Evaluation and critique of Healthcare Failure Mode and Effect Analysis applied in a radiotherapy case study

Chadwick, Liam; Fallon, Enda

doi:10.1002/hfm.20302

Cited by 17 publications

(37 citation statements)

References 18 publications

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“…First, the categories for frequency of occurrence are changed into easily defined categories in order to prevent team members from placing their own interpretation on the categories. [11][12][13][14][15][16][17][18][19] For instance, categories such as "less than once a year," "yearly," "monthly," "quarterly," and "weekly" are used instead of HFMEA™ categories such as "remote," "uncommon," "occasional," and "frequent." Second, the numbers in the HFMEA Hazard Scoring Matrix™ are replaced by arbitrary risk scale such as very low, low, high, and very high with accompanying red or green box, while the HFMEA™ originally used a numerical classification with more discrete levels that allows for more subtle differentiation between risks.…”

Section: Scorementioning

confidence: 99%

“…Both FMEA and m-HFMEA include five steps: (1) define the topic, (2) assemble the team, (3) develop a process map for the process consecutively numbering each step and substep of that process, (4) conduct the risk analysis, and (5) develop actions and outcomes. [11][12][13][14][15][16][17][18][19] In m-HFMEA, the fourth step has four substeps: (4a) identifying failure modes, (4b) identifying the causes of these failure modes, (4c) scoring each failure mode using the risk inventory matrix, and (4d) conducting a Decision Tree™ analysis. Each failure mode was identified in terms of severity (S) and frequency (F).…”

Section: Scorementioning

confidence: 99%

“…Detectability is defined as the likelihood of detecting the failure or the effect of failure before it occurs. 11,15…”

Section: Scorementioning

confidence: 99%

“…13,14 However, the main constraints often reported when conducting an HFMEA are the significant time commitment and resources needed. [15][16][17][18] The risk analysis has been streamlined further into a faster version of HFMEA™, called scenario analysis of failure modes effects and risks (SAFER), which is promoted in the Netherlands. [16][17][18] In France, a systematic approach called global risk analysis (GRA) adapted to health care process has been developed following a systemic evaluation of prospective risk analysis using HFMEA™.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of two prospective risk analysis methods: Traditional FMEA and a modified healthcare FMEA

et al. 2016

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Purpose: To examine the abilities of a traditional failure mode and effects analysis (FMEA) and modified healthcare FMEA (m-HFMEA) scoring methods by comparing the degree of congruence in identifying high risk failures. Methods: The authors applied two prospective methods of the quality management to surface image guided, linac-based radiosurgery (SIG-RS). For the traditional FMEA, decisions on how to improve an operation were based on the risk priority number (RPN). The RPN is a product of three indices: occurrence, severity, and detectability. The m-HFMEA approach utilized two indices, severity and frequency. A risk inventory matrix was divided into four categories: very low, low, high, and very high. For high risk events, an additional evaluation was performed. Based upon the criticality of the process, it was decided if additional safety measures were needed and what they comprise. Results: The two methods were independently compared to determine if the results and rated risks matched. The authors' results showed an agreement of 85% between FMEA and m-HFMEA approaches for top 20 risks of SIG-RS-specific failure modes. The main differences between the two approaches were the distribution of the values and the observation that failure modes (52, 54, 154) with high m-HFMEA scores do not necessarily have high FMEA-RPN scores. In the m-HFMEA analysis, when the risk score is determined, the basis of the established HFMEA Decision Tree™ or the failure mode should be more thoroughly investigated. Conclusions: m-HFMEA is inductive because it requires the identification of the consequences from causes, and semi-quantitative since it allows the prioritization of high risks and mitigation measures.

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Section: Scorementioning

confidence: 99%

Section: Scorementioning

confidence: 99%

“…Detectability is defined as the likelihood of detecting the failure or the effect of failure before it occurs. 11,15…”

Section: Scorementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A comparison of two prospective risk analysis methods: Traditional FMEA and a modified healthcare FMEA

et al. 2016

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“…7,8 Recently, FMEA was proposed for use in the quality assurance of radiation therapy by Huq et al, 9,10 and its use in photon radiation therapy QA has been reported in many publications. [11][12][13][14][15][16][17][18][19] However, the literature on the use of FMEA in proton therapy is scarce. Cantone et al analyzed potential errors in the treatment planning stage for a pencil beam proton scanning system.…”

Section: Introductionmentioning

confidence: 99%

Minimizing Treatment Planning Errors in Proton Therapy Using Failure Mode and Effects Analysis

Zheng

Johnson

Larson

2014

International Journal of Radiation Oncology*Biology*Physics

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Fuzzy analytic hierarchy process‐based risk priority number for risk assessments of commissioning process of a ring gantry LINAC

Chang

Jang

Lalonde

et al. 2022

J Applied Clin Med Phys

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Purpose We propose a fuzzy analytic hierarchy process (AHP)‐based risk priority number (RPN) method in failure modes and effects analysis (FMEA) to overcome the shortcomings of traditional RPN‐based FMEA. Our research group has previously published the FMEA to mitigate the failure modes (FMs) for the commissioning process of a ring gantry LINAC. However, inter‐relationships among FMs were observed in high ranked FMs due to a heavy reliance on imaging system. Methods Fuzzy AHP was applied to determine relative weights of risk impacts based on inter‐relationships among FMs. Since the time sequence dependency is a major factor for risk factors, a hierarchical structure of AHP was used to reflect the directional impacts such as causal influence and feedback loop. Two fuzzy weighted RPNs, called (RPNW and FRPNW, were calculated depending on the input values of severity (S), occurrence (O), and probability of not being detected (D) from the evaluators. The RPNW used numerical values, whereas the fuzzy values were used for FRPNW. Both RPNs were calculated by multiplying the weighted O, S, and D using the fuzzy AHP method. Results The differences between the two fuzzy RPN rankings are due to inherent fuzzy uncertainty and deviations in O, S, and D values submitted by the evaluators. Considering all results of traditional and fuzzy‐based FMEA, the two most highly ranked FMs were identified: errors in determining the non‐isocentric SSD and SSD from MV images because of the unique features of the ring gantry LINAC. Conclusion This study has demonstrated the feasibility of the use of a fuzzy AHP‐based RPN to perform comprehensive analysis and prioritization of FMs. The risk analysis using fuzzy AHP can be improved and/or refined based on the department's specific workflow and clinical preferences taking various priority weighting approaches into account.

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Evaluation and critique of Healthcare Failure Mode and Effect Analysis applied in a radiotherapy case study

Cited by 17 publications

References 18 publications

A comparison of two prospective risk analysis methods: Traditional FMEA and a modified healthcare FMEA

A comparison of two prospective risk analysis methods: Traditional FMEA and a modified healthcare FMEA

Minimizing Treatment Planning Errors in Proton Therapy Using Failure Mode and Effects Analysis

Fuzzy analytic hierarchy process‐based risk priority number for risk assessments of commissioning process of a ring gantry LINAC

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