A Case Study on Improving Intensive Care Unit (ICU) Services Reliability: By Using Process Failure Mode and Effects Analysis (PFMEA)

Yousefinezhadi, Taraneh; Nobari, Farnaz Attar Jannesar; Goodari, Faranak Behzadi; Arab, Mohammad

doi:10.5539/gjhs.v8n9p207

Cited by 12 publications

(9 citation statements)

References 32 publications

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“…In the reviewed articles, the other prevalent Failures among the Failures with high RPN scores were observed during the process of drug administration, injection, or medication use in the intensive care unit ( 11 , 17 , 23 , 24 , 27 – 34 ). Medication error refers to as a preventable incident that would lead to improper medication use, and ultimately to a patient’s damage or even death ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

“…Hospitalized patients are prone to bedsore because of inactivity and sleeping on beds. In the reviewed articles, Failures during the care processes to prevent bedsore were unacceptable Failures with RPNs >100 ( 11 , 24 , 38 ). Pressure ulcers are caused by ischemic pressure injuries to different body organs.…”

Section: Discussionmentioning

confidence: 99%

“…The endotracheal tube obstruction during the endotracheal tube insertion process was reported as a dangerous and unacceptable Failure with RPN= 810 (22). In general, Failures modes associated with endotracheal tube insertion were considered as unacceptable (11,(23)(24)(25)(26), proposing that the endotracheal intubation process is one of the fundamental processes in the intensive care units and that the smallest Failure could cause irreparable damages to the patients. As a result, a detailed examination of the processes involved in inserting or removing the endotracheal tube would contribute to the detection of potential Failures to be removed to the extent possible.…”

Section: Discussionmentioning

confidence: 99%

“…Much more attention should be paid to such Failures, and potential Failures need to be detected and prevented. One more potential Failure with a high RPN score in the reviewed articles was reported for the operation of medical devices or their malfunctioning or personnel's inattention to the alarms, which would lead to some damages to patients admitted to the intensive care units (17,24,38). A majority of Failures in the ICUs are due to the lack of attention to alarms and warnings from medical devices (17).…”

Section: Discussionmentioning

confidence: 99%

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Intensive Care Unit Risk Assessment: A Systematic Review

Homauni

Jame

Hazrati

et al. 2020

ijph

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Background: It is of paramount importance to reduce the probability of clinical risks to improve the quality of health care services, make the relationship between service providers and patients more effective, enhance patient satisfaction, and decrease the rate of complaints regarding medical errors in hospitals. This study aimed at detecting potential and unacceptable risks occurring in the hospital ICUs. Methods: In this systematic review, all studies examining the risk assessment of ICUs in hospitals using Failure Mode and Effect Analysis method were reviewed. Google scholar, PubMed, Scopus, SID, Magiran and Web of Science databases were searched to find relevant articles published from 1980 to 2019. Results: The most frequent failures detected in the reviewed articles consisted of high risk of infection inwards for medical and nursing operations, high infection rates inwards for medical devices’ operation within the unit, and early discharge. Moreover, the processes through which potential high-risk Failures were examined in these studies were injection or prescription process, suction process, the process of inserting or removing endotracheal tubes, the process of transferring patients from the operation room to the unit or vice versa, pressure ulcers, and processes related to the medical devices’ operation. Conclusion: There are many possible reasons for failure occurring throughout these processes, and the failure modes occurring in these processes are more probable to cause serious damages to patients, have high repeatability with low probability of failure detection as the failures cannot be discovered by the personnel.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Intensive Care Unit Risk Assessment: A Systematic Review

Homauni

Jame

Hazrati

et al. 2020

ijph

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“…It is generally acknowledged to be a useful tool available to health professionals for assessing and improving healthcare processes [ 27 , 28 , 29 ]. It is a good systematic technique that prospectively identifies, evaluates, prioritizes, and eliminates potential failure modes and effects to improve the safety, reliability, and quality of healthcare processes [ 30 , 31 , 32 , 33 , 34 ].…”

