Patient Safety: Healthcare Failure Mode and Effect Analysis

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Table of Contents

FMEA and HFMEA: Opportunities for Improvement
H/FMEA and Its Use
References

FMEA and HFMEA: Opportunities for Improvement

FMEA or Failure Modes and Effect Analysis is an approach to failure analysis that is widely used to evaluate the reliability of various hierarchical systems and define risks related to business activities. Importantly, there are three major types of FMEA that are centered around proper fault models, processes, or system design. In reference to the practical use of FMEA, there are ten key steps that are taken to implement the above-mentioned approach to risk prevention (FMEA Training, n.d.).

Within the frame of the first three steps, evaluators are expected to identify areas of attention and collect data on the most important failure modes, thereby describing the potential effect of all failures on a final product or service. After that, three more steps focusing on detection, frequency, and severity are implemented. In order to provide a comprehensive assessment, each component is to be evaluated quantitatively for each consequence. Then, three numbers for each failure are multiplied together to calculate RPN scores. Quantitative data is used to sort out priorities and encourage proper role distribution in a team. Using RPN scores calculated for each potential failure independently, it is possible to exclude failures that are not very common or involve limited opportunities for improvement. Based on this information, effective action plans are developed to encourage positive changes.

HFMEA or Healthcare Failure Modes and Effect Analysis are among the most commonly used variations of the previously discussed tool. HFMEA was designed a few years ago to assess and manage problems that take place in hospital settings. Nowadays, the use of this approach to risk assessment is inextricably connected with patient safety, which acts as one of the key values of healthcare.

H/FMEA and Its Use

From convenience considerations, HFMEA utilizes a less complicated algorithm if compared to FMEA. According to the U. S. Department of Veteran Affairs (n.d.), the basic form of HFMEA consists of five essential steps. First of all, conducting an HFMEA analysis involves choosing and defining a narrow topic for further investigation. Then, it is pivotal to form a team that involves experts in specific fields whose help is needed to design problem management strategies. After that, a process or problem under analysis is to be divided into subprocesses; this information is usually presented graphically to ensure demonstrability. Within the frame of the next step, all failure modes are analyzed with regard to their severity and probability, and the Decision Tree is used to sort out priorities. Finally, the information on potential failure modes is used to develop a few risk management strategies that are independent or interdependent.

Nowadays, patient safety can be affected by numerous problems. A significant problem that can be managed using H/FMEA impacts client safety in many health facilities, including LIJ Forest Hills Hospital and other hospitals in the country. Staff shortage or the presence of inadequate nurse-patient ratios pose a significant threat to patient safety, increasing the probability of fatal patient care outcomes due to nurse burnout. The existence of this problem does not always depend on staff attraction, and retention strategies designed and implemented by hospital managers since the public image of the profession and its popularity among future students are not stable.

Having described the problem and its consequences, such as lower patient satisfaction and higher mortality rates, it would be necessary to form a team. The representatives of all parties affected by the problem should be in the team. Recruiting is a process that affects specialists at different levels of any organization, and this is why hospital managers, HR managers, and nurse leaders would be included in the team. At this point, areas of responsibility would be defined. During the following step, team members would need to complete a diagram illustrating different steps of recruitment and retention processes, including searching strategies, the stage of setting requirements, and so on. Then, potential risks are to be defined with regard to each stage of the process; examples of such risks can be presented by overstated requirements for positions, lack of special benefits, low, competitive ability, poor social image, or other factors.

During the next step, the severity and probability of each potential risk factor are to be analyzed. Taking the complex nature of the identified problem into account, team members may be required to conduct additional research to define objective reasons that encourage nursing professionals to reject job offers or leave the company. The results of a hazard analysis would allow determining the degree to which further actions related to particular failure modes are critical to success.

The risk factors that are to be eliminated need to be described in detail and commented on. For instance, to control or eliminate more attractive professional growth opportunities or salaries offered by competitors, it would be necessary to improve bonus systems. The decision to initiate such studies would cause numerous positive outcomes. As the experience of another hospital in the area shows, the problem of patient safety can also be solved with the help of new communication systems (Zendrian, 2016). The use of the analysis tool would gradually improve patient satisfaction rates, eliminating the cases when patients do not receive enough attention. Apart from that, conducting H/FMEA analysis would help to come up with new ideas for the improvement of patient safety.