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

作     者：Askari, Roohollah Shafii, Milad Rafiei, Sima Abolhassani, Mohammad Sadegh Salarikhah, Elaheh 

作者机构：Shahid Sadoughi Univ Med Sci Sch Publ Hlth Dept Hlth Serv Management Yazd Iran Qazvin Univ Med Sci Sch Hlth Dept Hlth Management Qazvin Iran Shahid Sadoughi Univ Med Sci Abarkouh Paramed Sch Yazd Iran 

出 版 物：《INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE》 (国际保健质量保险杂志)

年 卷 期：2017年第30卷第3期

页      面：208-215页

学科分类：12[管理学] 1204[管理学-公共管理] 120402[管理学-社会医学与卫生事业管理(可授管理学、医学学位)] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 10[医学] 

主　　题：FMEA Intensive care unit Risk management Effectiveness 

摘      要：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.