Risk assessment of the emergency processes: Healthcare failure mode and effect analysis

Abstract

BACKGROUND: Ensuring about the patient's safety is the fi rst vital step in improving the quality of care and the emergency ward is known as a high-risk area in treatment health care. The present study was conducted to evaluate the selected risk processes of emergency surgery department of a treatment-educational Qaem center in Mashhad by using analysis method of the conditions and failure effects in health care. METHODS:In this study, in combination (qualitative action research and quantitative crosssectional), failure modes and effects of 5 high-risk procedures of the emergency surgery department were identified and analyzed according to Healthcare Failure Mode and Effects Analysis (HFMEA). To classify the failure modes from the "nursing errors in clinical management model (NECM)", the classification of the effective causes of error from "Eindhoven model" and determination of the strategies to improve from the "theory of solving problem by an inventive method" were used. To analyze the quantitative data of descriptive statistics (total points) and to analyze the qualitative data, content analysis and agreement of comments of the members were used. RESULTS:In 5 selected processes by "voting method using rating", 23 steps, 61 sub-processes and 217 potential failure modes were identifi ed by HFMEA. 25 (11.5%) failure modes as the high risk errors were detected and transferred to the decision tree. The most and the least failure modes were placed in the categories of care errors (54.7%) and knowledge and skill (9.5%), respectively. Also, 29.4% of preventive measures were in the category of human resource management strategy.CONCLUSION: "Revision and re-engineering of processes", "continuous monitoring of the works", "preparation and revision of operating procedures and policies", "developing the criteria for evaluating the performance of the personnel", "designing a suitable educational content for needs of employee", "training patients", "reducing the workload and power shortage", "improving team communication" and "preventive management of equipment's" were on the agenda as the guidelines.

<p>Risk Management in Executive Levels of Healthcare Organizations: Insights from a Scoping Review (2018)</p>

“…Risk identification is usually a necessary condition for later risk management. 25 Given dynamic and complex healthcare organizations, different risk sources can trigger hazardous situations, potentially harming the organization. 36 It is therefore essential to consider as many risk sources as possible within a classification to help participants familiarize themselves with the given system and potential risk sources.…”

“…43,59 The organizational RM team should be multidisciplinary and comprised of various specializations, in particular, managers, process owner experts, and RM experts (consultants and facilitators). 25,33 Also, the number of team members depends on the complexity of organizational issues. 33,40,43…”

“…According to the results, there were several methods for outlining risky processes that executive levels of HCOs can use depending on their needs: Textual system description, 8,41,53,59 activity breakdown structure (ABS), 8 radar charts, 34 flow charts, 3,25,28,30,38,45,50,56,62 All organizational processes (clinical and non-clinical processes, technology processes, etc.) 8 Customer perceptions, costs, functions and health status 8…”

“…8,31,34,40,55,59 1-4 Human or personnel resource 34,45,55,59 1-5 Financial: Form of financing, evaluation, return. 31,45,59 1-6 Organization conditions or location 45,55 1-7 Customer 43 1-8 Administrative or task 25,55 1-9 Knowledge and skill 40 1-10 Material and equipment: displays/integrity/positioning/ usability diagrams, 34,38,45,56,58 system diagram, 8,34,62 integration definition (IDEF), 35 and hierarchical task analysis Diagram (HTA) or task diagram, 26,28,35,42,57,62 communication diagram, 56,62 information diagram, 35,56,62,63 organizational diagram, 35,56,62,63 stakeholder diagrams, 56 swim lane activity diagram, 56 state transition diagram, 56 sequence diagram,…”

Motivation of the nurses in pre‐hospital emergency and educational hospitals emergency in the southeast of Iran

“…5 The most important duty of the emergency system is taking immediate action to rescue patients and also emergency is one of the main medical services, and it is often in the first line of the interaction of the patients and the health care system. 6,7 Manpower has an important role in changing and improving the health care system, and it is one of the crucial parts of the organizations that have been emphasized by the experts in human resources management. 8 Ignoring motivational conditions of the nurses leads to low occupational satisfaction and motivation, low quality of the services, slow recovery process, and lack of satisfaction of the people from health care services.…”