Background and Aim:Doubtlessly, permanent development in patient care services is not feasible without paying attention to the culture of safety by health and treatment institutes. The present study is an attempt to analyze the cultural aspects of patient safety in the emergency wards of hospitals affiliated with the Tehran Medical Science University. The viewpoint of the nurses and hospital officials and their priorities were studied. For prioritizing the results of this study the TOPSIS technique was chosen.Methods:The study was conducted as an analytical-descriptive and cross-sectional one. It was carried out in two parts: at first the cultural aspects of the patients were measured using a questionnaire for a six months period in 2011 in emergency wards of the hospitals under study. The study population was constituted of physicians and nurses of the emergency wards. The sample group (n=270) was selected through a cluster sampling and its size was determined by using the sample size formula. For data gathering, the standard questionnaire of Hospital Survey on Patient Safety Culture (HSOPSC) was used. The data were analyzed in SPSS. The aspects of the safety culture were prioritized using the TOPSIS model. The criteria were ranked by using the MATLAB software.Results:There was a significant relationship among the aspects of performance, teamwork, feedback, mistake relationships, and the support of the managers (P ≤ 0.05). The total point of the patient safety culture in the majority of the hospitals were at a mean level of 3. The maximum score was 5. The maximum and minimum mean points were obtained by the Hasheminejad and Sina hospitals respectively. The results of the multivariate decision-making analysis indicated that human, managerial, organizational, and environmental factors were at the top of priorities in a descending order. The factors were extremely effective in the improvement of safety in hospitals.Conclusion:Human factors were the most effective and important factors in the improvement of safety in emergency wards. Therefore, there is a need to pay more attention to such factors in safety improvement programming. Training, cultural works, preparation of organizational environments, and motivating environmental factors were of the main measures that must be taken into account by the managers.

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Goal:In this paper we will identify the frequency and reasons of midwives errors in patient claims referred to Isfahan legal medicine center during 5 past years.Methods:It is a cross – sectional study. The population of the study consisted of all patients claims from midwifery staffs occupied in hospitals, clinics and other healthcare centers from 2007-20012. The data were collected by a checklist. The data were analyzed by SPSS.Result:Results shown 41 claims (5.8%) of 708 claims were from midwives. In 43.9% of cases, midwives were convicted. In 38.9% cases negligence and in 44.4% cases, carelessness of governmental rules such as premature induction of labor were the main reasons of midwives malpractice. The 35-40 age groups had the most frequency with 31.7%. In 85.4% cases, midwives services were served in hospitals and in 12.2% cases; these services were served in home-health.Conclusion:With attention to importance of midwifery, the practitioners of this occupation should be informed of medical laws and regulations, crimes and infractions, blood money law, abortion laws and other legal materials.

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Purpose Today, healthcare organizations focus mainly on development and implementation of patient safety strategic plan to improve quality and ensure safety of provided services. The purpose of this paper is to recommend potential strategies for successful implementation of patient safety program in Iranian hospitals based on a strengths, weaknesses, opportunities, threats (SWOT) analysis. Design/methodology/approach In this qualitative study, key informant interviews and documentation review were done to identify strength and weakness points of Iranian hospitals in addition to opportunities and threats facing them in successful implementation of a patient safety program. Accordingly, the research team formulated main patient safety strategies and consequently prioritized them based on Quantitative Strategic Planning Matrix (QSPM) matrix. Findings The study recommended some of the potential patient safety strategies including provision of education for employees, promoting a safety culture in hospitals, managerial support and accountability, creating a safe and high-quality delivery environment, developing national legislations for hospital staff to comply with patient safety standards and developing a continuous monitoring system for quality improvement and patient safety activities to ensure the achievement of predetermined goals. Practical implications Developing a comprehensive and integrated strategic plan for patient safety based on accurate information about the health system’s weaknesses, strengths, opportunities and threats and trying to implement the plan in accordance with patient safety principles can help hospitals achieve great success. Originality/value Ministry of Health and Medical Education (MOHME) conducted a national study to recommend potential strategies for successful implementation of patient safety in Iranian hospitals based on a SWOT analysis and QSPM matrix.

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Background: Evidence-based practice (EBP) is an ambition for health service administrators. We aimed to systematically review the major relevant articles in case of barriers and facilitators to implementing evidence-based practice in health services. Methods and Materials: The type of study was a systematic review. We searched the libraries and online sources such as PubMed, MEDLINE, Wiley, EMBASE, ISI Web of Knowledge, Scopus, Science Direct, Cochrane Library, and Google scholar. We used keywords included “Evidence-Based Practice”, “Evidence-Based Management”, “Healthcare”, “Care Management, Evidence-Based Healthcare Management”, “Health Care”, Health”, “Barrier”, “Facilitator”, policy and “Evidence-Based Healthcare”. Results: In total, 12 studies were included. Several barriers and facilitators were recognized through the included papers, the factors such as organization support and a helpful education system improved skills, knowledge, and confidence to EBP. The outcomes of studies were identified as the employ of the internet as a highest-rated skill for increasing EBP quality. Conclusion: Generally, the results showed health service administrators should first identify barriers of EBP then transferred them to facilitators to the implementation of proper and efficient EBP. [GMJ.2020;9:e1645]

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