title: Recognising and referring children exposed to domestic abuse: a multi-professional, proactive systems-based evaluation using a modified Failure Mode and Effects Analysis (FMEA).
abstract: Failure Modes and Effects Analysis (FMEA) is a prospective quality assurance methodology increasingly used in healthcare, which identifies potential vulnerabilities in complex, high-risk processes and generates remedial actions. We aimed, for the first time, to apply FMEA in a social care context to evaluate the process for recognising and referring children exposed to domestic abuse within one Midlands city safeguarding area in England. A multidisciplinary, multi-agency team of 10 front-line professionals undertook the FMEA, using a modified methodology, over seven group meetings. The FMEA included mapping out the process under evaluation to identify its component steps, identifying failure modes (potential errors) and possible causes for each step and generating corrective actions. In this article, we report the output from the FMEA, including illustrative examples of the failure modes and corrective actions generated. We also present an analysis of feedback from the FMEA team and provide future recommendations for the use of FMEA in appraising social care processes and practice. Although challenging, the FMEA was unequivocally valuable for team members and generated a significant number of corrective actions locally for the safeguarding board to consider in its response to children exposed to domestic abuse.
authors.affiliation: School of Social, Psychological and Communication Sciences, Faculty of Health and Social Sciences, Leeds Beckett University, Leeds, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Ashley
authors.affiliation: Faculty of Health Studies, University of Bradford, Bradford, UK.|Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
authors.forename: Gerry
authors.initials: G
authors.lastname: Armitage
authors.affiliation: School of Nursing, Institute of Clinical Sciences, University of Birmingham, and Birmingham Children's Hospital, Birmingham, UK.
authors.forename: Julie
authors.initials: J
authors.lastname: Taylor
mesh_terms: D002648:Child; D002669:Child Welfare; D017579:Domestic Violence; D004739:England; D005260:Female; D000067495:Healthcare Failure Mode and Effect Analysis; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D012017:Referral and Consultation; D018570:Risk Assessment
keywords: child protection; child safeguarding; domestic violence; failure mode and effects analysis; multidisciplinary work; practitioner research