Failure Modes Effects Analysis ProjectSummary PROBLEMS 1. An FMEA will be performed on postoperative infections. Data is available by surgery type on the frequency, severity, and detectability of these infections. The director of quality improvement wants you to prepare a priority list giving the order in which the various sur- geries should be examined, to produce the greatest potential benefit for the organization. Severity is ranked from most severe (4) to least severe (1), and detectability is ranked from difficult to detect (4) to easy to detect (1). Calculate a frequency ranking from very high (5) to very low (1) based on the number of infections and cases shown in the following and the RPNs for each type of surgery. Which surgery should be examined first? Which surgery should be examined last? What is the maximum possible risk score for this analysis? Surgery Types Number of Infections Number of Cases Frequency Severity of Infections Detectability Risk Priority Number Thoracic 5 Neuro 1 Orthopedic 50 Plastic 32 Oral 25 General 100 200 3 3 100 4 3 2,000 2 2 800 1 2 500 1 1 5,000 2 1 2. Instead of the ordinal ranking of frequency, 1 to 5, used in problem 10.1, the director of quality improvement has collected data on the number of cases for each type of surgery and the num- ber of patients that contracted a postoperative infection. The director wants you to recalculate the RPN using the actual incidence rates of infection. Infection severity and detectability are ranked the same as in problem 10.1. Compare your new RPNs with those calculated in 10.1. How does the use of the incidence rate change the improvement work list? Which surgery should be examined last? What is the maximum possible risk score for this analysis? Surgery Types Number of Cases Number of Infections Rate of Infection Severity of Infections Detectability Risk Priority Number Thoracic 200 Neuro 100 Orthopedic 2,000 Plastic 800 Oral 500 General 5,000 5 3 3 1 4 3 50 2 2 32 1 2 25 1 1 100 2 1 Chapter ??: Failure Mode and Effects Analysis 3. Assume that in problem 10.2 strict adherence to antibiotic administration one hour prior to thoracic surgery has reduced the rate of infection to 1.0% and severity to 2.0. How did this improvement affect the priority list? Which surgery should be the primary target for improvement? 4. A hospital is setting its quality improvement agenda for the upcoming year and will per- form an FMEA in one area. The hospital has rated sentinel events for severity, probability, and detectability on the following scale: very high, high, moderate, low, very low. Calculate the risk priority number for each type of event. Which sentinel event should be the focus of the hospital’s FMEA effort? Event Severity Probability Detectability Hospital-acquired High Moderate Infection Medication Error Moderate High Patient Fall Low High Pressure Ulcer Low High Treatment Delay Low High High Moderate Very high Very high High
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