title: Application of Failure Mode Effect Analysis to Improve the Care of Septic Patients Admitted Through the Emergency Department.
abstract: Failure mode effect analysis (FMEA) is a proactive multistep tool used to analyze risks, identify failures before they occur, and prioritize preventive measures.
  
  
  
  A multidisciplinary team trained on FMEA methodology analyzed the process of treatment of septic patients and recorded processes under 3 major phases (recognition of severe sepsis, referral, and resuscitation). The team identified potential failure modes in each process; assigned severity, occurrence, and detection scores for each; and calculated the risk priority numbers (RPNs). Finally, higher-priority failure modes (RPN of ≥300) were analyzed to redesign the care process.
  
  
  
  We identified 27 processes and 48 failure modes with a mean RPN of 270. Twenty-two high-risk failures were identified by RPN of 300 or higher. All identified critical processes were related to phase 1 (recognition of sepsis) and phase 3 (resuscitation). The most critical process seemed to be related to the initial workup and treatment of septic patients, with 4 potential failure modes and a total RPN of 1485.
  
  
  
  Patient safety and care reliability issues are a major concern in health care. This study suggests that tools such as FMEA can enable a detailed analysis of the care process of septic patients by outlining potential failure modes and guiding improvement efforts.
authors.affiliation: From the *College of Medicine, and †College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences; and ‡Department of Quality Management, §Department of Emergency Medicine, and ∥Intensive Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Alamry
authors.forename: Souzan M
authors.initials: SM
authors.lastname: Al Owais
authors.forename: Abdellatif M
authors.initials: AM
authors.lastname: Marini
authors.forename: Hasan
authors.initials: H
authors.lastname: Al-Dorzi
authors.forename: Sami
authors.initials: S
authors.lastname: Alsolamy
authors.forename: Yaseen
authors.initials: Y
authors.lastname: Arabi
mesh_terms: D002983:Clinical Competence; D004632:Emergency Medical Services / Q000592:standards*; D004636:Emergency Service, Hospital; D006801:Humans; D010343:Patient Admission; D061214:Patient Safety; D058996:Quality Improvement; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012151:Resuscitation; D012306:Risk; D018570:Risk Assessment; D012308:Risk Management / Q000379:methods*; D018805:Sepsis / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome