Designing the Infrastructural Model for Smart Hospitals in Iran; a Mixed-Methods Approach

Introduction: The smartification of hospitals has the potential to enhance the quality of services, ensuring faster and more efficient healthcare delivery while improving the tracking and security of hospital equipment. We aimed to design an infrastructural model for smart hospitals in Iran. Methods: A mixed-methods approach was used combining qualitative Grounded Theory and quantitative descriptive-survey methods. The qualitative phase involved in-depth semi-structured interviews with 12 experts familiar with hospital smartification concepts. In the quantitative segment, 412 participants, including senior healthcare managers, IT specialists, hospital administrators, technology experts, and university faculty members, were surveyed using a structured questionnaire. Statistical analyses, including Kolmogorov-Smirnov and independent t-tests, were conducted, and a structural equation model was developed using SPSS 21 and LISREL 8.5 software. Results: In the qualitative phase, 135 initial codes and 22 subcategories were identified, eventually consolidated into six main categories: information and communication infrastructures, advanced medical technologies, hospital management, trained human resources, financial resources, and monitoring and control systems. The highest coefficient belonged to the information and communication infrastructures (F1) with a value of 94.3, while the lowest was related to monitoring and control (E5) with a value of 65.0, all indicating significant relationships among the dimensions of hospital smartification. Conclusion: Based on the findings, information and communication infrastructures; advanced medical facilities and technologies; human resources; management; monitoring and control systems; and financial resources were identified and validated as six main infrastructures of smart hospital in Iran

Assessing barriers to medical errors reporting among clinical staff members of teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences in Tehran - 2016

Background and Aims: One of the most important issues in the health sector is quality of care. Error reporting is essential to prevent errors and to learn from them. The aim of this study was to identify barriers to errors reporting in order to eliminate these barriers and to improve and encourage error reporting amongclinical staff members.Materials and Methods: In this cross-sectional study, 419 clinical staff members of teaching hospitals under the auspices of Shahid Beheshti University of Medical Sciences were selected using the multistage sampling method. The instrument for data collection was a researcher-developed questionnaire containing29 items and its validity and reliability were confirmed. Data were analyzed using SPSS 20 software and statistical tests. Ethical issues such as confidentiality of studied community were all considered.Results: The overall mean of barriers to errors reporting in our study was 3.13 of 5 which was at moderate level. Fear of error reporting consequences with mean score of 3.37 and staff attitudes with mean score of 2.70 were identified as the most important and less important barriers to error reporting. There wassignificant relationship between barriers to error reporting with staffs, educational level and their working shift (p < 0.05) so that barriers to error reporting was higher among physicians (3.39) and night shift (3.22) workers.Conclusion: The main barrier to error reporting was identified as the fear of error reporting consequences. Managers should have a nonpunitive approach to errors in the hospital so staff would report their errors voluntarily. By increasing the available data through error reporting, learning from errors is increased, and changes in hospital processes occurs.Keywords: Medical error, Error reporting, patient safety, Hospita

Unintentional Home Injury Prevention in Preschool Children; a Study of Contributing Factors

Introduction: Different factors such as parents’ knowledge and attitudes regarding preventive measures (PM) have a great role in reducing children unintentional home injuries. The present study aims to evaluate the contributing factors of unintentional home injury prevention in preschool victims presented to the emergency department. Methods: The subjects consisted of all the mothers of preschool children who were presented to the emergency department of Imam Hossein and Shohadaie-Hafte-Tir Hospitals, with unintentional home injuries, from March 2011 to February 2012. The participants were divided into two groups according to implementation of preventive measures status. The significant confounding factors of PM application was determined by chi-squared test and entered into the backward multivariate logistic regression model. Results: 230 mothers with the mean age of 29.4 ± 5.2 years were evaluated. 225 (97.83%) of them were still married, 74 (32.17%) had high school education or higher, 122 (53.04%) were homemakers, and 31 (13.49%) worked outside the home for at least 8 hours daily. High level of knowledge (OR = 0.05; 95% CI: 0.002‒0.32; P = 0.002), appropriate attitude (OR = 0.12; 95% CI: 0.03‒0.51; P = 0.01), having at least three children (OR = 7.2; 95% CI: 1.1‒32.9; P = 0.04), daily absence of mother for at least 8 hours (OR = 9.2; 95% CI: 2.2‒35.46; P = 0.002), and a history of home injury during the previous 3 weeks (OR = 8.3; 95% CI: 2.1‒41.3; P = 0.001) were independent factors which influenced application of preventive measures. Conclusion: Increasing mothers’ knowledge level and improving their attitudes were facilitating factors and mothers’ absence from the house for more than 8 hours a day and having at least 3 children were obstacles to application of preventive measures. In addition, a history of same injury during the previous 3 weeks increased the risk of repeated event

