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Application of healthcare failure mode and effect analysis in optimizing the emergency management process for acute
Jingyan Hu1, Minyi Guan1, Guangying Wu1
1Department of Emergency, Guangzhou Red Cross Hospital, Guangzhou, Guangdong Province 510000, China.
Objective:
To investigate the effectiveness of Healthcare Failure Mode and Effect Analysis (HFMEA) in optimizing the emergency management workflow for Acute Myocardial Infarction (AMI) and to assess its impact on emergency efficiency, clinical outcomes, and patient satisfaction.
Methods:
AMI patients treated at our hospital during different periods were enrolled and divided into two groups: a control group receiving conventional emergency procedures and a post-optimization group managed with an HFMEA-optimized emergency workflow. The HFMEA implementation involved forming a multidisciplinary team, constructing an integrated prehospital-to-in-hospital treatment process map, identifying high-risk failure modes based on the Risk Priority Number (RPN), developing targeted improvement measures, and establishing an information-based quality monitoring system. Outcome measures included key emergency time intervals, clinical outcomes, and healthcare quality indicators.
Results:
Following HFMEA implementation, the post-optimization group showed significant reductions in all key emergency time metrics compared with the control group, including triage time, time to first electrocardiogram, Door-to-Catheterization (D-to-C) time, and Door-to-Balloon (D-to-B) time (all P < 0.001), and the effect sizes for all major time-related indicators between the two groups reached the large-effect level (Cohen's d ≥ 0.8, r ≥ 0.5). The total incidence of adverse events was significantly lower in the post-optimization group (P < 0.05), while rescue success rates did not differ significantly between groups (P > 0.05). Regarding healthcare quality, patients in the post-optimization group had shorter hospital stays and higher satisfaction scores as measured by a dedicated survey instrument (both P < 0.05).
Conclusion:
HFMEA effectively identifies high-risk steps within the AMI emergency workflow. Targeted process optimization can significantly enhance emergency efficiency, reduce adverse events, improve healthcare quality, and optimize patient experience.