Related Experiment Videos
Émile Demers1, Laurence Collin-Lévesque1, Marianne Boulé2
1Pharm. D., M. Sc., est résident en pharmacie, Unité de recherche en pratique pharmaceutique, Centre hospitalier universitaire Sainte-Justine, Montréal, Québec.
Background:
Failure mode, effects, and criticality analysis (FMECA) is a systematic and proactive risk analysis method to determine major failures in complex processes.
Objective:
To identify all articles involving the use of failure mode and effects analysis (FMEA), FMECA, or FMECA in health care within the medication use system.
Data Sources Study Selection And Data Extraction:
The MEDLINE database was searched, for the period January 1990 to January 2017. The search included studies using the FMECA method, in part or in full, and dealing with one or several components of the medication use system. The reference lists of articles identified in the initial search were checked manually for additional pertinent references.
Data Synthesis:
The researchers identified 171 articles, and retained 39 for analysis: 32 describing use of the FMEA or FMECA approach and 7 describing use of the FMECA in health care approach. They identified between 4 to 378 failure modes, according to the published studies. Among the 39 articles, 10 reported a pre- and post-implementation analysis of corrective measures. In 4 of those 10 articles, the analysis was conducted on a theoretical basis, that is, before the corrective measures were actually implemented. Using the articles retained for analysis, a summary table was developed with the following elements: publication year, main author, country, primary objective, secondary objectives, descriptions of both method and results, and comments. The summary table gave the opportunity to comment on the use of the FMECA-type analysis within the medication use system.
Conclusions:
This literature review included 39 published articles using an FMEA, FMECA, or FMECA in health care approach within the medication use system. Most studies used either the FMEA or the FMECA approach, whereas the FMECA in health care approach was used only rarely. Only a minority of studies assessed the effects of corrective measures that were implemented. This overall approach allows for mapping of a care process, determination of failure modes, and prioritization of corrective measures. Its use for the assessment of the medication use system should be promoted.
Insights
Failure mode and effects analysis (FMEA) and its variations are effective for identifying and prioritizing risks in medication systems. Promoting these risk assessment methods can improve healthcare processes and patient safety.
Area of Science:
- Healthcare Risk Management
- Process Improvement Methodologies
Context:
- Failure Mode, Effects, and Criticality Analysis (FMECA) is a proactive method for identifying process failures.
- The medication use system is complex and prone to errors, necessitating robust risk assessment.
Purpose:
- To systematically review literature on the application of Failure Mode and Effects Analysis (FMEA), FMECA, or FMECA in healthcare within the medication use system.
- To identify trends, methodologies, and reported outcomes of FMEA/FMECA applications in medication safety.
Summary:
- A literature search (1990-2017) identified 39 articles on FMEA/FMECA in medication use systems.
- Most studies utilized FMEA or FMECA, with FMECA in healthcare used less frequently.
- Few studies reported on the post-implementation effects of corrective measures.
Impact:
- FMEA/FMECA facilitates mapping care processes, identifying failure modes, and prioritizing interventions.
- The review highlights the potential of FMEA/FMECA for enhancing medication safety and recommends its broader adoption.
- Further research should focus on assessing the impact of implemented corrective measures.