Identifying effective factors on the management of medication errors in hiv/aids patients in Iran's health system using structural equation modeling

Background: One of the centers that provide health services and treatment for HIV/AIDS patients is behavioral disease counseling centers. Today, patient safety and treatment combined with compliance with ethical and legal standards are among the most important concerns of medical and health centers, including the most important criteria for the credibility of an institution. In the meantime, medication errors in HIV/ AIDS patients lead to treatment disruption, drug poisoning, or even death. Considering the importance of the subject, the present research was conducted to identify and explain the factors affecting the management of medication errors in HIV/AIDS patients in Iran's health system. Methods: The present study is an applied study that was performed by descriptive method. First, by reviewing the research literature and interviewing 35 experts in the field of HIV / AIDS treatment, the variables and main components affecting the management of medication errors in HIV / AIDS patients were extracted and a research questionnaire was designed using them. Data were collected from 400 experts and specialists in infectious diseases, etc. Then, the collected data were analyzed using structural equation modeling, and SPSS23 software and LISREL software. Results: Four factors were identified as effective factors in medication error management in HIV/AIDS patients: organizational, educational, individual, and communication factors. Organizational factors and communication factors with a factor loading of 0.763 and 0.646 had the highest and lowest impact on drug error management in HIV / AIDS patients, respectively. Conclusion: To efficiently and effectively manage medication errors in HIV / AIDS patients, while considering all four factors, organizational and educational factors should be given more attention and emphasis by managers

Factores que afectan la independencia de la gestión hospitalaria en University of Medical Science en Iran

Introduction: Governmental hospitals have so far managed in different ways to increase the efficiency of hospitals, each of which has its disadvantages and advantages. This study aimed to determine the factors affecting the independence of hospital management in Iran University of Medical Science. Material and Methods: This descriptive-survey study was conducted pragmatically at hospitals of Iran University of Medical Sciences to identify obstacles and provide the necessary infrastructure by conducting study and follow-up. The sample was 94 people including university dean, deputies and chief executives of hospitals, educational and research deputies, therapists and professionals. Questionnaire was used as data collection tools and field data collection method. Results: The mean age of participants was 47.24 ± 5.41 years. Cronbach's alpha of 41 questions was assessed to test the reliability of the questionnaire. The total alpha coefficient was 0.843. The results showed that the mean score of all domains based on experience time was not significantly different (p> 0.05). The mean score of all domains in the first and third items based on education was statistically significant (p <0.05). In other items, there was no significant difference based on education level (p> 0.05). Conclusion: In general, according to the results and extracted five items, the independence of hospital management can improve the efficacy of services and satisfy the patients and staff.Introducción: Los hospitales gubernamentales hasta ahora se han manejado de diferentes maneras para aumentar la eficiencia de los hospitales, cada uno de los cuales tiene sus desventajas y ventajas. Objetivo: determinar los factores que afectan la independencia de la gestión del hospital en la Universidad de Ciencias Médicas de Irán. Material y métodos: este estudio de encuesta descriptiva se realizó pragmáticamente en los hospitales de la Universidad de Ciencias Médicas de Irán para identificar obstáculos y proporcionar la infraestructura necesaria mediante la realización de estudios y seguimiento. La muestra fue de 94 personas, incluidos decanos universitarios, diputados y directores ejecutivos de hospitales, diputados de educación e investigación, terapeutas y profesionales. El cuestionario utilizó como herramientas de recolección de datos y método de recolección de datos de campo. Resultados: La edad media de los participantes fue de 47,24 ± 5,41 años. Se evaluó el alfa de Cronbach de 41 preguntas para evaluar la fiabilidad del cuestionario. El coeficiente alfa total fue de 0,843. Resultado: Los resultados mostraron que la puntuación media de todos los dominios basada en el tiempo de experiencia no fue significativamente diferente (p> 0,05). La puntuación media de todos los dominios en el primer y tercer ítems basados ​​en educación fue estadísticamente significativa (p <0,05). En otros ítems, no hubo diferencias significativas en función del nivel educativo (p> 0,05). Conclusión: En general, de acuerdo con los resultados y extraídos cinco ítems, la independencia de la gestión hospitalaria puede mejorar la eficacia de los servicios y satisfacer a los pacientes y al personal

