ENT one day surgery: critical analysis with the HFMEA method

Area of Science:

• Healthcare Quality Improvement
• Patient Safety Research
• Surgical Process Analysis

Background:

• Adverse events in hospitals are frequent, with surgery accounting for a significant portion.
• Surgical patients experience adverse events at rates of 3-22%, with higher risks in pediatric ENT surgery.
• Physician requests prompted a quality improvement project in two Belgian hospitals.

Purpose of the Study:

• To evaluate the process flow for ear, nose, and throat (ENT) patients using Healthcare Failure Mode & Effect Analysis (HFMEA).
• To redesign the ENT patient care process to enhance patient safety.
• To identify and mitigate potential failure modes in surgical processes.

Main Methods:

• Prospective analysis of processes in two ENT One Day Clinics.
• Application of the Healthcare Failure Mode & Effect Analysis (HFMEA) method.
• Involvement of a multidisciplinary team and fostering an open safety culture.

Main Results:

• Absence of active patient identity checks was identified as a major failure mode in both hospitals.
• Redesign involved implementing a surgical safety checklist and an active identity check protocol.
• HFMEA proved effective in detecting failure modes requiring immediate safety interventions.

Conclusions:

• Healthcare Failure Mode & Effect Analysis (HFMEA) is a valuable tool for identifying failure modes in surgical care processes.
• Systematic analysis by multidisciplinary teams is crucial for enhancing patient safety.
• Active identity checks and safety checklists are key to improving ENT surgical patient safety.