HEALTHCARE FAILURE MODE AND EFFECT ANALYSIS DESIGN FOR INDONESIA HOSPITAL LABORATORIES: A LITERATURE REVIEW

Background: Error rate in medical laboratories is very low. Only one error is identified every 330–1,000 events. The goal of laboratory services should outweigh patient safety in a well-structured manner. Healthcare Failure Mode and Effect Analysis (HFMEA) is a proactive preventive method for identifying and evaluating potential failure.Aims: This study identified factors affecting patient safety in hospital laboratories and described potential risk identification process using the HFMEA.Methods: This study was conducted between March-July 2020 and retrieved data from PubMed, Scopus, and Google Scholar. The data were generalized and extracted into Table 2 based on factors dealing with patient safety in hospital laboratories. This study performed a risk identification design based on the steps of HFMEA.Results: Out of 4,062 articles collected, only 8 articles between 2013–2020 were included for analysis. The highest error rate in laboratories occurred in the pre-analytic phase (49.2%–84.5%). The errors included clotted and inadequate specimen volume, and thus the specimens were rejected. Factors related to patient safety in laboratories were patient condition, laboratory staff performance (including training, negligence, and burnout), facilities, and accreditation.Conclusion: The HFMEA process used the result of hazard analysis with severity and probability criteria categorized into health sector. Decision tree analysis could determine the next step of the work process. The HFMEA must be adjusted to the equipment and technologies in each hospital laboratory. Leader’s commitment in monitoring and evaluation is required to maintain patient safety culture. More comprehensive data from Indonesian hospital laboratories are needed to generate more representative and applicable results.Keywords: error, HFMEA, laboratory, patient safety

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Risk identification of a hospital laboratory pre-analytics through failure mode and effect analysis

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i4.33380 ◽

2021 ◽

Vol 12 (4) ◽

pp. 31-38

Author(s):

Debdatta Das ◽

Krishna Pal ◽

Sudip Roy ◽

Moushumi Lodh

Keyword(s):

Patient Safety ◽

Failure Mode ◽

Laboratory Testing ◽

Failure Modes ◽

Risk Identification ◽

Post Intervention ◽

Effect Analysis ◽

Laboratory Errors ◽

Corrective Actions ◽

Analytical Phase

Background: Implementing an active system to identify, monitor and manage risk from laboratory errors can enhance patient safety and quality of care. Aims and Objectives: Failure Mode and Effect Analysis (FMEA) technique allows evaluating and measuring the hazards of a process malfunction, to decide where to execute improvement actions, and to measure the outcome of those actions. The aim of this study was to assess pre analytical phase of laboratory testing, mitigate risk and thereby increase patient safety. Materials and Methods: Steps followed in the study were: planning the study, selecting team members, analysis of the processes, risk analysis, and developing a risk reduction protocol by incorporating corrective actions. A Fault Tree Analysis diagram was used to plot the cascade of faults leading to the pre analytical errors. Risk Priority Number (RPN) was assigned. A minimum cut- off 40 RPN was considered for interventions and highest RPN errors were prioritized with corrective actions. Post intervention RPN score was calculated. Results: Eight failure modes had the highest RPN. Corrective actions were prioritized against these errors. RPN scores of test ordering error, sample collection error, transport errors, error in patient identification, site selection, urine samples not received, sample accessioning and sample processing errors decreased, post intervention. Conclusion: With thorough planning, we can use FMEA as a common standard to analyze risk in pre analytical phase of laboratory testing.

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The link between healthcare risk identification and patient safety culture

International Journal of Health Care Quality Assurance ◽

10.1108/ijhcqa-04-2018-0098 ◽

2019 ◽

Vol 32 (3) ◽

pp. 574-587 ◽

Cited By ~ 7

Author(s):

Mecit Can Emre Simsekler

Keyword(s):

Patient Safety ◽

Safety Culture ◽

Patient Safety Culture ◽

Risk Identification ◽

Content Type ◽

Safety Risks ◽

Identification Practices ◽

The Relationship ◽

Current Risk ◽

Tools And Methods

PurposeRisk identification plays a key role identifying patient safety risks. As previous research on risk identification practices, as applied to patient safety, and its association with safety culture is limited, the purpose of this paper is to evaluate current practice to address gaps and potential room for improvement.Design/methodology/approachThe authors carry out interview-based questionnaires in one UK hospital to investigate real-world risk identification practices with eight healthcare staff, including managers, nurses and a medical consultant. Considering various aspects from both risk identification and safety culture practices, the authors investigate how these two are interrelated.FindingsThe interview-based questionnaires were helpful for evaluating current risk identification practices. While gaining significant insights into risk identification practices, such as experiences using current tools and methods, mainly retrospective ones, results also explicitly showed its link with the safety culture and highlighted the limitation in measuring the relationship.Originality/valueThe interviews addressed valuable challenges affecting success in the risk identification process, including limitations in safety culture practice, training, balancing financial and safety concerns, and integrating risk information from different tools and methods.

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