اولویت‌بندی معیارهای ارزیابی عملکرد مدیریت ایمنی بیمار در مراکز درمانی
محورهای موضوعی : -مدارک پزشکیسیده شبنم عظیمی حسینی 1 , نبی اله منصوری 2 , رضا عزیزی نژاد 3 , حسن کریم زادگان 4
1 - دانشجوی دکتری، گروه مدیریت محیط زیست، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
2 - استاد، گروه مهندسی محیط زیست، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
3 - استادیار، گروه بیوتکنولوژی و به‌نژادی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
4 - استادیار، گروه مهندسی محیط زیست، واحد لاهیجان، دانشگاه آزاد اسلامی، لاهیجان، ایران
کلید واژه: ایمنی بیمار, ارزیابی عملکرد, مراکز درمانی,
چکیده مقاله :
مقدمه: خدمات غیرایمن در عرصه سلامت هم چنان یک معضل جهانی گسترده به شمار می آید. گرچه در دهه گذشته پیشرفت قابل ملاحظه‌ای رخ داده است اما هنوز کاستی های متعددی وجود دارد و میزان آسیب های تحمیل‌شده به بیماران به طور غیرقابل قبولی بالاست. ازآنجاکه ارزیابی مراکز درمانی منجربه بهبود عملکرد، افزایش سلامت، کاهش حوادث و در نهایت افزایش رضایت بیماران، به عنوان یکی از مهم ترین ذینفعان این مراکز می گردد، وجود معیارهای ارزیابی ضروری است و مطالعه ای یافت نگردید که به معرفی و اولویت بندی این معیارها بپردازد. روش پژوهش: با بررسی مهم ترین روش های ارزیابی مراکز درمانی، معیارهای مرتبط با ایمنی بیمار،جمع آوری گردیده و میزان اهمیت آنان با استفاده از نظر خبرگان و از طریق روش آنتروپی تعیین می گردد. یافته‌ها: یافته های این پژوهش منجربه استخراج معیارهای مدیریت ایمنی بیمارگردید که به معیار بهداشت و کنترل عفونت در تمامی روش های ارزیابی بررسی شده، اشاره شده است .در نهایت موارد مذکور در 19 معیار گروه بندی و اولویت بندی گردید که معیارهای امکانات درمانی و پایش بیمار و مدیریت ایمنی بیمار به ترتیب با کسب اوزان 0/0987 و 0/0855 بیشترین جایگاه اهمیت را از منظر خبرگان پژوهش به دست آوردند. نتیجه‌گیری: در روش های ارزیابی و مطالعات بررسی شده، معیارهای متفاوتی در زمینه مدیریت ایمنی بیمار ارائه شده است که جمع آوری و بررسی آنان، بستری مناسب جهت ایجاد روش ارزیابی جامعی را فراهم می آورد. بنابراین از نتایج این تحقیق می‌توان در جهت خودارزیابی، مقایسه مراکز مختلف و در نتیجه بهبود عملکرد استفاده نمود.
Introduction: Unsafe health services are still a widespread global problem. Although significant progress has been made in the last decade, there are still numerous shortcomings and the rate of harm inflicted on patients is unacceptably high. Since the evaluation of medical centers leads to improved performance, increased health, reduced accidents and ultimately increased patient satisfaction as one of the most important stakeholders of these centers, the existence of evaluation criteria is essential. No study was found to introduce and prioritize these criteria. Methods: By reviewing the most important methods of evaluation of healthcare centers, criteria related to patient safety are extracted and their importance is determined using the opinion of experts and through entropy method. Results: The findings of this study led to the establishment of a database of patient safety management criteria that the health and infection control criteria in all evaluation methods have been mentioned. Finally, the mentioned cases were grouped and prioritized to 19 criteria that the criteria of medical facilities and patient monitoring and patient safety management gained the most important position from the perspective of research experts by gaining weights of 0.0987 and 0.0855, respectively. Conclusion: In the evaluation methods and studies, different criteria in the field of patient safety management have been presented, the collection and review of which provide a suitable context for the establishment of a comprehensive evaluation method. Therefore, the results of this research can be used for self-assessment, comparison of different centers and thus improving performance.
1- Arabameri Y, Hasani AA. A Comprehensive Satisfaction Assessment Model for Healthcare Services. Journal of Healthcare Management , 2019; 9(4): 67-78. Available from: http://jhm.srbiau.ac.ir/article_14106.html [Persian].
2- Sajadi H, Hariri M, Karimi S, Baratpour S. Performance self assessment by the excellence model in different hospitals of Isfahan University of Medical Sciences and Healthcare Services. Research in Medicine, 2008; 32(3): 227-231. Available from: http://pejouhesh.sbmu.ac.ir/article-1-522-fa.html[Persian].