بررسی موانع گزارش دهی خطاهای پزشکی از دیدگاه کارکنان بالینی بیمارستان‌های آموزشی دانشگاه علوم پزشکی شهید بهشتی در شهر تهران 1395

Background and Aims: One of the most important issues in the health sector is quality of care. Error reporting is essential to prevent errors and to learn from them. The aim of this study was to identify barriers to errors reporting in order to eliminate these barriers and to improve and encourage error reporting amongclinical staff members.Materials and Methods: In this cross-sectional study, 419 clinical staff members of teaching hospitals under the auspices of Shahid Beheshti University of Medical Sciences were selected using the multistage sampling method. The instrument for data collection was a researcher-developed questionnaire containing29 items and its validity and reliability were confirmed. Data were analyzed using SPSS 20 software and statistical tests. Ethical issues such as confidentiality of studied community were all considered.Results: The overall mean of barriers to errors reporting in our study was 3.13 of 5 which was at moderate level. Fear of error reporting consequences with mean score of 3.37 and staff attitudes with mean score of 2.70 were identified as the most important and less important barriers to error reporting. There wassignificant relationship between barriers to error reporting with staffs, educational level and their working shift (p < 0.05) so that barriers to error reporting was higher among physicians (3.39) and night shift (3.22) workers.Conclusion: The main barrier to error reporting was identified as the fear of error reporting consequences. Managers should have a nonpunitive approach to errors in the hospital so staff would report their errors voluntarily. By increasing the available data through error reporting, learning from errors is increased, and changes in hospital processes occurs.زمینه و اهداف: یکی از مهمترین موضوعات در بخش سلامت، کیفیت ارائه مراقبتها میباشد. گزارش دهی خطاها برای پیشگیری و یادگیری از خطاها ضروری است. هدف این مطالعه، شناسایی موانع گزارش دهی خطاها در جهت رفع موانع و بهبود و تشویق گزارش دهی در کارکنان بالینی بود. مواد و روشها: در این مطالعه مقطعی، 419 نفر از کارکنان بالینی بیمارستانهای آموزشی منتخب دانشگاه علوم پزشکی شهید بهشتی به روش نمونه گیری چند مرحلهای انتخاب شدند. ابزار جمع آوری داده ها، پرسشنامه محقق ساخته 29 موردی موانع گزارش دهی خطا بود که روایی و پایایی آن مورد تایید قرار گرفت. دادهها با استفاده از نرم افزار SPSS20 و آزمونهای آماری تجزیه و تحلیل شد. در کلیه مراحل انجام پژوهش، موازین اخلاقی نظیر محرمانه ماندن نام کارکنان بالینی، مراعات گردید . یافته ها: میانگین کل موانع گزارش دهی خطا 3/13از 5 بود که در سطح متوسطی قرار داشت. ترس از پیامدهای گزارش دهی با میانگین 3/37و نگرش کارکنان با میانگین 2/70بعنوان مهمترین و کم اهمیت ترین موانع گزارش دهی خطا شناسایی شدند. موانع گزارش دهی با سطح تحصیلات و شیفت کاری رابطه معناداری داشت p<0.05به طوری که موانع گزارش دهی در بین پزشکان و افراد شیفت شب بیشتر بود. نتیجه گیری: مانع اصلی گزارش دهی خطا، ترس از پیامدهای گزارش دهی بود. مدیران باید رویکرد غیرتنبیهی به خطا در بیمارستان داشته باشند تا کارکنان داوطلبانه خطای خود را گزارش کنند. با افزایش دادههای موجود از طریق گزارش دهی، یادگیری از خطاها افزایش یافته و تغییراتی در فرایندهای بیمارستانی ایجاد میشود

The Relationship between Patient Safety Culture and Barriers to Medical Errors Reporting Among Nurses in Tehran Hospitals

