Presentation Authors: Gema Romeu-Magraner*, Sara Villarroya-Castillo, Alberto Budía-Alba, Pilar Bahilo-Mateu, Marta Trassierra-Villa, José Daniel López-Acón, Domingo de Guzmán Ordaz-Jurado, Francisco Boronat-Tormo, Valencia, Spain
Introduction: The failure mode and effects analysis (FMEA) has been used as a tool in risk management and quality improvement to reduce the occurrence of human or system failures._x000D_
The objective is to identify the weaknesses in endourological surgery process (percutaneous nephrolithotomy, retrograde intrarrenal surgery and ureterorrenoscopy) in order to improve the safety of the usual procedures.
Methods: A first phase of processes modeling in key activities at Lithotripsy and Endourology Unit was developed, involving all the professionals included in the clinical process (Business Process Management, BPM).In a second phase, the severity, frequency and detection failure capacity was defined in 1 to 5 scale (One is lowest severity and frequency and five is highest severity and frequency; and one is the highest detection capacity and five lowest).After that, for each failure mode, the possible cause and effect were identified, calculated getting initial Risk Priority Number (RPN) (severity x frequency x detection capacity) and classify in 4 groups for priorization. Possible corrective actions were discussed for each failure mode. After the application of this corrective actions final RPN was calculated, evaluating the effectiveness of these.
Results: In endourological surgery process, 7 potential failures were identified, and 10 corrective actions was proposed. Initial RPN identified 1 severe risk failure, 4 moderate risk failures and 2 admissible risk failures. After approval in the quality committee of the Unit, the improvement action measures were implemented. Final RPN was calculated after 6 months to evaluate the efficacy of these measures. It showed a significant reduction in risk, identifying only 7 potential admissible risk failures. No extreme, severe or moderate risks were identified in the reassessment (Table 1).
Conclusions: The FMEA was useful tool in proactive risk management because it allowed us to reduce, predict and prevent possible mistakes, and to adopt mesures to risk reduction in surgery, improving safety profile and health care quality in a Lithotripsy and Endourology Unit.