Original scientific paper

https://doi.org/10.11613/BM.2018.020713

Utilization of a healthcare failure mode and effects analysis to identify error sources in the preanalytical phase in two tertiary hospital laboratories

Adolfo Romero orcid.org/0000-0002-7824-2347 ; Haematology Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain; Nursing Department, Health Sciences School, University of Málaga, Spain
Juan Gómez-Salgado orcid.org/0000-0001-9053-7730 ; School of Nursing, University of Huelva, Huelva, Spain; University Espiritu Santo, Guayaquil, Ecuador
Adolfo Romero-Arana orcid.org/0000-0002-2267-3236 ; Fundación IMABIS, Málaga, Spain
Carlos Ruiz-Frutos ; University Espiritu Santo, Guayaquil, Ecuador; Environmental Sciences Department, University of Huelva, Huelva, Spain

Abstract

Introduction: The presence of errors in the preanalytical phase is a thoroughly studied problem. A strategy to increase their source detection
might be the use of the Healthcare Failure Mode and Effects Analysis (HFMEA). The aim of this study is improving the capacity of
identifying sources of error during the preanalytical period in samples provided by primary care clinics (PCC) with the use of the HFMEA as
a tool in the laboratories of two tertiary hospitals.
Materials and methods: A HFMEA was carried out in each laboratory, by means of the creation of groups of experts with similar characteristics
(doctors and nurses from PCC and laboratory, support staff, and laboratory technicians). The Risk Priority Number (RPN) was
calculated.
Results: Items with elevated RPN were presented in both centers. The highest RPN were in LAB1: “two request notes for a patient” and
“the segregation of oncology urgent samples” (both with 384), while in LAB2 was “the lack of information in patients with oral glucose
overload test” (RPN 576). Considering the different steps in the preanalytical phase, LAB1 paid attention in sampling, samples reception
and the programming in the Laboratory Information System, while LAB2 paid attention in the request form, the appointment system,
sampling procedures, transport and reception.
Conclusion: The laboratories prioritized the problems differently. However, both centers offer solutions to these possible sources of error.
We proposed improvement actions that can be resolved easily, with a low cost for the system, mainly to schedule a specific formative
programme and a deep revision of the existing protocols.

Keywords

preanalytical phase; Healthcare Failure Mode and Effects Analysis; quality assessment; errors

Hrčak ID:

201533

URI

https://hrcak.srce.hr/201533

Publication date:

15.6.2018.

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