Background: Risk management is
improving quality of health care services and creating a safer system of care.
We determined the main maternal and fetal risks in five Hospitals (Tehran-Iran)
to offer some practical strategies to decline obstetric adverse events and
provide better pregnancy outcome. Methods: A descriptive, cross-sectional study
was carried out in 5 Iranian hospitals (2011-2012).？Twelve Obstetricians/perinatalogists and midwives from 5
hospitalswho were in charge of
Maternity Units, were our assistants in these hospitals. We organized a
secretariat including Obstetricians/perinatalogists and midwives. The
principles of Obstetrics Risk Management were introduced to them in a 2 days’
workshop. Then the delegates from each hospital were asked to report the most
common obstetrical complications of their hospitals. The main results were 24
complications. Then for sorting these risks we asked them to do scoring of the
24 complication with 1 - 10 grading in 4 aspects of probability of occurrence,
possibility of prevention, priority of interventions and short term response to
interventions. Post partum haemorrhage, labor management problems, and neonatal
hypothermia got the highest scores in these regards, and then these 24 items
were categorized in 2 groups of risk assessment and hospital management.
Finally based on Risk Management Rules in Clinical Governance, the
complications analysis was done with use of failure mode, effects analysis and
practical strategies to decline obstetrical adverse events were suggested.
Results: We understood all reported complications had common infrastructural
problems: defects in Risk Assessment and Hospital Management Policies. We
focused on basic infrastructural management in these 2 main subjects and in
these two: our main problems were related to staff management and hospital
management issues. Conclusion: Since managerial and staff dependent problems
were our main problems, these two should be considered as our main priorities
in risk management program.