Document Type: Review article


1 PhD Student in Health Services Management, Science and Research Branch, Islamic Azad University, Tehran, Iran

2 Department of Health Services Management, Science and Research Branch, Islamic Azad University, Tehran, Iran.

3 Department of Health Services Management, Science and Research Branch, Islamic Azad University, Tehran, Iran

4 Shahrekord University of Medical Sciences, Nursing Department


Background and aims: Patient safety, as one of the main components of the health care quality, implies
avoiding any injury and damage to the patient when providing health care services. In other words,
patient safety means his or her safety against any adverse and harmful event when receiving health care
services. Based on the above-mention explanations, the present study was conducted to determine the
patterns of patient safety management.
Methods: A systematic review method was used to meet the objectives of the study. In order to access
the scientific documentation and evidence related to the subject published during 1998-2018, English
keywords including “Patient Safety Model”, “Patient Safety”, and “Patient Safety of Management” were
searched in Medine, PubMed, and Google Scholar databases and Persian versions of these keywords
were also looked for in Jihad-e Daneshgahi’s Scientific Information Database (SID) and Iranian Journals
database (Magiran).
Results: The findings of this study suggested that most of the studies on designing a model for patient
safety highlighted important dimensions including guidance and leadership, communication,
organizing, information management, control and monitoring, participation and decision-making, as
well as planning and coordination.
Conclusion: In general, using patterns and frameworks designed for patient safety improves patient
safety against uncertain incidents since the human and financial consequences of such incidents
impose overwhelming sufferings on patients.


Main Subjects

1. Shali M, Joolaee S, Hooshmand A, Haghani H. Committed
Nurse: This Patient is wrong. Medical Ethics Journal.
2016;10(34):11-30. [Persian].
2. Akbari R, Zarei E, Gholami A, Mousavi H. A survey of patient
safety culture: A tool for improving patient safety in healthcare
providers service organizations. Iran Occupational Health.
2015;12(4):76-88. [Persian].
3. Arshadi Bostanabad M, Jebreili M, Kargari Rezapour M.
Patient safety culture assessment in neonatal intensive care
units of Tabriz from the perspective of nurses in 2013. Iranian
Journal of Nursing Research. 2015;3(38):26-35. [Persian].
4. World Health Organization (WHO). Definitions of key
concepts from the WHO patient safety curriculum guide
(2011). WHO; 2018.
5. Mayelafshar M, Memarpour M, Riahi L. The Relationship
Between the Type of Medication Errors Reported and Patient
Safety Standards in a Public Hospital in Tehran City. Journal
of School of Public Health and Institute of Public Health
Research. 2017;15(3):252-66. [Persian].
6. Mohebifar R, Alijanzadeh M, Safari Variani A, Khoshtarkib H,
Ghanati E, Teymouri F, et al. Studying patient safety culture
from the viewpoint of staffs in educational hospitals in Tehran
City. Journal of Health and Safety at Work. 2015;5(1):57-64.
7. Razavi F, Mazloomi N, Torkestani Ms. Assessing hospitals
clinical risk management. Quarterly Journal of Nersing
Management. 2016;5(1):49-59. doi: 10.29252/ijnv.5.1.49.
8. Najafpour Z, Pourreza A. The Analysis Of Safe Clinical Services
Indicators Of Tehran University Of Medical Sciences Selected
Hospitals. Payavard Salamat. 2016;9(6):566-78. [Persian].
9. Bayatmanesh H, Zagheri Tafreshi M, Manoochehri H,
Akbarzadeh Baghban A. Evaluation of Patient-Related Nursing
Care with Standards in Intensive Care Unit (ICU). Armaghane
Danesh. 2017;22(3):375-89. [Persian].
10. Nobahar M. Professional errors and patient safety in intensive
cardiac care unit. Journal of Holistic Nursing and Midwifery.
2015;25(3):63-73. [Persian].
11. Shamsadini Lori A, Osta A, Atashbahar O, Ramazani S,
Pourahmadi M, Ahmadi Kashkoli S. Patient Safety Culture
from the Viewpoint of Nurses of Teaching Hospitals Affiliated
with Shahid Beheshti University of Medical Sciences. Journal
of Health Based Research. 2016;2(1):81-92. [Persian].
12. Baghaei R, Pourrashid S, Khalkhali H. The effect of using
SBAR model in nursing handoff on communication dimension
of nursing care from the patients’ view. Journal of Nursing
and Midwifery Urmia University of Medical Sciences.
2016;14(6):562-70. [Persian].
13. Lee CT, Doran DM. The Role of Interpersonal Relations in
Healthcare Team Communication and Patient Safety: A Proposed
Model of Interpersonal Process in Teamwork. Can J Nurs Res.
2017;49(2):75-93. doi: 10.1177/0844562117699349.
14. Raazmara MR, Jani MR, Moudi A, Sarvari MH, Drogar Z,
Zolfaghri HR, et al. Prioritization of contributing factors on
patient safety by analytical hierarchy process. Quarterly
Journal of Nersing Management. 2016;5(1):70-8. doi:
10.29252/ijnv.5.1.78. [Persian].
15. Rabeian M, Masoudi Asl I, Nazari H, Azari S. Studying TUMS
Hospital Managers’ Viewpoints Regarding the Observance of
Total Quality Management Components in 2012. Payavard
Salamat. 2017;11(3):104-11. [Persian].
16. Parker D. Managing risk in healthcare: understanding
your safety culture using the Manchester Patient Safety
Framework (MaPSaF). J Nurs Manag. 2009;17(2):218-22. doi:
17. Jozi SA, Gholamnia R, Ramezani H. Evaluate the effectiveness
of training programs in HSE management system using
the EFQM Excellence Model Guide (case study: Center of
Research and Training for Occupational Technical safety
and Health). Journal of Occupational Hygiene Engineering.
2017;4(1):1-9. doi: 10.21859/johe-04011. [Persian].
18. Sakai R. H-I Model: Basic Framework of Sciences and
Technologies in Patient Safety. Journal of Medical Safety.
19. Edwards MT. An organizational learning framework for
patient safety. Am J Med Qual. 2017;32(2):148-55. doi:
20. Nuntawinit C, Wongkhomthong J, Luangamornlert S,
Chomson S. A model of safety performance in perioperative
registered nurses. Siriraj Med J. 2017;61(6):292-6.
21. van Gelderen SC, Hesselink G, Westert GP, Robben PB,
Boeijen W, Zegers M, et al. Optimal governance of patient
safety: A qualitative study on barriers to and facilitators for
effective internal audit. J Hosp Adm. 2017;6(3):15-25. doi:
22. Panesar SS, deSilva D, Carson-Stevens A, Cresswell KM,
Salvilla SA, Slight SP, et al. How safe is primary care? A
systematic review. BMJ Qual Saf. 2016;25(7):544-53. doi:
23. Campbell SM, Reeves D, Kontopantelis E, Sibbald B, Roland
M. Effects of pay for performance on the quality of primary
care in England. N Engl J Med. 2009;361(4):368-78. doi: 