3- Barati A, Nabilo B. A Comparative study of the organizational superiority model in Healthcare at selected countries proposing a model for Iran. Journal of Health Administration, 2005; 7(18): 14-19. Available from: http://jha.iums.ac.ir/article-1-89-fa.pdf [Persian].
4- Australian Safety and Compensation Council. Occupational Health and Safety risk factors for rural and metropolitan nurses: comparative results from a national nurses survey, 2008. Available from: https://www.safeworkaustralia.gov.au/system/files/documents/1702/ohsrisk_factors_rural_metropolitannurses_comparativeresults_nationalnursessurvey_2008_pdf.pdf
5- WHO. Patient safety Global action on patient safety; 2018: 1-8.
6- Slawomirski L, Auraaen A, Klazinga N. The economics of patient safety strengthening a value-based approach to reducing patient harm at national level. OECD; 2017: 1-25.
7- Vries EN De, Ramrattan MA, Smorenburg SM, Gouma DJ, Boermeester MA. The incidence and nature of in-hospital adverse events : a systematic review. Qual Saf Health Care, 2008; 17: 216–223.
8- Committee on Improving the Quality of Health Care Globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide. National Academies Press .The national academies of sciences engineering medicine; 2018: 1-399. Available from: http://nap.edu/25152.
9- Moheb M, Ferdosi M, Haghighat M, Rejalian F. Prioritizing key human resource performance indicators by multi criteria decision making method in selective hospital of Isfahan medical science university,2015;6(1):43-50. Available from: http://jhm.srbiau.ac.ir/article_7260.html [In Persian].
10- Emami H, Ravaghi H, Mohaghegh M. Assessment of Patient Safety in Hospitals. Ministry of Health and Medical Education Medical; 2011: 1-179. [In Persian]
11- ACHS. The Australian Council on Healthcare Standards .National safety and quality health service standards program, 2015; 3: 1-6.
12- HAS. Hospitals accreditation process in France. French National Authority for Health; 2014: 1-14.
13- Ministry of Health Minister Office sector. Egyptian HealthCare Accreditation Foundation Level of Hospital Standards. Accreditation Executive committee; 2014: 1-54.
14- Tabrizi J, Gharibi F. Developing a national accreditation model via Delphi Technique. Journal of Hospital, 2011; 11(2): 9-17. [In Persian]
15- Ministry of Health and Medical Education. National Accreditation Standards of Iranian Hospitals, 2018; 4: 1-10 [Persian].
16- Van Beuzekom M, Boer F, Akerboom S, Hudson P. Patient safety : latent risk factors. British Journal of Anaesthesia, 2010; 105(1): 52–59. Available from: http://dx.doi.org/10.1093/bja/aeq135
17- Mahrous MS. Patient safety culture as a quality indicator for a safe health system : Experience from Almadinah Almunawwarah, KSA. Journal of Taibah University Medical Sciences, 2018; 13(4): 377–383. Available from: https://doi.org/10.1016/j.jtumed.2018.04.002
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19- Safdari R, Mirzaee M, Mehdibagli M. Compilation of Patient Safety Dashboard Indicators. Journal of Payavard Salamat, 2018; 12(2): 150-160 [Persian].
20- Bergman L, Pettersson M, Chaboyer W, Carlstrom E, Ringdal M. Improving quality and safety during intrahospital transport of critically ill patients : A critical incident study .Australian Critical Care, 2019; 33(1): 12-19.
Available from: https://doi.org/10.1016/j.aucc.2018.12.003.
21- Kim CH, Jeong SY, Kwon MS. Effects of hazard perception training (HPT) on nursing students’ risk sensitivity to patient safety and developing safety control confidence. Applied Nursing Research, 2018; 39: 160-166. Available from: https://doi.org/10.1016/j.apnr.2017.10.020
22- Boamah Sh, Laschinger S, Wong C, Clarke S. Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing outlook, 2017; 66(2): 180-189. Available from: https://doi.org/10.1016/j.outlook.2017.10.004.
23- Ghasemi V. Estimation of Optimum Sample Size in Structural Equation Modeling Assessing Its Adequacy for Social Researchers. Iranian Journal of Sociology, 2012; 12(4): 138-161. Available from: https://www.magiran.com/paper/1059386?lang=en [In Persian].
24- de Vet HCW, Mokkink LB, Mosmuller DG, Terwee CB. Spearman–Brown prophecy formula and Cronbach’s alpha: different faces of reliability and opportunities for new applications. Journal of Clinical Epidemiology, 2017; 85: 45-49.Available from: https://doi.org/10.1016/j.jclinepi.2017.01.013.
