title: Evaluation of time- and cost-saving modifications of HFMEA: an experimental approach in radiotherapy.
abstract: OBJECTIVE
  : This study aimed to evaluate different shortcuts of Healthcare Failure Mode and Effects Analysis (HFMEA) in a radiotherapy setting.
  
  
  METHODS
  : A 2 × 2 study design was set up, in which 4 similar groups analyzed separately the possible risks of the same process by using different versions of HFMEA.
  
  
  METHODS
  : In the Maastricht Radiation Oncology clinic, a radiotherapy institute in the Netherlands, treatment of cancer patients is organized within 3 different units, each focusing on a specific area (thorax, abdomen, and neck-head). The institute plans to treat all radiation areas in one generalized unit (Linac-pool).
  
  
  METHODS
  : All 4 teams were composed of 3 radiation technologists (1 from each working unit), 1 manager radiation technologist, and 1 facilitator.
  
  
  METHODS
  : Prospective risk analyses were completed in parallel within 1 month.
  
  
  METHODS
  : Time investment and cost data on the different steps of the HFMEAs were registered from the organizations' perspective. Each team suggested a number of corrective actions for the Linac-pool. The quality and feasibility of the proposed actions were assessed by an expert panel (managers and safety staff).
  
  
  RESULTS
  : The HFMEA analyses resulted in direct costs varying from 1028.6 to 1701.6 euros. In total, the expert panel assessed 86 corrective actions, of which 43 (50%) were relevant to implement before the start of the Linac-pool. Many of these actions related to the compliance, control, and education of standard operating procedures in daily practice of radiotherapy.
  
  
  CONCLUSIONS
  : On the basis of the results of this case study, it seems feasible to develop less time- and cost-consuming versions of HFMEA, which would increase even more the added value of prospective risk analysis tools for health care organizations.
authors.affiliation: Hasselt University, Diepenbeek, Belgium. annemie.vlayen@uhasselt.be
authors.forename: Annemie
authors.initials: A
authors.lastname: Vlayen
mesh_terms: D003365:Costs and Cost Analysis; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy; D009426:Netherlands; D019982:Organizational Case Studies; D010348:Patient Care Team / Q000458:organization & administration*; D061214:Patient Safety; D011446:Prospective Studies; D011878:Radiotherapy / Q000191:economics / Q000379:methods*; D018570:Risk Assessment; D013997:Time Factors