title: High Rate of Implementation of Proposed Actions for Improvement With the Healthcare Failure Mode Effect Analysis Method: Evaluation of 117 Analyses.
abstract: The aims of this study were to investigate what kind of impact the Healthcare Failure Mode Effect Analysis (HFMEA) had on the organization in 1 county council in Sweden and to evaluate the method of working for multidisciplinary teams performing HFMEA. Three main outcome measures were used: the quality of the documentation from the HFMEAs, fulfillment of the primary goal of the HFMEA, and, finally, whether proposed actions for improvement were implemented.
  
  
  
  The study involved retrospective analysis of the documentation from 117 performed HFMEAs from 3 hospitals in the county council of Östergötland, Sweden, and interviews or questionnaires with team leaders and managers between 2006 and 2010.
  
  
  
  A proposed change in the organizational structure was the most common issue in the analyses. Eighty-nine percent of the written reports were of high quality. A median of 10 serious risks were detected, and 10 proposed actions (median) were made. In 78% of the HFMEAs, all or a large part of these had been implemented a few years afterward. We were unable to find factors that promoted the rate of implementation of proposed actions. Seventy-eight percent of the managers were completely satisfied with the results of the HFMEA. The mean cost per risk analysis was &OV0556;1909.
  
  
  
  Most of the proposed actions were implemented. The use of HFMEA can be improved using fewer team leaders but with more experience. The work involved in writing a report can be reduced without loss of impact on the organization.
authors.affiliation: From the Center for Healthcare Development, County Council of Östergötland; and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Annica
authors.initials: A
authors.lastname: Öhrn
authors.forename: Carin
authors.initials: C
authors.lastname: Ericsson
authors.forename: Christer
authors.initials: C
authors.lastname: Andersson
authors.forename: Johan
authors.initials: J
authors.lastname: Elfström
mesh_terms: D006761:Hospitals / Q000592:standards*; D006801:Humans; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000458:organization & administration; D058996:Quality Improvement; D012189:Retrospective Studies; D018570:Risk Assessment; D012308:Risk Management / Q000379:methods* / Q000458:organization & administration; D013548:Sweden