[Assessment of anesthesia-surgery risk management at hospitals of Isfahan university of medical sciences, using ECRI institute standards in 2011]

Introduction: Up to the present, the most complaints are about medical malpractice in anesthesia - surgery wards. To identify defects and promot patient safety, an efficient and effective system of risk management is necessary. The aim of this study is to determine anesthesia- surgery risk management and root cause analysis of events in Isfahan University of Medical Sciences hospitals

Methods: A standard structured checklist that has been developed by ECRI institute was applied. The checklists were filled onsite through direct observation and interviews with anesthesia and surgical personnel in 46 operating rooms at 4 hospitals. Data were analyzed by SPSS, Excel and Minitab software. Root causes of events were plotted using Fish Bone diagram

Results: Total means score of anesthesia- surgery risk management status was 2.13 on the scale of 3 which is at the intermediate level. There was a significant difference between the four hospitals. These hospitals only met 45% of the predetermined standards. The highest compliance with standards [69%] was for "Anesthesia and surgical equipment" while the lowest with 11% was for "Training in risk management"

Conclusion: The results of this study developed a list of factors leading to risks and errors in anesthesia - surgical wards. The results can be used in benchmarking hospitals and performing educational and managerial interventions. Also, these results can lead to the development of a clinical guideline that could be mandated by policymakers to reach the final goal of health care systems, i.e. promotion of patient safety and provision of consumer satisfaction

Risk management status of waste anesthetic gases Using ECRI institute standards

The aim of this study was assessment the risk management status of waste anesthetic gases in academicals hospitals in Iran to prevent from harmful effects of these gases on employees' health. A descriptive-analytic study was designed in 2011. Standard structured checklist developed by ECRI institute [Emergency Care Research Institute] was applied. Checklists were filled onsite through direct observation and interviews with anesthesia personnel in 46 operating rooms at 4 hospitals from all of the hospitals under affiliation of Isfahan University of Medical Sciences. These hospitals were selected based on the number of surgical beds. Total means score of WAGs risk management status was 1.72 from the scale of 3. In the studied operating rooms, only 28% complied with predetermined standards, 16% needed improvement and 56% had no compliance. Total mean scores of compliance in planning, training and evaluation and monitoring of waste anesthetic gases were weak and equipment and work activity was at medium level. The risk management status of waste anesthetic gases in the hospitals to be weak, therefore operating room personnel are exposed to medium to high level of these gases. The hospital mangers should prepare and apply scavenging equipment, development of control program, quality improvement, risk management and maintenance of anesthesia equipment. Finally, ongoing monitoring and evaluation, education to personnel and modification of policy and procedures and improvement of work activities should be considered