25- Sadeghi M. Zoning Desertification Potential Hazard Using MADM Approach and Shannon Entropy Model in Khezrabad Region, Yazd .Iranian Journal of soil research, 2014; 28(3): 557-572. Available from:http://srjournal.areo.ir/article_100024_6feb058fc3caed975a4b75a8be5053e1.pdf [Persian].
26- Pei-Yue L, Hui Q, Jian-Hua W. Application of Set Pair Analysis Method Based on Entropy Weight in Groundwater Quality Assessment - A Case Study in Dongsheng City , Northwest China. E-Journal of Chemistry, 2011; 8(2): 851-858. Available from: https://www.hindawi.com/journals/jchem/2011/879683.
27- Ghorbani M, Asadi H, Khamneh H, Farsadizadeh D. Derivation of Instantaneous Unit Hydrograph (IUH) using the Shannon Entropy Theory. Journal of Watershed Management Research, 2014; 5(10): 30-43. Available from: http://panel.agriis.ir/Attachments/Files/2682015526105940906.pdf [Persian].
28- Rahmani H, Moosakhani M,Memarzade GH. The combination of Delphi method and Shannon entropy to deal with administrative corruption, using fuzzy inference system. Journal of Industrial management studies, 2017; 15(44): 75-115. Available from: https://www.sid.ir/fa/journal/ViewPaper.aspx?id=320013 [In Persian].
29- Joint Commission International. Joint Commission International Accreditation Standards for Hospitals, 2014; 5: 1-71.
30- HAS. Certification manual for healthcare organizations. Department for the Improvement of Quality and Safety of Healthcare; 2010: 1–120.
31- The Australian Council on healthcare Standards. National Safety and Quality Health Service Standards program; 2015: 1-6.
32- UNFPA Evaluation office. Independent country programme evaluation Lebanon; 2014: 1-117.
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1- Arabameri Y, Hasani AA. A Comprehensive Satisfaction Assessment Model for Healthcare Services. Journal of Healthcare Management , 2019; 9(4): 67-78. Available from: http://jhm.srbiau.ac.ir/article_14106.html [Persian].
2- Sajadi H, Hariri M, Karimi S, Baratpour S. Performance self assessment by the excellence model in different hospitals of Isfahan University of Medical Sciences and Healthcare Services. Research in Medicine, 2008; 32(3): 227-231. Available from: http://pejouhesh.sbmu.ac.ir/article-1-522-fa.html[Persian].
3- Barati A, Nabilo B. A Comparative study of the organizational superiority model in Healthcare at selected countries proposing a model for Iran. Journal of Health Administration, 2005; 7(18): 14-19. Available from: http://jha.iums.ac.ir/article-1-89-fa.pdf [Persian].
4- Australian Safety and Compensation Council. Occupational Health and Safety risk factors for rural and metropolitan nurses: comparative results from a national nurses survey, 2008. Available from: https://www.safeworkaustralia.gov.au/system/files/documents/1702/ohsrisk_factors_rural_metropolitannurses_comparativeresults_nationalnursessurvey_2008_pdf.pdf
5- WHO. Patient safety Global action on patient safety; 2018: 1-8.
6- Slawomirski L, Auraaen A, Klazinga N. The economics of patient safety strengthening a value-based approach to reducing patient harm at national level. OECD; 2017: 1-25.
7- Vries EN De, Ramrattan MA, Smorenburg SM, Gouma DJ, Boermeester MA. The incidence and nature of in-hospital adverse events : a systematic review. Qual Saf Health Care, 2008; 17: 216–223.
8- Committee on Improving the Quality of Health Care Globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide. National Academies Press .The national academies of sciences engineering medicine; 2018: 1-399. Available from: http://nap.edu/25152.
9- Moheb M, Ferdosi M, Haghighat M, Rejalian F. Prioritizing key human resource performance indicators by multi criteria decision making method in selective hospital of Isfahan medical science university,2015;6(1):43-50. Available from: http://jhm.srbiau.ac.ir/article_7260.html [In Persian].
10- Emami H, Ravaghi H, Mohaghegh M. Assessment of Patient Safety in Hospitals. Ministry of Health and Medical Education Medical; 2011: 1-179. [In Persian]
11- ACHS. The Australian Council on Healthcare Standards .National safety and quality health service standards program, 2015; 3: 1-6.
12- HAS. Hospitals accreditation process in France. French National Authority for Health; 2014: 1-14.
13- Ministry of Health Minister Office sector. Egyptian HealthCare Accreditation Foundation Level of Hospital Standards. Accreditation Executive committee; 2014: 1-54.
