Abdi Zhaleh, Ravaghi Hamid
National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Iran.
School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Int J Health Plann Manage. 2017 Apr;32(2):147-162. doi: 10.1002/hpm.2335. Epub 2016 Jan 12.
Root cause analysis (RCA) has been widely used for retrospective investigations of patient safety incidents. To increase patient safety competencies, RCA has recently been introduced in Iranian hospitals. The aims of the current study were to explore team members' experiences and perceptions of RCA and to identify the challenges and benefits of using it in Iranian hospitals from their perspective. A qualitative study was conducted consisting of 32 semi-structured interviews with health professionals who participated in the national training programme and were involved in RCA investigations. Data were analysed using the thematic analysis method. The participants encountered a range of obstacles while conducting RCA, including time constraints, a lack of resources, the blame culture and unsupportive colleagues. They stressed the need for further leadership support and cultural change within the Iranian healthcare system to facilitate the application of RCA. RCA was perceived as a beneficial analytical tool that improved patient care, fostered teamwork and communication among staff and promoted safety culture. This study concluded that applying RCA in the Iranian healthcare setting has had a significant impact on improving commitment to safety. However, the general adoption of this method is hindered by the lack of workplace and system supports. To maximize profits from RCA, clinical leaders must assign a high priority to RCA investigations and support RCA team efforts. Copyright © 2016 John Wiley & Sons, Ltd.
根本原因分析(RCA)已被广泛用于对患者安全事件的回顾性调查。为提高患者安全能力,RCA最近已被引入伊朗医院。本研究的目的是探讨团队成员对RCA的经验和看法,并从他们的角度确定在伊朗医院使用RCA的挑战和益处。进行了一项定性研究,包括对参加国家培训计划并参与RCA调查的卫生专业人员进行32次半结构化访谈。使用主题分析法对数据进行分析。参与者在进行RCA时遇到了一系列障碍,包括时间限制、资源短缺、责备文化和不支持的同事。他们强调伊朗医疗系统需要进一步的领导支持和文化变革,以促进RCA的应用。RCA被视为一种有益的分析工具,可改善患者护理、促进工作人员之间的团队合作和沟通,并促进安全文化。本研究得出结论,在伊朗医疗环境中应用RCA对提高安全承诺产生了重大影响。然而,这种方法的普遍采用受到工作场所和系统支持不足的阻碍。为了从RCA中获取最大收益,临床领导者必须高度重视RCA调查并支持RCA团队的工作。版权所有©2016约翰威立父子有限公司。