Using Failure Mode, Effect and Criticality Analysis to improve safety in the cancer treatment prescription and administration process

Abstract

Background Administering cancer drugs is a high-risk process, and mistakes can have fatal consequences. Failure Mode, Effect and Criticality Analysis (FMECA) is a widely recognized method for identifying and preventing potential risks, applied in various settings, including healthcare. The aim of this study was to recognize potential failures in cancer treatment prescription and administration, with a view to enabling the adoption of measures to prevent them. Methods This study consists of a FMECA. A team of resident doctors in public health at the University of Padua examined the cancer chemotherapy process with the support of a multidisciplinary team from the Veneto Institute of Oncology (an acknowledged comprehensive cancer center), and two other provincial hospitals. A diagram was drafted to illustrate 9 different phases of chemotherapy, from the adoption of a treatment plan to its administration, and to identify all possible failure modes. Criticality was ascertained by rating severity, frequency and likelihood of a failure being detected, using adapted versions of already published scales. Safety strategies were identified and summarized. Results Twenty-two failure modes came to light, distributed over the various phases of the cancer treatment process, and seven of them were classified as high risk. All phases of the cancer chemotherapy process were defined as potentially critical and at least one action was identified for a single high-risk failure mode. To reduce the likelihood of the cause, or to improve the chances of a failure mode being detected, a total of 10 recommendations have been identified. Conclusions FMECA can be useful for identifying potential failures in a process considered to be at high risk. Safety strategies were devised for each high-risk failure mode identified.

Infection Control Strategies for MDRO Based on Failure Mode and Effects Analysis: An Empirical Study on Postoperative Infections in Cancer Patients

“…Research by Buja A et al [5] further con rmed the potential of FMEA to enhance safety in cancer treatment prescriptions and management processes, while studies by Cornejo-Juárez, P et al [2,18] emphasized the severe impact of hospital-acquired infections on cancer patients, especially those in the ICU. These measures have improved the quality of medical services and patient satisfaction, demonstrating the practical application value of the FMEA method in infection prevention and control, and providing important references for future prevention and control strategies in similar public health crises.…”

“…Despite continuous improvements in the prevention and control measures for hospital infections, there is still a lack of research on risk assessment and prevention strategies for MDRO infections after surgery in cancer patients. Failure Mode and Effects Analysis (FMEA), as a systematic method for assessing medical risks, has been widely applied in the medical eld [4,5] , but research on its use for postoperative MDRO infection risk assessment in cancer patients is still insu cient. This study will employ the FMEA method to systematically assess the risk of MDRO infections after surgery in cancer patients and develop targeted prevention and control measures based on this assessment, in order to provide a strong scienti c basis for clinical practice.…”