14- Tabrizi J, Gharibi F. Developing a national accreditation model via Delphi Technique. Journal of Hospital, 2011; 11(2): 9-17. [In Persian]
15- Ministry of Health and Medical Education. National Accreditation Standards of Iranian Hospitals, 2018; 4: 1-10 [Persian].
16- Van Beuzekom M, Boer F, Akerboom S, Hudson P. Patient safety : latent risk factors. British Journal of Anaesthesia, 2010; 105(1): 52–59. Available from: http://dx.doi.org/10.1093/bja/aeq135
17- Mahrous MS. Patient safety culture as a quality indicator for a safe health system : Experience from Almadinah Almunawwarah, KSA. Journal of Taibah University Medical Sciences, 2018; 13(4): 377–383. Available from: https://doi.org/10.1016/j.jtumed.2018.04.002
18- Olmsted MPH, Russell N. Prevention by Design Construction and Renovation of Health Care Facilities for Patient Safety and Infection Prevention. Infectious Disease Clinics of North America, 2016; 30(3): 713–728. Available from: http://dx.doi.org/10.1016/j.idc.2016.04.005
19- Safdari R, Mirzaee M, Mehdibagli M. Compilation of Patient Safety Dashboard Indicators. Journal of Payavard Salamat, 2018; 12(2): 150-160 [Persian].
20- Bergman L, Pettersson M, Chaboyer W, Carlstrom E, Ringdal M. Improving quality and safety during intrahospital transport of critically ill patients : A critical incident study .Australian Critical Care, 2019; 33(1): 12-19.
Available from: https://doi.org/10.1016/j.aucc.2018.12.003.
21- Kim CH, Jeong SY, Kwon MS. Effects of hazard perception training (HPT) on nursing students’ risk sensitivity to patient safety and developing safety control confidence. Applied Nursing Research, 2018; 39: 160-166. Available from: https://doi.org/10.1016/j.apnr.2017.10.020
22- Boamah Sh, Laschinger S, Wong C, Clarke S. Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing outlook, 2017; 66(2): 180-189. Available from: https://doi.org/10.1016/j.outlook.2017.10.004.
23- Ghasemi V. Estimation of Optimum Sample Size in Structural Equation Modeling Assessing Its Adequacy for Social Researchers. Iranian Journal of Sociology, 2012; 12(4): 138-161. Available from: https://www.magiran.com/paper/1059386?lang=en [In Persian].
24- de Vet HCW, Mokkink LB, Mosmuller DG, Terwee CB. Spearman–Brown prophecy formula and Cronbach’s alpha: different faces of reliability and opportunities for new applications. Journal of Clinical Epidemiology, 2017; 85: 45-49.Available from: https://doi.org/10.1016/j.jclinepi.2017.01.013.
25- Sadeghi M. Zoning Desertification Potential Hazard Using MADM Approach and Shannon Entropy Model in Khezrabad Region, Yazd .Iranian Journal of soil research, 2014; 28(3): 557-572. Available from:http://srjournal.areo.ir/article_100024_6feb058fc3caed975a4b75a8be5053e1.pdf [Persian].
26- Pei-Yue L, Hui Q, Jian-Hua W. Application of Set Pair Analysis Method Based on Entropy Weight in Groundwater Quality Assessment - A Case Study in Dongsheng City , Northwest China. E-Journal of Chemistry, 2011; 8(2): 851-858. Available from: https://www.hindawi.com/journals/jchem/2011/879683.
27- Ghorbani M, Asadi H, Khamneh H, Farsadizadeh D. Derivation of Instantaneous Unit Hydrograph (IUH) using the Shannon Entropy Theory. Journal of Watershed Management Research, 2014; 5(10): 30-43. Available from: http://panel.agriis.ir/Attachments/Files/2682015526105940906.pdf [Persian].
28- Rahmani H, Moosakhani M,Memarzade GH. The combination of Delphi method and Shannon entropy to deal with administrative corruption, using fuzzy inference system. Journal of Industrial management studies, 2017; 15(44): 75-115. Available from: https://www.sid.ir/fa/journal/ViewPaper.aspx?id=320013 [In Persian].
29- Joint Commission International. Joint Commission International Accreditation Standards for Hospitals, 2014; 5: 1-71.
30- HAS. Certification manual for healthcare organizations. Department for the Improvement of Quality and Safety of Healthcare; 2010: 1–120.
31- The Australian Council on healthcare Standards. National Safety and Quality Health Service Standards program; 2015: 1-6.
32- UNFPA Evaluation office. Independent country programme evaluation Lebanon; 2014: 1-117.