Background & Objectives: According to World Health Organization, patient safety is a serious public health issue, an important aspect of the quality of health care, and a vital prerequisite for universal health coverage. The objective of this study was to investigate nurses' perceptions of patient safety culture (PSC), barriers to medical error reporting, as well as the relationship between the two. Methods: This descriptive-analytical study was conducted in six public hospitals in Tehran on 420 nurses who were selected using multistage sampling. The Hospital Survey on Patient Safety Culture (HSOPSC) and a researcher-made questionnaire on barriers to medical error reporting were utilized. Data were analyzed using correlation tests, t-test, analysis of variance (ANOVA), and multivariate regression analysis using SPSS software (version 20). Results: The mean score of patient safety culture was 52.01 and the mean score of barriers to error reporting was 3.13. Manager expectations and actions had the highest mean score (69.8) and non-punitive response to errors had the lowest mean score (23.6) among the dimensions of patient safety culture. Fear of the consequences of reporting an error was the most important perceived barrier to error reporting (3.37). There was a significant negative correlation between safety culture and perceived barriers to error reporting (P<0.001). Conclusion: Setting up an anonymous reporting system as well as increasing managers' support for error reporting and providing positive feedback to nurses are essential steps to improve error reporting. Key¬words: Patient Safety Culture, Error Reporting, Medical Error, Teaching Hospital Citation: Daneshkohan A, Mahfoozpour S, Palesh M, Fazli Ouchhesar B, Fazali Ouchhesar F. The Relationship between Patient Safety Culture and Barriers to Medical Errors Reporting Among Nurses in Tehran Hospitals. Journal of Health Based Research 2020; 5(4): 435-50. [In Persian

Attitudes of Health Care providers toward Teamwork, Safety Climate and knowledge

ABSTRACTBackground and aim: According to importance of occupational health for health care providersand patient safety in hospitals, implementation of safety culture with teamwork is an acceptableprinciple.This study aims to assess attitude of health care providers toward teamwork, safetyclimate and knowledge transfer through team collaboration at an educational medical center in.2009.Method and materials: This was a descriptive study. All 225 resident physicians, nurses and otherparamedics of an educational hospital of Tehran participated in the study. The tool for datacollection was the Safety Attitudes Questionnaire (SAQ). Content validity and reliability of thequestionnaire was assessed and confirmed. Data was analyzed using SPSS 16 and Chi square test.Results:The results demonstrated that 59% of nurses, 52% of physicians and 58%of paramedicsbelieved that tasks are performing by teamwork. 30% of nurses, 21% of physicians and 39 % ofparamedics had a sense of safety in workplace. 78% of nurses, 55 % of physicians and 73% of otherparamedics believed that knowledge could transfer through team collaboration. Amongdemographic characteristics there were significant relationship between attitude of health careproviders on teamwork with their marital status (p=0.001); attitude of health care providers onsafety climate with their work experience (p=0.04); attitude of health care providers on knowledgetransfer trough teamwork with organizational position (p=0.016).Conclusion: Attitude assessment of health care providers toward teamwork, safety climate andpatients' or health care providers' safety is necessary to modify and improve the current deficits andto achieve to the culture of learning from errors. Managers can have an appropriate guide toestablish safety culture with this sort of attitude assessments.Keywords : Teamwork, Safety Climate, Patient Safety, Knowledge Transfer.REFERENCES-Blegen M Pepper G Rosse J (2005). Safety climate on hospital units: A new measure. Advances in Patient Safety:From Research to Implementation, Agency for Health Research and Quality Safety. 4: 429-443.-Felknor SA et al (2000). Safety climate and its association with injuries and practices in public hospitals in Costa Rica .International Journal of Occupational and Environmental Health. 6 (1) 2-18.-Gerson RM et al (2000). Hospital safety climate and its relationship with safe work practices and work place exposureincident. AJIC: American Journal of Infection Control. 28 (3) 211-227.-Joint Comission on Accreditation of Health Care Organizations (2005). Hospital's National Patient Safety Goals [online] http://www.jointcommission.org/ [9July2012]-Kevin J et al (2008). Hospitalists use teamwork to improve care, increase efficiency in hospital .Human ResourceManagement Journal. 47 (3) 621-61.-Kaya S et al (2000). Variation in caregiver perceptions of teamwork climate and safety climate in a tertiary carehospital in Turkey .24th International Society for Quality in Health Care Conference. September 30 - October 3, 2007,Boston, USA.-Kohn LT et al (1999). To err is human: building a safer health system. A report of the committee on quality of healthcare in America ,Institute of Medicine .Washington DC .National Academy Press.Leonard M Graham S Bonacum D (2004). The human factor: the critical importance of effective teamwork andcommunication in providing safe care. Quality and Safety in Health Care. 13 (1) 85-90.Meterko M et al (2004). Teamwork culture and patient satisfaction in hospitals. Medical Care. 42(5) 492-498.Pronovost PJ Sexton B (2005). Assessing safety culture: Guidelines and recommendations. Quality and Safety in HealthCare. 4 (14) 231-233.-Gershon R et al (2000). Hospital safety climate and its relationship with safe work practices and workplace exposureincidents. American Journal of Infection Control 28 (3) 211-221.-Rudman WJ et al (2006). Teamwork and safety culture in small rural hospitals in Mississippi. Patient Safety andQuality Healthcare, November/December 2006, Available Online: http://www.psqh.com/novdec06/mississppi.html.-Sexton JB et al (2000). Error ,stress and teamwork in medicine and aviation :cross sectional surveys. British MedicalJournal. 320 (7237) 745-9-Sexton JB et al (2003). The safety attitude questionnaire: guidelines for administration. The University of Texas Centerof Excellence for Patient Safety Research and Practice, University of Texas, 99-108-Sexton J B et al (2006). Variation in caregiver perceptions of teamwork climate in labor and delivery units. Journal ofPerinatology. 26 (8) 463-70-Shosteck K (2005). Improve patient safety Teamwork takes hold to. The Risk Management Reporters. 24 (1) 1-24.-Safety Attitude Questionnaire SAQ (2012) Team- work and safety climate, Texas University, Center for Health Carequality and safety [on line] http://www.uth.tmc.edu/schools/med/imed/patient_safety/documents/Survey-SAQTeamwork-Safety-Climate%20.pdf (23/7/2012)-Spencer M (2008). Safety climate surveys-experience from SPI [online] http//:www.wales.nhs.uk/sites3/docopen.cfm-Vincent C Taylor-Adams S Stanhope N (1998). Framework for analyzing risk and safety in clinical medicine. BritishMedical Journal. 316 (7138)1154-1157

