Comparação entre Métodos de Priorização de Riscos em Radioterapia

Abstract

Ferramentas de gerenciamento de risco proativas, como Análise de Modo de Falha e Efeito (Failure Mode and Effects Analysis – FMEA), foram importadas da engenharia e têm sido amplamente utilizadas na Radioterapia. Uma etapa importante desse processo é a priorização de riscos e muitos são os métodos para realizá-la. Esse trabalho compara a priorização de riscos da fase de planejamento computadorizado em implantes intersticiais com braquiterapia de alta taxa de dose realizada com os métodos de Análise de Modo de Falha e Efeito na Saúde (Health Care Failure Mode and Effects Analysis – HFMEA) e FMEA com diretrizes dadas pelo Task Group 100 (TG 100) da Associação Americana de Físicos em Medicina. Dos 33 possíveis modos de falha desse processo, 21 demandam maior atenção quando avaliados por HFMEA e 22 quando avaliados por FMEA TG 100. Apesar da grande coincidência entre os métodos, HFMEA se mostrou mais simples em sua execução.

Ferramentas para a organização do processo de trabalho na segurança do paciente

“…23,28 Then, the severity and frequency of failure modes are determined and the Hazard Score is checked. 14 The Hazard Score severity rating and its values include "catastrophic" (4), "critical" (3), "moderate" (2) and "negligible" (1). 14,23 The probability categories include "frequent" (often in one year), "occasional" (often in two years), "rare" (sometimes between two and five years), and "remote" (five to 30 years), also adopting values of four to one, respectively.…”

“…14 The Hazard Score severity rating and its values include "catastrophic" (4), "critical" (3), "moderate" (2) and "negligible" (1). 14,23 The probability categories include "frequent" (often in one year), "occasional" (often in two years), "rare" (sometimes between two and five years), and "remote" (five to 30 years), also adopting values of four to one, respectively. 14,23 Severity and probability values should be multiplied and the Hazard Sore Matrix score category observed.…”

“…14,23 The probability categories include "frequent" (often in one year), "occasional" (often in two years), "rare" (sometimes between two and five years), and "remote" (five to 30 years), also adopting values of four to one, respectively. 14,23 Severity and probability values should be multiplied and the Hazard Sore Matrix score category observed. 14,23,28 The Decision Tree is the one in which, among the failure modes raised, those with greater criticality, low control effectiveness and little detection are verified, that is, scores equal to or greater than eight.…”

“…14,23 Severity and probability values should be multiplied and the Hazard Sore Matrix score category observed. 14,23,28 The Decision Tree is the one in which, among the failure modes raised, those with greater criticality, low control effectiveness and little detection are verified, that is, scores equal to or greater than eight. 14,23 As a criticality, we understand the impact of failure at a certain point in the process, checking whether it is a point of weakness that, when occurring in isolation, generates the error and destabilizes the workflow.…”

“…In this way, the reduction of errors can bring benefits of quality care with the least possible damage to the patient. 7,13,14 There is evidence in the literature that exposes the applicability of the tools in daily health care. [15][16][17][18] Results are observed regarding the functionality of its use through the mapping of error-generating events, leading to the delimitation of strategies that avoid their manifestation.…”