Failure mode and effect analysis: improving intensive care unit risk management processes

Abstract

Purpose Failure modes and effects analysis (FMEA) is a practical tool to evaluate risks, discover failures in a proactive manner and propose corrective actions to reduce or eliminate potential risks. The purpose of this paper is to apply FMEA technique to examine the hazards associated with the process of service delivery in intensive care unit (ICU) of a tertiary hospital in Yazd, Iran. Design/methodology/approach This was a before-after study conducted between March 2013 and December 2014. By forming a FMEA team, all potential hazards associated with ICU services - their frequency and severity - were identified. Then risk priority number was calculated for each activity as an indicator representing high priority areas that need special attention and resource allocation. Findings Eight failure modes with highest priority scores including endotracheal tube defect, wrong placement of endotracheal tube, EVD interface, aspiration failure during suctioning, chest tube failure, tissue injury and deep vein thrombosis were selected for improvement. Findings affirmed that improvement strategies were generally satisfying and significantly decreased total failures. Practical implications Application of FMEA in ICUs proved to be effective in proactively decreasing the risk of failures and corrected the control measures up to acceptable levels in all eight areas of function. Originality/value Using a prospective risk assessment approach, such as FMEA, could be beneficial in dealing with potential failures through proposing preventive actions in a proactive manner. The method could be used as a tool for healthcare continuous quality improvement so that the method identifies both systemic and human errors, and offers practical advice to deal effectively with them.

Intensive Care Unit Risk Assessment: A Systematic Review

“…The pulmonary thromboembolism prevention is a critical process, and that mortality rates would be significantly decreased through identifying potential Failures in this process. The endotracheal tube obstruction during the endotracheal tube insertion process was reported as a dangerous and unacceptable Failure with RPN= 810 (22). In general, Failures modes associated with endotracheal tube insertion were considered as unacceptable (11,(23)(24)(25)(26), proposing that the endotracheal intubation process is one of the fundamental processes in the intensive care units and that the smallest Failure could cause irreparable damages to the patients.…”

Human resource risk control through COVID-19 risk assessment in Indonesian manufacturing

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Developing strategies for patient safety implementation: a national study in Iran

“…As mentioned by Ravaghi et al (2014), openness toward change and resolving the root causes of errors were other important enablers of service quality development in healthcare organizations. To create a safe therapeutic environment and avoid medical errors, Askari et al (2017) focused on developing a prospective risk assessment approach entitled “Failure Modes and Effects Analysis.” Such an approach was believed to be helpful in dealing with potential failures in a proactive manner instead of responding them reactively (Askari et al , 2017; Shafii et al , 2016).…”