The Relationship between Occupational Stress & Related Injuries among Physician’s Assistants: A Case-Control Study

 Background and Objective: Job stress can have a direct impact on the incidence of work-related injuries and unsafe behavior and the highest rates of occupational injuries are in the health professions. Therefore, as we did not find any studies regarding the physician's assistants job stress; this research was performed to determine the relationship between job stress and occupational injuries among physician's assistants working at different units of hospitals affiliated to Shahid Beheshti University of Medical Sciences. Materials and Methods: This analytical study (case – control) was performed among physician's assistants working at 5 hospitals affiliated to Shahid Beheshti University of Medical Sciences. 50 cases (with occupational injuries) were compared with 50 controls (without occupational injuries) about job stress. Job stress was measured by Osipow questionnaire with 6 domains; validity (content) and reliability, were confirmed by Cronbach's alpha = 0.89. The Mann-Whitney test for comparison of means and chi-square test for comparison of proportions were used. Results: The mean stress scores did not show significant difference between the two groups in all domains except in role ambiguity and role boundary. After grouping stress scores, we observed significant differences in all domains, except in the responsibility (p=0.11). The stress score due to responsibility was very high for case (84.6%) and control (71.4%) groups. Maximum odds ratio was estimated in the role ambiguity field (OR= 8.36). Conclusion: Because of some unavoidable stressors in medical practice and the necessity of preventing mental and behavioral effects of stress; implementing measures and actions to improve the quality of working life, education and coping strategies, are the duties of the departments, and the director of the hospital, in order to maintain the health of the current staff and to prevent their displacement. REFERENCES1- Khalilzadeh R, Yavarian R, Khalkhali H. The Relationship of Job Stress, Depression and Anxiety of Nursing Staff of Urmia University of Medical Sciences.UNMF. 2005;3(1):10-7. [Full Text in Persian].2- Abedini S. Occupational stress in nurses working in hospitals in Bandar Abbas on 2003. Faslnamedena. 2006;2(3). [Full Text in Persian].3- Mcgrath A, Reid N, Boore. Occupational stess nursing.Int J Nurse Stud. 2003;40(5):555-65.4- Breslow M. The role of stress hormones in preoperative myocardial ischemia.IntAnesthesiolclin. 1992;30(1):81-100.5- Thorbjornsson C, Alfredsson L, Fredriksson K, Koster M, Michelsen E, Vingard. Psychosocial and physical risk factors associated with low back pain: a 24-year fallow up among women and men in a broad range of occupations. B Med J. 1998;55(2):84-90.6- Winkleby M, Rangland D, Syme S. Self-reported stressors and hypertension: evidence of an inverse association. Amer J Epidemiol. 1998;127(1):124-34.7- Soori H, Rahimi M, Mohseni H. Association between Job Stress and Work-Related Injuries: A Case-Control. irje. 2006;1(3 and 4):53-8. [Full Text in Persian].8- Bahraini A, Ghasemi M, Sabah A. Study of stress in a group of specialists and residents from different fields ShahidBeheshti University of Medical Sciences. TebvaTazkieh. 2005;85. [Full Text in Persian].9- Karin E, Tore G, Tyssen R, Olaf G. Counseling for burnout in Norwegian doctors: one year cohort study. BMJ. 2008;337.10- Bahribinabaj N, Moghimian M, Atarbashi M, Gharche M. The relationship between burnout and mental health in nurses and midwiferies.Ofogh-e-Danesh 2003;9(1):99-104. [Full Text in Persian].11- Knesebeck O, Klein J, KG KF. Psychosocial Stress Among Hospital Doctors in Surgical Fields. DtschArztebl Int. 2010;107(14):248–53.12- Ghods A, Alhani F, Anosheh M, M MK. Epidemiology of occupational accidents in Semnan (2002-2006). koomesh. 