Section: Introductionmentioning

confidence: 99%

Integrating Quality Tools and Methods to Analyze and Improve a Hospital Sterilization Process

2021

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Healthcare facilities are facing major issues and challenges. Hospitals continuously search approaches to improve operations quality, optimize performance, and minimize costs. Specifically, an efficient hospital sterilization process (HSP) allows reusable medical devices (RMDs) to be more quickly available for healthcare activities. In this context, this paper describes an integrated approach developed to analyze HSP and to identify the most critical improvement actions. This proposed approach integrates four quality tools and techniques. Firstly, a structured analysis and design technique (SADT) methodology is applied to describe HSP as a hierarchy of activities and functions. Secondly, the failure modes and effects analysis (FMEA) method is used as a risk assessment step to determine which activity processes need careful attention. Thirdly, a cause–effect analysis technique is used as a tool to help identify all the possible improvement actions. Finally, priority improvement actions are proposed using the quality function deployment (QFD) method. To validate the proposed approach, a real sterilization process used at the maternity services of Hedi-Cheker Hospital in the governorate of Sfax, Tunisia, was fully studied. For this specific HSP, the proposed approach results showed that the two most critical activities were (1) improving the coordination between the sterilization service and the surgery block and (2) minimizing the average duration of the sterilization process to ensure the availability of RMDs in time.

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A novel approach to infectious disease control and radiotherapy risk management

et al. 2023

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Background: Infectious disease outbreaks have always presented challenges to the operation of healthcare systems. In particular, the treatment of cancer patients within Radiation Oncology often cannot be delayed or compromised due to infection control measures. Therefore, there is a need for a strategic approach to simultaneously managing infection control and radiotherapy risks. Purpose: To develop a systematic risk management method that uses mathematical models to design mitigation efforts for control of an infectious disease outbreak, while ensuring safe delivery of radiotherapy. Methods: A two-stage failure mode and effect analysis (FMEA) approach is proposed to modify radiotherapy workflow during an infectious disease outbreak. In stage 1, an Infection Control FMEA (IC-FMEA) is conducted, where risks are evaluated based on environmental parameters, clinical interactions, and modeling of infection risk. occupancy risk index (ORI) is defined as a metric for infection transmission risk level in each room, based on the degree of occupancy. ORI, in combination with ventilation rate per person (R p ), is used to provide a broad infection risk assessment of workspaces. For detailed IC-FMEA of clinical processes, infection control failure mode (ICFM) is defined to be any instance of disease transmission within the clinic. Infection risk priority number (IRPN) has been formulated as a function of time, distance, and degree of protective measures. Infection control measures are then systematically integrated into the workflow. Since the workflow is perturbed by infection control measures, there is a possibility of introducing new radiotherapy failure modes or increased likelihood of existing failure modes. Therefore, in stage 2, a conventional radiotherapy FMEA (RT-FMEA) should be performed on the adjusted workflow. Results:The COVID-19 pandemic was used to illustrate stage 1 IC-FMEA. ORI and R p values were calculated for various workspaces within a clinic. A deep inspiration breath hold (DIBH) CT simulation was used as an example to demonstrate detailed IC-FMEA with ICFM identification and IRPN evaluation. A total of 90 ICFMs were identified in the DIBH simulation process. The calculated IRPN values were found to be progressively decreasing for workflows with minimal, moderate, and enhanced levels of protective measures. Conclusion:The framework developed in this work provides tools for radiotherapy clinics to systematically assess risk and adjust workflows during the evolving circumstances of any infectious disease outbreak.

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A Case Study on Improving Intensive Care Unit (ICU) Services Reliability: By Using Process Failure Mode and Effects Analysis (PFMEA)

Cited by 12 publications

References 32 publications

Intensive Care Unit Risk Assessment: A Systematic Review

Intensive Care Unit Risk Assessment: A Systematic Review

Integrating Quality Tools and Methods to Analyze and Improve a Hospital Sterilization Process

A novel approach to infectious disease control and radiotherapy risk management

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