title: [Systematic approach for dysfunctional analysis in radiotherapy].
abstract: OBJECTIVE
  We previously presented a systematic and structured approach to acquire an accurate functional model of the patient's process in radiotherapy. This approach relied on new functional structuring patterns, derived from system engineering and knowledge engineering. Additionally, we propose a complementary methodical process for the dysfunctional analysis of the obtained functional model.
  
  
  METHODS
  The procedure is based on joint implementation of two qualitative methods named "Failure modes and effects analysis" (FMEA) and "Hazard and operability" (HazOp).
  
  
  RESULTS
  All the technical, the human and the organizational dimensions of the patient's process are pooled in a unique, exhaustive and detailed dysfunctional analysis. The application of this systematic approach within a particular institution can precisely identify the risks incurred by patients in care, but also highlight the logical sequence between precursor events and incidents.
  
  
  CONCLUSIONS
  The dysfunctional analysis presented in this document will be used for the development still in process of quantified risk models.
authors.affiliation: Centre de recherche en automatique de Nancy CRAN, CNRS, UMR 7039, campus sciences, université de Lorraine, BP 239, 54506 Vandœuvre-lès-Nancy cedex, France. alexandre.reitz@univ-lorraine.fr
authors.forename: A
authors.initials: A
authors.lastname: Reitz
authors.forename: E
authors.initials: E
authors.lastname: Levrat
authors.forename: J-F
authors.initials: JF
authors.lastname: Pétin
authors.forename: A
authors.initials: A
authors.lastname: Noël
authors.forename: D
authors.initials: D
authors.lastname: Aigle
authors.forename: D
authors.initials: D
authors.lastname: Peiffert
authors.forename: P
authors.initials: P
authors.lastname: Graff
mesh_terms: D006801:Humans; D019300:Medical Errors; D008962:Models, Theoretical; D061214:Patient Safety; D017064:Process Assessment, Health Care; D011785:Quality Assurance, Health Care; D011878:Radiotherapy / Q000009:adverse effects*; D018570:Risk Assessment; D012308:Risk Management