. In this regard, surgical processes were extracted from the beginig of the surgical planning to discharge patient from the post-anesthesia care unit, after that the potential errors associated with each process were identified. Finally, the risk priority number of each of them was calculated according to the indicators of Occurrence (O), Severity (S), and Detectability (D). Score analysis was performed using descriptive statistics and SPSS software.
Results: In the present study, during the analysis of processes related to surgical care, 17 primary surgery processes and 75 sub processes (from surgical planning to discharg from the post-anesthesia care unit) were identified. Seventy failure modes were identified. Ultimately, after analyzing the failure modes in the risk matrix, among the 70 identified failure modes, two failure modes had unacceptable risk, including no proper cleaning of the operation theatre and marking the surgical site, and there was Seven other failure modes with moderate risk, including unappropraite  hand hygiene and environmental and operating room fixed equipment disinfection, central oxygen disconnection, lack of equipments in night shift, delay in delivery of prostheses to the surgical site, transfer of patient who requires intensive care to the ward, were identified. Human and organizational causes contributed the most to the occurrence of potential errors.
Conclusion: Analysis of failure modes showed that the highest probability of error occurs in the processes during surgery and due to human and organizational factors. Identification of 70 potential errors in 17 processes of the Operating Room indicates the integrity of FMECA’s preventive approach in identifying and prioritizing the high-risk areas of the processes, insensitive parts such as the operating room.

Zahra Aghasizadeh, Ali Reza Pouya, Nasser Motahari Farimani, Ali Vafeaa Najjar,
Volume 16, Issue 1 (3-2022)
Abstract

Background and Aim: Hospitals are the most important component of the health system and accurate evaluation of their performance is important. So far, much research has been done on the evaluation of hospitals using DEA models, but in these studies, organizations are considered as a black box and system processes and relationships between them are ignored. In this study, the efficiency of hospitals was evaluated using network envelopment analysis and its results were compared with simple envelopment analysis.
Materials and Methods: The method of the present research was ptactical and the nature of the survey was descriptive. The research population was all hospitals and educational centers affiliated to Mashhad University of Medical Sciences with a capacity of more than one hundred beds, which included twelve public hospitals and forty-eight sections. To collect information, methods of observing and studying documents, records and statistics of hospital activities have been used. For validation, by calculating Spearman correlation coefficient, it was found that the proposed model has a significant correlation with the Black Box DEA Model and the validity of the model was confirmed. SOLVER DEA and EXCEL software were used to implement the model.
Results: The results show that by considering the internal departments of the organization as well as the relations between the departments, a more accurate analysis of the efficiency of the hospitals would be done and we will have a better separation in the ranking between the organizations. Also, by using the network DEA model, the overall efficiency, the efficiency of each department and the rank of each department in comparison with similar departments in other hospitals are determined.
Conclusion: The framework presented in this study can be an appropriate criterion for measuring the efficiency of hospitals and their internal sections by determining the overall position of each hospital relative to other hospitals and by determining the efficiency of the section. By determining the efficiency of the internal departments of hospitals, a suitable priority is provided for allocating resources and investing in different departments in the direction of organizational improvement.


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