Improving patient safety through combining quantitative and qualitative methods, was the focus of the thesis of IEM student Jedidja Visser, under supervision of dr.ir. Gréanne Leeftink, in collaboration with UMC Utrecht. Her work is recently published in Ergonomics. In this paper, we propose to combine Healthcare Failure Mode and Effects Analysis with Computer Simulation (HFMEA-CS) for prospective risk analysis of complex and potentially harmful processes, to prevent critical incidents from occurring in healthcare. HFMEA-CS combines expert opinions with quantitative analyses, such that the results are more reliable, reproducible, and fitting for complex healthcare settings. A case study in UMC Utrecht’s endocrinology department showed the working of HFMEA-CS to analyse drug adherence performance in the surgical admission to discharge process of pheochromocytoma patients, and improve this drug adherence towards 99%.
Want to know more? The full text of the paper is available here: Reducing failures in daily medical practice: Healthcare failure mode and effect analysis combined with computer simulation.
Abstract: This study proposes a risk analysis approach for complex healthcare processes that combines qualitative and quantitative methods to improve patient safety. We combine Healthcare Failure Mode and Effect Analysis with Computer Simulation (HFMEA-CS), to overcome widely recognised HFMEA drawbacks regarding the reproducibility and validity of the outcomes due to human interpretation, and show the application of this methodology in a complex healthcare setting. HFMEA-CS is applied to analyse drug adherence performance in the surgical admission to discharge process of pheochromocytoma patients. The multidisciplinary team identified and scored the failure modes, and the simulation model supported in prioritisation of failure modes, uncovered dependencies between failure modes, and predicted the impact of measures on system behaviour. The results show that drug adherence, defined as the percentage of required drugs received at the right time, can be significantly improved with 12%, to reach a drug adherence of 99%. We conclude that HFMEA-CS is both a viable and effective risk analysis approach, combining strengths of expert opinion and quantitative analysis, for analysing human-system interactions in socio-technical systems.