Failure mode and effects analysis: a comparison of two common risk prioritisation methods

McElroy, Lisa M.; Khorzad, Rebeca; Nannicelli, Anna P.; Brown, Alexandra R.; Ladner, Daniela P.; Holl, Jane L.

doi:10.1136/bmjqs-2015-004130

Cited by 27 publications

(21 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

Section: Discussionmentioning

confidence: 94%

“…Our study shares the same limitations as the HFMEA method itself, namely the low external validity and reproducibility of results obtained in a certain context, 20 the subjectivity of judgements, 21 as well as the diversity of scales applied to calculate the RPN. 21 In particular, the choice of a different occurrence scale, although required because of the specificity of the context, may hamper comparability with other HFMEA exercises conducted using the De Rosier method. This study considered the risks relating to the specimen’s route without taking into account the effect of other programme procedures on the population, such as the selection of the test type and cut-off, 21 as well as the different characteristics of the various tests, such as varying sensitivity to high ambient temperatures.…”

Section: Discussionmentioning

confidence: 94%

See 1 more Smart Citation

Implementation of Failure Mode and Effects Analysis to the specimens flow in a population-based colorectal cancer screening programme using immunochemical faecal occult blood tests: a quality improvement project in the Milan colorectal cancer screening programme

et al. 2018

View full text Add to dashboard Cite

BackgroundA multidisciplinary working group applied the Healthcare Failure Mode and Effects Analysis (HFMEA) approach to the flow of kits and specimens for the first-level test of a colorectal cancer screening programme using immunochemical faecal occult blood tests.MethodsHFMEA comprised four steps: (1) identification and mapping of the process steps (subprocesses); (2) analysis of failure modes and calculation of the risk priority numbers (RPNs); (3) identification of corrective actions; and (4) follow-up and evaluation of corrective actions.ResultsThe team identified 9 main failure modes, 12 effects and 34 associated causes. RPN scores ranged from 2 to 96. Failure modes within the first five positions in the ranking list ordered by RPN concerned: ‘degraded haemoglobin in the specimen’, ‘mixed-up kits’ and ‘anonymous specimen’. All of these could lead to false-negative results and/or subjects with positive tests not being recalled for assessment. The team planned corrective actions for those failure modes. As a result, the follow-up of corrective actions showed a significant decrease in the proportion of anonymous kits from 11.6 to 4.8 per 1000 (relative reduction of 59%). The HFMEA exercise led to a reduction in: missed positive tests; missed cancer and high-risk adenomas; complaints about the communication of test results to a person who never did the test; and false-negative results due either to haemoglobin degradation or an expired sampling tube.ConclusionsHFMEA is a useful tool for reducing errors in colorectal cancer screening programmes using faecal occult blood tests and is characterised by a straightforward interpretation of results and ease of communication to healthcare managers and decision makers.

show abstract

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 94%

Implementation of Failure Mode and Effects Analysis to the specimens flow in a population-based colorectal cancer screening programme using immunochemical faecal occult blood tests: a quality improvement project in the Milan colorectal cancer screening programme

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Multidisciplinary tools systematically collect data relevant to front-line care delivery problems (from staff and patients) 83 84. Teams then assess and rank the apparent safety threats, for example with streamlined versions of tools like Healthcare Failure Modes and Effects Analysis or Hierarchical Task Analysis 81 85. These tools inform the strategic selection of high priority targets for local improvement efforts.…”

Section: A Model Of Alignment For Successful Qimentioning

confidence: 99%

Beyond clinical engagement: a pragmatic model for quality improvement interventions, aligning clinical and managerial priorities

2015

View full text Add to dashboard Cite

Despite taking advantage of established learning from other industries, quality improvement initiatives in healthcare may struggle to outperform secular trends. The reasons for this are rarely explored in detail, and are often attributed merely to difficulties in engaging clinicians in quality improvement work. In a narrative review of the literature, we argue that this focus on clinicians, at the relative expense of managerial staff, has proven counterproductive. Clinical engagement is not a universal challenge; moreover, there is evidence that managers—particularly middle managers—also have a role to play in quality improvement. Yet managerial participation in quality improvement interventions is often assumed, rather than proven. We identify specific factors that influence the coordination of front-line staff and managers in quality improvement, and integrate these factors into a novel model: the model of alignment. We use this model to explore the implementation of an interdisciplinary intervention in a recent trial, describing different participation incentives and barriers for different staff groups. The extent to which clinical and managerial interests align may be an important determinant of the ultimate success of quality improvement interventions.

show abstract

“… 15 This was followed by a simplified failure mode and effect analysis (SFMEA), where each step in the process was identified as well as potential failures and then the failures were evaluated and ranked. 16 , 17 The final step was to develop potential strategies to address high-ranking failures. The SFMEA revealed failures related to provider awareness and education, family education and preparation, and scheduling and follow-up.…”

Section: Methodsmentioning

confidence: 99%

Implementation of a Process for Initial Transcranial Doppler Ultrasonography in Children With Sickle Cell Anemia

Crosby

Joffe

Davis

et al. 2016

American Journal of Preventive Medicine

View full text Add to dashboard Cite

Stroke, a devastating complication of sickle cell anemia (SCA), can cause irreversible brain injury with physical and cognitive deficits. Transcranial Doppler ultrasonography (TCD) is a non-invasive tool for identifying children with SCA at highest risk of stroke. National guidelines recommend that TCD screening begin at age 2 years, yet there is research to suggest less than half of young children undergo screening. The purpose of this project was to use quality improvement methods to improve the proportion of patients aged 24–27 months who successfully completed their initial TCD from 25% to 75% by December 31, 2013. Quality improvement methods (e.g., process mapping, simplified failure mode effect analysis, and plan–do–study–act cycles) were used to develop and test processes for identifying eligible patients, scheduling TCDs, preparing children and families for the first TCD, and monitoring outcomes (i.e., TCD protocol). Progress was tracked using a report of eligible patients and a chart showing the age in months for the first successful TCD (population metric). As of December 2013, 100% of eligible patients successfully completed their initial TCD screen; this improvement was maintained for the next 20 months. In November 2014, a Welch’s one-way ANOVA was conducted. Results showed a statistically significant difference between the average age of first TCD for eligible patients born in 2009 and eligible patients born during the intervention period (2010–2013; F[1,11.712]=16.03, p=0.002). Use of quality improvement methods to implement a TCD protocol was associated with improved TCD screening rates in young children with SCA.

show abstract

Failure mode and effects analysis: a comparison of two common risk prioritisation methods

Cited by 27 publications

References 30 publications

Implementation of Failure Mode and Effects Analysis to the specimens flow in a population-based colorectal cancer screening programme using immunochemical faecal occult blood tests: a quality improvement project in the Milan colorectal cancer screening programme

Implementation of Failure Mode and Effects Analysis to the specimens flow in a population-based colorectal cancer screening programme using immunochemical faecal occult blood tests: a quality improvement project in the Milan colorectal cancer screening programme

Beyond clinical engagement: a pragmatic model for quality improvement interventions, aligning clinical and managerial priorities

Implementation of a Process for Initial Transcranial Doppler Ultrasonography in Children With Sickle Cell Anemia

Contact Info

Product

Resources

About