A proactive risk assessment through healthcare failure mode and effect analysis in pediatric surgery department

Abstract

Background: Patient safety is the first step to improve the quality of care. Objectives: Therefore, the present study aimed to examine the risk assessment of processes in a pediatric surgery department using the Health Failure Mode and Effect Analysis (HFMEA) in 2017 - 2018. Methods: In this research, a mixed-method design (qualitative action and quantitative descriptive cross-sectional study) was used to analyze failure mode and their effects. The nursing errors in the clinical management model were used to classify failure modes, and the theory of inventive problem solving was used to determine a solution for improvement. Results: According to the five procedures selected by the voting method and their rating, 25 processes, 48 sub-processes, and 218 failure modes were identified with HEMEA. Eight risk modes (3.6%) were found as non-acceptable risks and were transferred to the decision tree. The main root causes (hazard score ≥ 4) were as follows: Technical-related factors (14.34%), organizational-related factors (31.9%), human-related factors (45.3%), and other factors (7.6%). Conclusions: The HFMEA method is very effective in identifying the possible failure of treatment procedures, determining the cause of each failure mode, and proposing improvement strategies.