Evaluating inputs of failure modes and effects analysis in identifying patient safety risks

Area of Science:

• Healthcare Quality Improvement
• Patient Safety Research
• Systems Engineering in Medicine

Background:

• Growing emphasis on systems approaches for enhancing patient safety and quality.
• Limited research on the impact of inputs, like structured brainstorming and system mapping approaches (SMAs), in risk identification processes.
• Need to evaluate specific systems approaches in real-world healthcare environments.

Purpose of the Study:

• To evaluate the inputs of Failure Modes and Effects Analysis (FMEA), a systems approach, for identifying patient safety risks.
• To assess the impact of structured brainstorming and system diagrams within the FMEA process in a clinical setting.

Main Methods:

• Conducted a Failure Modes and Effects Analysis (FMEA) exercise in a newly established adult attention deficit hyperactivity disorder service.
• Utilized a system diagram identified as highly useful by stakeholders.
• Involved service stakeholders and facilitators in the FMEA process.

Main Results:

• The formal structure of FMEA, supported by system diagrams, enhances comprehensive system coverage for risk identification.
• Structured brainstorming within the FMEA process, guided by a predefined system diagram, may restrict participants' ability to identify novel risks.
• System diagrams contribute to a more thorough identification of potential patient safety risks.

Conclusions:

• Failure Modes and Effects Analysis (FMEA) inputs, particularly system diagrams, show potential for improving patient safety risk identification.
• Healthcare organizations should not rely exclusively on FMEA for identifying patient safety risks.
• Complementary methods are necessary for comprehensive risk identification and prioritization in healthcare.