Introduction: Up to the present, the most complaints are about medical malpractice in anesthesia - surgury wards. To identify defects and promot patient safety, an efficient and effective system of risk management is necessary. The aim of this study is to determine anesthesia- surgury risk management and root cause analysis of events in Isfahan University of Medical Sciences hospitals.
Methods: A standard structured checklist that has been developed by ECRI institute was applied. The checklists were filled onsite through direct observation and interviews with anesthesia and surgical personnel in 46 operating rooms at 4 hospitals. Data were analyzed by SPSS, Excel and Minitab software. Root causes of events were plotted using Fish Bone diagram.

  Results: Total means score of anesthesia- surgery risk management status was 2.13 on the scale of 3 which is at the intermediate level . There was a significant difference between the four hospitals. These hospitals only met 45% of the predetermined standards. The highest compliance with standards (69%) was for "Anesthesia and surgical equipment" while the lowest with 11% was for "Training in risk management".

  Conclusion: The results of this study developed a list of factors leading to risks and errors in anesthesia - surgical wards. The results can be used in benchmarking hospitals and performing educational and managerial interventions. Also, these results can lead to the development of a clinical guideline that could be mandated by by policymakers to reach the final goal of health care systems, i.e. promotion of patient safety and provision of consumer satisfaction.