Journal of Patient Safety & Quality Improvement

Journal of Patient Safety & Quality Improvement

Identification and Assessment of the Potential Error Causes in a Fertility and Infertility Center Using Pareto Analysis in Isfahan, Iran

Document Type : Original Article

Authors
Ashraf Dehghan 1
Soheila Ehsanpour 2
Rouhollah Sheikh Abumasoudi 3
1 MSc Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
2 Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Science, Isfahan, Iran.
3 MSc in School of Management and Medical Information, Isfahan University of Medical Science, Isfahan, Iran.
10.22038/psj.2020.44094.1252
Abstract
Introduction:
Identifying errors and examining their causes in diagnostic and therapeutic processes is special conditions which has considerable impact on fertility medicine. 
Porpuse: The purpose of this investigation is to identifying and assessing the causes of potential errors in the Isfahan Fertility and Infertility Center using Pareto analysis
Materials and Methods:
Data for this study were a Descriptive-analytic study approach was adopted to assess the management practice of twofold: 1. identification of errors in process of from admission to stimulate ovulation and 2. Evaluation of causes of errors in process by using Pareto analysis. 
Results:
Of the 5 proposed processes, 123 errors were identified. The result ,as shown in chart1, indicate that the most common causes of error in each of the 5 processes related to "Mistake in entering the system information by personnel(13%), patient’s swarm(25%), Lack of knowledge(33%), Occupation of personnel(39%) and Doctor mistake in prescription(record, date and condition tests(45%).In fact, 80% of the causes of the error were in each of the 5 processes considered at 20% of them.
Conclusion:
Pareto chart seems to be a useful tool for identifying the main problem created by diagnostic and therapeutic processes and can identify the true cause of errors, including common errors. 
Keywords
Iran
Infertility
Pareto analysis
Quality
Risk assessment
  1. 1. Kempe A, Theorell T, Alwazer FN, Christensson K, Johansson A. Yemeni women’s perceptions of own authority during childbirth: What does it have to do with achieving the Millennium Development Goals?. Midwifery. 2013 Oct 1; 29(10):1182-9.
  2. Thomson R, Pryce A. Patient safety-epidemiological considerations. Health care errors and patient safety. 2009 Mar 12; 15.
  3. Kennedy CR, Mortimer D. Risk management in IVF. Best Practice & Research Clinical Obstetrics & Gynecology. 2007 Aug 1; 21(4):691-712.
  4. Shaw D, Cook RJ. Applying human rights to improve access to reproductive health services. International Journal of Gynecology & Obstetrics. 2012 Oct; 119:S55-9.
  5. Ombelet W, Cooke I, Dyer S, Serour G, Devroey P. Infertility and the provision of infertility medical services in developing countries. Human reproduction update. 2008 Sep 26; 14(6):605-21.
  6. kermani A, Mazloumi A, Naslseraji J, Ghasemzade F. Identification and Evaluation of Human Errors Related to Nursing Duties in the Emergency Department of one of the Semnan Hospitals. "Occupational Medicine Quarterly. 2012 March; 4(4): 20-43.
  7. National Academies of Sciences, Engineering, and Medicine. Medication errors injure 1.5 million people and cost billions of dollars annually: Report offers comprehensive strategies for reducing drug-related mistakes.
  8. Jafarian A, Parsapour A, Haj-Tarkhani A, Asghari F, Razavi SH, Yalda A. A survey of the complaints entering the Medical Council Organization of Tehran in three time periods: the years ending on 20 March 1992, 20 March 1997 and 20 March 2002. Journal of medical ethics and history of medicine. 2009; 2.
  9. Thatte U, Hussain S, de Rosas-Valera M, Malik MA. Evidence-based decision on medical technologies in Asia Pacific: experiences from India, Malaysia, Philippines, and Pakistan. Value in Health. 2009 Nov 1; 12:S18-25.
  10. Foussard C, Denis-Remis C. Risk assessment: methods on purpose? International Journal of Process Systems Engineering. 2014; 2:4337-52.
  11. Beheshti MH, Hajizade R, Hosseinalizadeh F, davoodi F. Investigation of the most important direct cause of occupational accidents based on the Pareto Chart. Two Iranian Occupational Health Monthly. 2015 Aug-Sep; 12:3: 38-45.
  12. Gardner DK, Weissman A, Howles CM, Shoham Z, editors. Textbook of assisted reproductive techniques fourth edition: volume 2: Clinical perspectives. CRC press; 2012 Jun 27.
  13. Bennett LR, Wiweko B, Hinting A, Adnyana IP, Pangestu M. Indonesian infertility patients’ health seeking behaviour and patterns of access to biomedical infertility care: an interviewer administered survey conducted in three clinics. Reproductive health. 2012 Dec; 9(1):24.
  14. Verhaak CM, Smeenk JM, Evers AW, Kremer JA, Kraaimaat FW, Braat DD. Women’s emotional adjustment to IVF: a systematic review of 25 years of research. Human reproduction update. 2006 Aug 29; 13(1):27-36.
  15. Creel LC, Sass JV, Yinger NV. Overview of quality of care in reproductive health: definitions and measurements of quality. New Perspectives on Quality of Care. 2002; 1:1-8.
  16. ATTAR JN, Tofighi S, Hafezimoghadam P, Maleki MR, Goharinezhad S. Risk assessment of processes of rasoule akram emergency department by the failure mode and effects analysis (FMEA) methodology.2010;13(3):
    165-176.
  17. Lago P, Bizzarri G, Scalzotto F, Parpaiola A, Amigoni A, Putoto G, Perilongo G. Use of FMEA analysis to reduce risk of errors in prescribing and administering drugs in pediatric wards: a quality improvement report. BMJ open. 2012 Jan 1; 2(6):e001249.
  18. Yarmohammadian MH, TOUFIGHI S, SAGHAEIANNEZHAD ES, NASERI BT. Risks involved in medical records processes of Al-Zahra hospital. Health information management.2007 march4; 1(7):51-59.

 

  1. Mazloum R, Hashemizadeh M, Dadpoor B, Ebrahimi M. Identification and assessment of common errors in the admission and transportation process of patients in the Central Emergency Department of Imam Reza Hospital applying the prospective approach of "Failure Mode and Effects Analysis" (FMEA). Evidence Based Care Quarterly.2013 March; 3:4(9):7-18.
  2. Waghefi M, Ghodsian M,Adib A. Attitude to Errors in Laboratory Data Harvesting ", Tarbiat Modarres University, 9th Iranian Hydraulic Conference. 9th Iranian Hydraulic Conference. 2011
  3. Mostadam M, Sedigh R, Haghighirad F. mproving Patients' Satisfaction Index in Health Service Center Using Six Sigma Approach. Health Management. 2014; 5:2:55-65.
  4. Atashgar K and Khosravi B. Improving Quality and Reducing Costs in Taleghani Medical Institute Using Six Sigma. . Health Information Management. 2014. Nov; 11(7): 840-850.
Journal of Patient Safety & Quality Improvement
Volume 8, Issue 3
Summer 2020
Pages 145-151