HEALTH & SAF E T Y
FMEA system methodology The FMEA methodology could be considered an end-to-end risk assessment. It needs a broad team to take part. People who can bring skills across all of the process, within and from outside of the clinical setting, and enable a thorough examination of each step to be made. The key steps are: 1 Define every process step, end-to-end. 2 Identify the potential failures at each process step.
3 Assess and then rank the failures. 4 Identify corrective actions. 5 Implement actions known to reduce or eliminate risk.
Figure 1A Severity Rating scale
Having a broad team enables a detailed process flow to be established and all potential risks to be identified, however small. Once this is done, you can quantify all of the potential failure modes objectively for each process step. This is done by assessing each failure mode and giving it a score out of 10 for the following: l Severity (how likely is the process step likely to result in an injury).
l Occurrence (How often is it likely to happen).
l Detection (How easy is it to spot the injury risk).
To help with scoring and to make it objective, scoring guides are used as shown in Fig 1a,1b and 1c.
Figure 1B Occurrence rating scale
The score for each failure mode can then be established (see Figure 2 below.) The scoring guides are very helpful to determine the risk factor of each failure mode of every process step. This enables the team to identify which risks should be worked on as a priority and which risks are considered low and unlikely to result in injury. The objective of the activity is to reduce or eliminate all risks at every step of the end-to-end process.
FMEA for needle stick injuries Let us consider the FMEA with respect to needle stick injuries. (Figure 3). In this example, process step number 17 describes the need to dispose of the used needle. To do this, the requirement is to put it in the sharps bin. The team has identified some potential failure modes that could cause injury (a,b,c). We will use 17b, sharps bin falls over, as our example. It is scored with a severity rating
Severity x Occurrence x
Figure 1c Detection scale rating
50 l
WWW.CLINICALSERVICESJOURNAL.COM
Detection=Risk Factor The higher the risk factor score, the greater priority should be given to addressing it.
Figure 2: Calculation of risk priority number MARCH 2021
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