2009;10(2):95-100. [Full Text in Persian].13- Kooranian F, Khosravi A, Esmaeeli H. The relationship between hardiness/ locus of control and burnout in nurses.Ofogh-e-Danesh. 2008;14(1):58-67. [Full Text in Persian].14- Kabirzadeh A, Mohsenisaravi B, Asghari Z, Bagherianfarahabadi E, Bagerzadehladari R. Rate of General Health, Job Stress and Factors in Medical Records Workers. Journal of Health Information Management. 2007;4(2):215-2. [Full Text in Persian].15- Osipow S, Spokane A. Occupational stress inventory Psychological. Gesundheitswesen. 2002;64:259-66.16- Abdi H, Kalani Z, Harazy M. Occupational stress in nurses. JSSU. 2000;8(4):17-21. [Full Text in Persian].17- Abdi H, Shahbazi L. Occupational stress in nurses working in ICU and its relationship to burnout. JSSU. 2001;9(3):58-63. [Full Text in Persian].18- Rahmani F, Behshid M, Zamanzadeh V, Rahmani F. Relationship between general health, occupational stress and burnout in critical care nurses of Tabriz teaching hospitals. IJN. 2010;23(66):54-63. [Full Text in Persian].19- Falkum E. Time stress among Norwegian physicians. pidsskr nor Lange furan. 1997;117(7):954- 9.20- Abdi H, Shahbazi L. occupational stress in nurses. Yazd Univ Med Sci J. 2008;8(4):17-21. [Full Text in Persian].21- Sharifian S, Aminian O, Kiyani M, Barouni S, Amiri F. The evaluation of the degree of occupational stress and factors influencing it in forensic physicians working in Legal Medicine Organization in Tehran in the autumn of 2005. 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Feasibility of Using Economic Evaluation Evidence in Pharmaceutical Sector of the Iranian Health System: A Stakeholder Perspective

Background. Economic evaluation evidence can improve policies and decision-making processes in medicine and health system, prevent wastage of resources caused by trial and error, and facilitate the patients' access to medications. Therefore, the present study aimed to explore the feasibility of using economic evaluation evidence in the Iranian pharmaceutical sector. Methods. In this qualitative study, 29 stakeholders selected by purposeful sampling were interviewed using semi-structured interviews. The statistical population consisted of 29 experts in the fields of pharmacology, management, policymaking, and health economics. The inclusion criteria for participants included being employed in decision-making fields, having a minimum of a master's degree, as well as possessing sufficient and comprehensive knowledge of the subject matter. The interviews were analyzed adopting content analysis method, and the data were coded using the MAXQDA 11 software. Results. In order to identify the obstacles and facilitators of the application of economic evaluation evidence in medicine and health system, the study findings were extracted from three main sections (i.e., characteristics of production and extraction of evidence and information, mechanisms and requirements of using evidence, opportunities and benefits of using evidence) and 11 sub-sections of the identification. Conclusion. In sum, implementing all identified facilitators and mechanisms needed to establish a robust foundation was found extremely important for correcting an economic evaluation and evidence-based management. Removing the obstacles to an evidence-based management was also found crucial for creating an enabling environment required to implement the evidence-based practices effectively and for facilitating the production and utilization of evidence sources