Patient Safety Friendly Hospital Initiative: Does it work in Iran?

Dear Editor-in-Chief

The problem of providing unsafe medical care in health care systems now is a widespread issue throughout the world. It can cause many side effects such as high rate of morbidity and mortality and can affect hospital efficiency in a bad way (1, 2). In this regard, governments in both developed and developing countries try to reach an acceptable level of safety in hospitals (3,4)

In 2007, the WHO Eastern Mediterranean Regional Office (EMRO) started the patient safety friendly hospital initiative (PSFHI) to highlight the importance of safety issues in hospitals. The program was implemented in 6 countries and then expanded to other countries in the region (5).

Soon after that, Iran joined to the program. At first level (pilot phase) 10 selected hospitals got involved. Accordingly, the Ministry of Health and Medical Education (MoHME) expanded it to nearly 100 other hospitals throughout the country. Tehran University of Medical Sciences as one of the top medical universities in the country started the program with one hospital in the pilot phase. Then gradually, program was implemented in 7 other educational hospitals affiliated to the University.

To assess hospitals PSFHI, the WHO assessment tool was used. PSFHI assessment tool has been comprised of 140 patient safety standards in five domains including leadership and management, patient and public involvement, safe evidence-based clinical practice, safe environment and lifelong learning. Standards are categorized into critical [20], core [90] and developmental [30]. Generally in the starting phase hospitals been evaluated with critical standards which are the least and mandatory standards that hospitals have to comply to become enrolled in PSFHI.

Assessment results showed that hospitals affiliated to TUMS are very good performing in critical standards. The average rate for critical standards was 75 % and this is a high score compared to a report, which conducted in seven countries and the range of compliance to the critical standards varied from 10 % to 77 % (6).

According to the domains, the results showed that hospitals could get the highest score in the leadership and management domain, which indicates that managerial commitment to patient safety, is a key factor in these hospitals.