Designing an executive framework for active risk management in the operating room of hospitals in Iran

Abstract

Abstract Introduction: The operating room is one of the most important and complex working environments in a hospital where many accidents are likely to occur. The aim of risk management in hospitals is to reduce the probability of accidents that happen to patients and employees. This study was conducted with the aim of designing the executive framework of active risk management in the operating rooms of hospitals in iran. Methodology: This study is a multi-method research. To examine "risk management frameworks, patterns and models, active risk management programs, features of active risk management programs and implementation strategies and risk management frameworks, prerequisites,. In the next stage, interview sessions were held to identify the essential components of the risk management framework, prerequisites, requirements, obstacles and facilitators for the implementation of active risk management in two perspectives. In the third stage, the status of implementation of risk management in the operating rooms of selected teaching hospitals in Tabriz city was evaluated and analyzed using the risk management evaluation framework, which included the steps related to the translation of this tool. Finally, using the results of the previous steps, the initial framework of active risk management was determined at the level of teaching hospitals in the country, and finally, the designed implementation framework was validated using Delphi criteria. The implemented framework was implemented in one of the general hospitals in Tabriz city that are willing to cooperate. Findings: In the literature review phase, a total of 21 studies were included in the study, which were the same in terms of the purpose and methods of data collection. According to the analysis of the findings of the study, the characteristics of risk management programs were classified into 6 main factors that include goals, components, stages, results, prerequisites and facilitators of the risk management program and 35 sub-factors. In a qualitative study, the essential components of active risk management in the operating room in 4 main themes, types of risks, principles, processes and framework of risk management in the operating room and 27 sub-themes based on standard classification for types of risks, principles, processes and framework Risk management was divided. Obstacles and prerequisites for active risk management in the operating room were divided into three themes including managerial obstacles and prerequisites, organizational resources (financial, human, equipment and facilities) and cultural issues. In the third stage and evaluation of hospitals, in the ranking of the areas, the area of results has the highest score (2.06), (satisfactory level) and the area of participation has the lowest score (1.13), (level of learning and awareness). In the ranking of hospitals in each area, hospital A has the highest score in all areas and hospital H in the area of leadership, strategy and risk management, and hospital F in the area of people, participation and processes, and hospital G in the area of results has the lowest. are points In the fourth stage, the risk management framework was finalized with the dimensions of design and planning, implementation and execution, evaluation, coordination, commitment and leadership, environment preparation, identification and evaluation, consultation, monitoring and improvement, and in the last stage, the compiled framework was implemented. and led to the improvement of results in all fields and indicators in the selected hospital. Conclusion: The implementation of different dimensions of the risk management framework in the operating room, which includes resources and infrastructure, stages, prerequisites and facilitators, principles and the framework of risk management, will lead to more effective decisions and taking more appropriate actions to minimize risks, and as a result , the quality and safety of care provided in the operating room will improve. Keywords: risk, risk management, operating room