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A streamlined failure mode and effects analysis
Author(s) -
Ford Eric C.,
Smith Koren,
Terezakis Stephanie,
Croog Victoria,
Gollamudi Smitha,
Gage Irene,
Keck Jordie,
DeWeese Theodore,
Sibley Greg
Publication year - 2014
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.4875687
Subject(s) - failure mode and effects analysis , facilitator , psychological intervention , quality management , medicine , quality assurance , protocol (science) , reliability engineering , patient safety , operations management , medical physics , risk analysis (engineering) , engineering , nursing , psychology , health care , management system , social psychology , external quality assessment , alternative medicine , pathology , economics , economic growth
Purpose: Explore the feasibility and impact of a streamlined failure mode and effects analysis (FMEA) using a structured process that is designed to minimize staff effort. Methods: FMEA for the external beam process was conducted at an affiliate radiation oncology center that treats approximately 60 patients per day. A structured FMEA process was developed which included clearly defined roles and goals for each phase. A core group of seven people was identified and a facilitator was chosen to lead the effort. Failure modes were identified and scored according to the FMEA formalism. A risk priority number, RPN , was calculated and used to rank failure modes. Failure modes with RPN > 150 received safety improvement interventions. Staff effort was carefully tracked throughout the project. Results: Fifty‐two failure modes were identified, 22 collected during meetings, and 30 from take‐home worksheets. The four top‐ranked failure modes were: delay in film check, missing pacemaker protocol/consent, critical structures not contoured, and pregnant patient simulated without the team's knowledge of the pregnancy. These four failure modes had RPN > 150 and received safety interventions. The FMEA was completed in one month in four 1‐h meetings. A total of 55 staff hours were required and, additionally, 20 h by the facilitator. Conclusions: Streamlined FMEA provides a means of accomplishing a relatively large‐scale analysis with modest effort. One potential value of FMEA is that it potentially provides a means of measuring the impact of quality improvement efforts through a reduction in risk scores. Future study of this possibility is needed.