Analyse des risques a priori du processus de prise en charge des patients en radiothérapie : exemple d’utilisation de la méthode Amdec

Meyrieux, C.; Garcia, R.; Pourel, N.; Mège, Alice; Bodez, V.

doi:10.1016/j.canrad.2012.07.188

Cited by 21 publications

(6 citation statements)

References 9 publications

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“…12 In this study, the a priori analysis of risks associated with the medication-use process for temperature-sensitive drugs was carried out by the FMECA method because it is the most suitable method for the hospital setting, according to several previous studies. 9,[13][14][15] It has been recommended by the French Haute Autorité de Santé (National Authority for Health) 16 as a reference method for risk analysis and has been recommended by several other health organizations, in particular the Institute for Healthcare Improvement, 17 the Institute for Safe Medication Practices Canada, 18 and the American Association of Physicists in Medicine. 19 The FMECA method is based on the concept of brainstorming.…”

Section: Discussionmentioning

confidence: 99%

“…The FMECA involved 6 steps: training, functional analysis, qualitative study, quantitative study, determination of the hierarchy of criticality, and proposals for improvement. [8][9][10] Step 1: Training the Team A multidisciplinary working group was trained to ensure consistency in the discussion and rating of failure modes. The group was made up of 8 members: 2 pharmacists (H.S., K.B.J.…”

Section: Study Design and Settingmentioning

confidence: 99%

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Application of Failure Mode, Effects, and Criticality Analysis to the Medication-Use Process for Temperature-Sensitive Drugs in a University Hospital

Sakly

Chakroun²,

Jeddou

2022

CJHP

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Background: In the hospital setting, the medication-use system for temperature-sensitive drugs is a high-risk process. Objectives: To analyze the risks associated with the hospital-based medication-use process and to propose corrective and preventive actions for the most critical failure modes. Methods: A multidisciplinary team was trained to analyze the medication-use process for temperature-sensitive drugs and to identify potential failures using a risk analysis method known as failure mode, effects, and criticality analysis (FMECA). The medication-use process, from initial supply to administration to patients, was investigated using “the 5 Ws and How” method (Who? What? Where? When? Why? How?), and the causes of the failure modes were analyzed using Ishikawa diagrams. The most critical failure modes were selected using the Pareto law, and relevant improvement actions were proposed. Results: This analysis identified 41 failure modes for the 9 stages of the medication-use process, of which only 36 were deemed assessable by the participants. Eighteen (50%) of these failure modes were critical, according to the Pareto law, with criticality indices between 12 and 60. The stage of tidying up and storage in patient care units had the highest number of critical failures (n = 5). A total of 48 corrective actions were proposed. Conclusion: The proposed action plan prioritized 3 areas for improvement: the documentation system, staff training, and equipment acquisition. A second FMECA should be carried out to reassess the medication-use process after implementation of these improvement actions. The second FMECA, allowing detection of residual risks and identification of new risks, will be part of a continuous improvement process. RÉSUMÉ Contexte : Le circuit des médicaments thermosensibles en milieu hospitalier fait partie des processus à risque. Objectifs : Analyser a priori les risques liés à ce circuit et proposer des actions correctives et préventives contre les modes de défaillances les plus critiques. Méthodes : Une équipe pluridisciplinaire a été formée pour analyser le circuit des médicaments thermosensibles et identifier les défaillances par la méthode de l’analyse des modes de défaillances, de leurs effets et de leurs criticités (AMDEC). Le processus, qui va de l’approvisionnement jusqu’à l’administration des médicaments aux patients, a été décortiqué en utilisant la méthode « Qui? Quoi? Où? Quand? Comment? Pourquoi? » (QQOQCP) et les causes des défaillances ont été analysées à l’aide de diagrammes d’Ishikawa. Les défaillances les plus critiques ont été sélectionnées par la loi de Pareto, et des mesures d’amélioration pertinentes ont été proposées. Résultats : Cette analyse a mis en évidence 41 modes de défaillances pour les 9 étapes du circuit, dont uniquement 36 sont jugés évaluables par les membres de l’équipe pluridisciplinaire. Dix-huit modes sur 36 (soit 50 %) sont critiques selon la loi de Pareto, avec des indices de criticité répartis entre 12 et 60. L’étape comprenant le nombre le plus élevé de défaillances critiques est celle du rangement et du stockage dans les services de soins, avec 5 défaillances. Au total, 48 mesures correctives ont été proposées. Conclusions : Le plan d’action proposé priorisait 3 domaines d’amélioration : le système de documentation, la formation du personnel et l’acquisition d’équipements. Une deuxième AMDEC devrait être réalisée pour réévaluer le circuit après la mise en œuvre des mesures d’amélioration. La deuxième AMDEC permettra la détection des risques résiduels et l’identification de nouveaux risques et s’inscrira dans une démarche d’amélioration continue.

