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Information Journal Paper

Title

APPLYING THE PROACTIVE FAILURE MODE AND EFFECTS ANALYSIS (FMEA) METHODOLOGY FOR IMPROVING THE TRIAGE PROCESS IN AN EMERGENCY DEPARTMENT

Pages

  161-170

Keywords

FAILURE MODE AND EFFECTS ANALYSIS (FMEA)Q3
EMERGENCY DEPARTMENT (ED)Q3

Abstract

 Background & Aim: TRIAGE and patient assessment is at the root of many RISK MANAGEMENT issues related to Emergency Department (ED). The aim of this research was to identify and analyze all the failure modes (and/or improvable points) of TRIAGE process in Rasool-e-Akram Emergency Department (ED) and propose actions in order to optimize this process.Materials and Methods: In this descriptive research, failures was identified and analyzed by the qualitative quantitative Failure Modes and Effects Analysis (FMEA) methodology. FMEA is a team-based, systematic, proactive methodology that is used to prevent process and product problems before they occur. Gathering data was focused on groups through weekly sessions of FMEA team which its results documented on FMEA main worksheet.Findings: By FMEA methodology, 29 failure modes along 11 listed TRIAGE tasks were identified and documented. With 85% reliability (that is reducing risk of failures with Risk Priority Number (RPN) > 150), 4failures were identified as a high risk ones in this studied process which included "delayed entry of patient/patient s family to ED" with RPN=252, "short-time TRIAGE for patient initial assessment" and "incorrect recording of patient blood oxygen" with 245 and "Delayed patient electrocardiography" with 160. The RPN of "Delayed entry of patient/patient s family to ED" failure was reduced from 252 to 112, while some actions had taken to reduce one of this failure causes' occurrence.Conclusion: According to these findings, FMEA was an efficient and effective methodology for identifying and prioritizing the improvable points of a running TRIAGE process in a crowded and complex hospital ward, such as an ED and also for predicting effective risk reduction actions.

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