Failure Modes and Effects Analysis (FMEA)

Failure modes and effects analysis (FMEA) is a systematic methodology used in various industries, including healthcare, to identify and prioritize potential failure modes within a system, process, or product and to determine the effects of those failures. In a healthcare context, FMEA is primarily focused on patient safety and quality improvement.

Here's how FMEA typically works:

1. Identifying processes: The first step is to identify the processes or systems within healthcare delivery that are critical for patient safety or quality of care. This could include processes such as medication administration, surgical procedures, diagnostic testing, etc.
2. Identifying failure modes: Once the processes are identified, healthcare professionals (often in a multidisciplinary team) brainstorm potential failure modes within each process. A failure mode is any way in which the process could fail to deliver the intended outcome. For example, in medication administration, a failure mode could be administering the wrong medication or administering the correct medication at the wrong dosage.
3. Determining effects: For each identified failure mode, the team assesses the potential effects on patient safety or quality of care. This involves considering factors such as the severity of harm to the patient, the likelihood of the failure occurring, and the detectability of the failure before it reaches the patient.
4. Assigning risk priority numbers (RPNs): To prioritize which failure modes to address first, the team assigns a risk priority number (RPN) to each failure mode. The RPN is calculated by multiplying the scores for severity, likelihood, and detectability. Failure modes with higher RPNs are considered a higher priority for mitigation.
5. Developing mitigation strategies: Once the high-priority failure modes are identified, the team develops strategies to mitigate or eliminate them. This could involve process redesign, implementing new safety protocols, providing additional training to staff, or introducing new technology or equipment.
6. Implementing changes: The next step is to implement the agreed-upon changes or improvements to the processes to reduce the risk of failures occurring.
7. Monitoring and review: Finally, FMEA is an iterative process, and it's essential to continuously monitor the effectiveness of the implemented changes and review the process regularly to identify any new failure modes that may arise.

FMEA differs from root cause analysis (RCA), which addresses problems after they occur. In comparison, FMEA is a preventative measure completed before adverse events occur.