On the need for revising healthcare failure mode and effect analysis for assessing potential for patient harm in healthcare processes

Abrahamsen, Håkon Bjorheim; Abrahamsen, Eirik Bjorheim; Høyland, Sindre

doi:10.1016/j.ress.2016.06.011

Cited by 33 publications

(16 citation statements)

References 28 publications

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“…Although such knowledge of the clinical process is an important consideration, overreliance on expert knowledge is highlighted as a potential pitfall to assessing risks in a non-biased way. In such cases, bias of the decision makers influences outcomes of the risk assessment using the HFMEA approach (Goodrum and Varkey 2017;Kricke et al 2017;Abrahamsen et al 2016).…”

Section: Concepts and Methodologies For Risk Assessment In Health Carementioning

confidence: 99%

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A comparative risk assessment of dialysis care processes in the home and hospital care contexts

Chemweno

Pintelon

2020

Int J Syst Assur Eng Manag

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Dialysis processes within the home care context is associated with risk factors which are not very prominent in the hospital context. This includes risk factors such as unanticipated device malfunction, or erroneous operation of the equipment, which exposes the patient to injury while undergoing dialysis. Importantly, the mentioned risk factors are further attributed to technical aspects such as sub-optimal equipment maintenance or following improper clinical procedures when administering care to the patient. Hence, it is important to follow a methodological approach to identify and assess hazards embedded within the dialysis treatment process, and on this basis, formulate effective strategies to mitigate their negative consequences on patient safety. This paper presents a comparative risk assessment for in-hospital versus in-home dialysis care. For the two cases, the risk assessment considers expertise of care givers involved in administering dialysis. The findings show that performing risk assessment for hospital environment, is more structured owing to expertise of clinicians and care givers responsible for administering dialysis. However, assessing risks for the home-care environment is more challenging owing to absence of domain knowledge, hence a survey approach to structure the risk assessment process is necessary. Moreover, risks in the home care context is influenced by logistical aspects, and lack of domain knowledge for maintaining dialysis equipment. Overall, insights from the comparative studies yields important learning points expected to improve dialysis care as more healthcare providers transfer care to the home environment.

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Section: Concepts and Methodologies For Risk Assessment In Health Carementioning

confidence: 99%

“…After which, the most important risk factors were prioritized using metrics adapted from the HFMEA approach. The primary reason for applying the adapted metrics is owing to the intangible nature of risk factors (Abrahamsen et al 2016).…”

Section: Methodsmentioning

confidence: 99%

A comparative risk assessment of dialysis care processes in the home and hospital care contexts

Chemweno

Pintelon

2020

Int J Syst Assur Eng Manag

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“…The SHERPA-based method in healthcare is called the observational clinical human reliability analysis (OCHRA) technique, and allows technical errors in general [52,53] and endoscopic [54] surgeries to be evaluated. One more special method of HRA in healthcare is Healthcare Failure Mode and Effect Analysis (HFMEA) [51,55], which is an FMEA-based method with applications in surgery [55] and transplantation medicine [56] among others [57]. This method provides a qualitative analysis of healthcare systems for the probabilistic evaluation of medical errors.…”

Section: Human Reliability Analysis In Healthcarementioning

confidence: 99%

Application of the Structure Function in the Evaluation of the Human Factor in Healthcare

et al. 2020

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A structure function is one of the possible mathematical models of systems in reliability engineering. A structure function maps sets of component states into system performance levels. Methods of system reliability evaluation based on structure function representation are well established. A structure function can be formed based on completely specified data about system behavior. Such data for most real-world systems are incomplete and uncertain. The typical example is analysis and evaluation of the human factor. Therefore, the structure function is not used in human reliability analysis (HRA) typically. In this paper, a method for structure function construction is proposed based on incomplete and uncertain data in HRA. The proposed method application is considered for healthcare to evaluate medical error. This method is developed using a fuzzy decision tree (FDT), which allows all possible component states to be classified into classes of system performance levels. The structure function is constructed based on the decision table, which is formed according to the FDT. A case study for this method is considered by evaluating the human factor in healthcare: complications in the familiarization and exploitation of a new device in a hospital department are analyzed and evaluated. This evaluation shows the decreasing of medical errors in diagnosis after one year of device exploitation and a slight decrease in quality of diagnosis after two months of device exploitation. Numerical values of probabilities of medical error are calculated based on the proposed approach.

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“…Each HEMS care process contains sub-processes, differently influenced by the various system components and interactions. Such a breakdown of processes is common in risk analysis (see, e.g., Abrahamsen et al, 2016).…”

Section: Part 1 -Systems Approach For the Identification Of Knowledgementioning

confidence: 99%

On the use of economic evaluation of new technology in helicopter emergency medical services

Sørskår

Abrahamsen

2019

IJBCRM

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When evaluating new technology in helicopter emergency medical services (HEMS), economic evaluation is normally part of the assessment. The outcome of economic evaluation may provide fruitful insight for the decision-makers, but, due to the complexity of the HEMS system, it is challenging to perform such evaluations in this context. A change in the components affects the whole system, and a lack of consideration of system components and their interactions may lead to unintended economic consequences when implementing new technology. Ultimately, this may cause a negative contribution to overall patient safety. We propose a conceptual methodology, using a systems model as part of the economic evaluation. The article is a revised and expanded version of a conference article presented at ESREL 2017, Slovenia.

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On the need for revising healthcare failure mode and effect analysis for assessing potential for patient harm in healthcare processes

Cited by 33 publications

References 28 publications

A comparative risk assessment of dialysis care processes in the home and hospital care contexts

A comparative risk assessment of dialysis care processes in the home and hospital care contexts

Application of the Structure Function in the Evaluation of the Human Factor in Healthcare

On the use of economic evaluation of new technology in helicopter emergency medical services

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