Using Failure Mode and Effects Analysis (FMEA) to Improve Patient Safety in u-Health Nursing Service

Saturday, 26 July 2014

Hanna Choi, MA
Korean Academy of Medical Sciences (KAMS), Seoul, South Korea


The aim of this study is to identify and assess the management of risk in relation to the use of a tele-nursing service to promote service quality and assure patient safety. This study utilizes failure mode and effect analysis, a proactive technique. Low-income older adults generally have higher requirements for a u-health service as they suffer from more diseases and thus have more of a need for health management than the general adult population. However, there are difficulties and possible risk factors given their low health literacy rates and inability to use new u-Health devices. The FMEA method is utilized to implement the new service in an effort to prevent avoid errors before they occur.


First, the context was established, after which four multidisciplinary teams of four persons each, including a tele-nurse, an internet company staff member, a representative from the equipment manufacturer, and a person serving as a manager of the participant resident, were assembled to analyze the possible causes of issues that can arise during the tele-nursing service process. Second, analyses of identification risk areas were conducted to examine the risk factors associated with the process, looking forward at component failure rather than backward. Failure modes were scored with a risk priority number (RPN) for each step and change, by multiplying the Occurrence, Severity, and Detection scores according to the JCAHO classification.


Twenty three clinical error and failure modes were analyzed in relation to the u-Health nursing service. As a result, accidents could be sorted into two types: care service (43.5%) and system (56.5%) accidents. A flow diagram indicating the four points of preparation for bio-signal measurements, measurement followed by device instructions, the checking of the result by the participant and tele-nurse, and an assessment outcome, was devised . A hazard analysis according to the RPN risk priority number was conducted to analyze elements leading to the following areas: a lack of preparation for bio-signal check-ups(24 score), forgetting the measurement method(15 score), emergencies which could arise(15 score), situations related to the internet connection network(12 score) and power(12 score), not following the instructions of the u-Health measurement device(12 score), and assessments of older people by telephone(12 score).


We understood where and when risk tasks are undertaken during a participants check their bio-signal. FMEA to Tele-nursing services for patient safety enhance and reduce from significant risks. Identified many clinical risk assessment management can be preventable usage in service using aged population.