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Section: Discussionmentioning

confidence: 99%

Section: Study Design and Settingmentioning

confidence: 99%

Application of Failure Mode, Effects, and Criticality Analysis to the Medication-Use Process for Temperature-Sensitive Drugs in a University Hospital

Sakly

Chakroun²,

Jeddou

2022

CJHP

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“…FMEA is a proactive risk assessment tool used to identify potential vulnerabilities in complex, high-risk processes and to generate remedial actions to counteract them before they result in adverse events. It is generally acknowledged to be a useful tool available to health professionals for assessing and improving healthcare processes [ 27 , 28 , 29 ]. It is a good systematic technique that prospectively identifies, evaluates, prioritizes, and eliminates potential failure modes and effects to improve the safety, reliability, and quality of healthcare processes [ 30 , 31 , 32 , 33 , 34 ].…”

Section: Introductionmentioning

confidence: 99%

Integrating Quality Tools and Methods to Analyze and Improve a Hospital Sterilization Process

2021

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Healthcare facilities are facing major issues and challenges. Hospitals continuously search approaches to improve operations quality, optimize performance, and minimize costs. Specifically, an efficient hospital sterilization process (HSP) allows reusable medical devices (RMDs) to be more quickly available for healthcare activities. In this context, this paper describes an integrated approach developed to analyze HSP and to identify the most critical improvement actions. This proposed approach integrates four quality tools and techniques. Firstly, a structured analysis and design technique (SADT) methodology is applied to describe HSP as a hierarchy of activities and functions. Secondly, the failure modes and effects analysis (FMEA) method is used as a risk assessment step to determine which activity processes need careful attention. Thirdly, a cause–effect analysis technique is used as a tool to help identify all the possible improvement actions. Finally, priority improvement actions are proposed using the quality function deployment (QFD) method. To validate the proposed approach, a real sterilization process used at the maternity services of Hedi-Cheker Hospital in the governorate of Sfax, Tunisia, was fully studied. For this specific HSP, the proposed approach results showed that the two most critical activities were (1) improving the coordination between the sterilization service and the surgery block and (2) minimizing the average duration of the sterilization process to ensure the availability of RMDs in time.

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“…In nuclear power, safety analysis consists of ensuring the validity of each confinement barrier, its independence, and its correct operation under normal and accident conditions (Couturier, 2020). Since the occurrence of serious accidents in radiation therapy in France, this concept of safety barrier is used to evaluate the technical and human provisions defined to make this care process safe (Meyrieux et al, 2012;François et al, 2010;Pernet 2013;Reitz, 2014;Brusadin et al, 2017;Thellier, 2017) This article focuses on the human safety barriers deployed in radiation therapy, i.e. validation, control, and verification actions (measurements, calculations, tests) that ensure that the right dose is delivered to the right patient, at the right time and in the right place.…”

Section: Introductionmentioning

confidence: 99%

Radiotherapy risk management: Going beyond the concept of safety barriers

Thellier

Poret

Carminati³

2021

Radioprotection

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The traditional approaches to safety in risk activities have been applied to radiotherapy following the occurrence of serious accidents. This strategy is based on the characterization of specific risks and the definition of preventive and protective measures, particularly for the implementation of safety barriers. Evaluating the performance of safety barriers makes it possible, in theory, to determine the level of risk control. This article presents a literature review that highlights the limits of the safety barrier concept. To overcome these limitations, we then introduce the notion of “activities contributing to safety” (ACS). This concept allows us to better take into account the managerial, contextual, organizational and human dimensions of safety and to promote risk control through a more realistic approach.

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Analyse des risques a priori du processus de prise en charge des patients en radiothérapie : exemple d’utilisation de la méthode Amdec

Cited by 21 publications

References 9 publications

Application of Failure Mode, Effects, and Criticality Analysis to the Medication-Use Process for Temperature-Sensitive Drugs in a University Hospital

Application of Failure Mode, Effects, and Criticality Analysis to the Medication-Use Process for Temperature-Sensitive Drugs in a University Hospital

Integrating Quality Tools and Methods to Analyze and Improve a Hospital Sterilization Process

Radiotherapy risk management: Going beyond the concept of safety barriers

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