by Ruth Elzer, RN, MS
Parts I and II of this series outlined two tools for risk assessment and how each can assist in evaluating the impact of potential risks within a hospital. This installment will focus on Failure Mode and Effects Analysis (FMEA). This tool can be used to examine an event and its component parts to discover weaknesses and decrease the likelihood that they will occur.
Many hospitals use FMEA to evaluate complex processes like those associated with sentinel events. A thorough FMEA seeks to answer several key questions:
- What steps in the process are at greatest risk for failure?
- How might each step fail (commonly referred to as “failure modes”)?
- If a step were to fail, what impact would it have?
- What is the severity of the effect, rated from insignificant to critical?
- How frequently will the step likely fail, based on prior experience?
- How will the failure likely be discovered?
- How can the risks be mitigated or removed to lessen failure?
FMEA Components
Like the Focused Risk Vulnerability Analysis tool, the FMEA grid requires a subjective score to be assigned based on experience with the situation. This leads to an objective assignment of a number that represents the risk. The numerical scores of each factor are then multiplied. The product represents the compounded weight of the risk and its potential impact on the process. Items with large scores warrant immediate actions, while mid-level and low scored items can be addressed as time and resources allow.
While FMEA is more than a single tool, the Failure Mode and Effects grid helps to target the most damaging aspects of a failing process. Other key components of a thorough FMEA examination include a clear flowchart of the steps of the process in question and an action plan to mitigate the highest-risk elements found during the examination.
Using FMEA to Minimize Risk in Your Hospital
FMEA can be a valuable tool during the redesign of processes. When a process is redesigned, it is tempting to assume that it will simply work as designed. But, careful examination of the process steps through FMEA can often uncover gaps in thinking and lead to corrective actions that save time and energy.
In addition, this method can be used as part of a Root Cause Analysis investigation of a sentinel event. In this application, FMEA tests the redesigned process to see if potential for error has been eliminated from the process.
Regardless of the scope and number of risk assessments at your hospital, it’s worth the effort of developing a range of assessment tools tailored to various situations. The time and commitment devoted to performing risk assessments will result in a safer hospital environment and demonstrate to surveyors that the organization is devoted to a culture of safety. So, in 2010, take another look at your hospital’s risk assessment practices to ensure the highest level of patient safety and survey readiness.
Please register at www.compass-clinical.com/risk-assessment-tools-form to download the FMEA template.