24. Lenburg CB, Klein C, Abdur-Rahman V, Spencer T, Boyer S.
The COPA model: a comprehensive framework designed to
promote quality care and competence for patient safety. Nurs
Educ Perspect. 2009;30(5):312-7.
25. Doroudi H, Shami R, Gharehbaghi H. Nurses Viewpoints
on Relationship between Components of Working System of
Nurses with Patients Safety Using Sips Model. Preventive Care
in Nursing & Midwifery Journal. 2015;5(2):75-83. [Persian].
26. Mostadam M, Raissi S, Haghighirad F. Improving Patient’s
Satisfaction Index in a Given Healthcare Center Using the
Six Sigma Methodology. Journal of Healthcare Management.
2014;5(2):55-65. [Persian].
27. Cook R, Rasmussen J. “Going solid”: a model of system
dynamics and consequences for patient safety. Qual Saf Health
Care. 2005;14(2):130-4. doi: 10.1136/qshc.2003.009530.
28. Mosadeghrad AM, Arab M, Shahidi Sadeghi N. A survey
of clinical governance success in Tehran hospitals. Hakim
Research Journal. 2016;19(3):129-40. [Persian].
29. Kavosi Z, Setoodehzadeh F, Fardid M, Gholami M, Khojastefar
M, Hatam M, et al. Risk Assessment of the Processes of
Operating Room Department using the Failure Mode and
Effects Analysis (FMEA) Method. Hospital. 2017;16(3):57-70.
30. Khanna N, Shaya FT, Gaitonde P, Abiamiri A, Steffen B, Sharp
D. Evaluation of PCMH Model Adoption on Teamwork and
Impact on Patient Access and Safety. J Prim Care Community
Health. 2017;8(2):77-82. doi: 10.1177/2150131916678496.
31. Zagheri Tafreshi M, Rassouli M, Zayeri F, Pazookian M.
Development of nurses’ medication error model: mixed
method. Quarterly Journal of Nersing Management.
2014;3(3):35-50. [Persian].
32. Edwards MT. An Organizational Learning Framework for
Patient Safety. Am J Med Qual. 2017;32(2):148-55. doi:
33. Institute for Healthcare Improvement (IHI). SBAR Tool:
Situation, Background, Assessment, Recommendation.
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