Failure-Mode Effects And Criticality Analysis (FMECA)

In 1949, the U.S. Department of Defense developed a qualitative method named Failure-Mode Effects and Criticality Analysis (FMECA) to identify potentially error-prone systems and process vulnerabilities (Gershengorn, Kocher & Factor, 2014). Initially, this method was applicable in critical industries such as aeronautics and atomic power plants. Since 2001, it has been adopted by service industries like healthcare organizations to evaluate process failures and improve patient safety. This proactive risk-assessment approach is used in addressing operational challenges such as operating room turn-over, emergency room waiting time, door-to-balloon time, etc. Hence, it can be asserted that FMECA procedure is an effective tool in identifying and
Some of the tactics to address the top three identified failure modes would be providing cross-training staff to prepare the catheterization laboratory, adopting a protocol system to transfer the STEMI patients directly to the catheterization laboratory, activating the catheterization laboratory earlier by the emergency medicine physician, etc. Cross-training the ER nurses, physicians and whole Cardiac Care Unit (CCU) to prepare the catheterization laboratory for activation (on the patient’s arrival) can benefit the hospitals in eliminating the unnecessary wait time for the patients. If the catheterization laboratory is readily available, then the cardiologist can begin the process of revascularization immediately, which can certainly aid in reducing the delay (Rocha, 2013). Likewise, by utilizing a protocol system such as PH-ECG (Pre-Hospital 12 leads Electrocardiogram), which is performed by paramedics as a reperfusion therapy for STEMI can help the patients in transferring directly to the catheterization laboratory. This manifests that training the EMS staff to interpret PH-ECGs can assist in activating the labs earlier, which in turn, fastens the process of STEMI diagnosis. Consequently, the issues related to locating the patient’s exam room and gathering patient’s history by the ER physician eliminates. Furthermore, according to Bradley et al. (2006), one of the tactics in decreasing door-to-balloon time involves activating the catheterization laboratory by the emergency medicine physician (without consulting a cardiologist) through a central paging system, staff arrival within 20 minutes of notification, providing feedback in real-time and interdisciplinary association throughout the