Implementing a new scale for failure mode and effects analysis (FMEA) for risk analysis in a radiation oncology department

TY - JOUR

T1 - Implementing a new scale for failure mode and effects analysis (FMEA) for risk analysis in a radiation oncology department

AU - Baehr, Andrea

AU - Oertel, Michael

AU - Kröger, Kai

AU - Eich, Hans Theodor

AU - Haverkamp, Uwe

PY - 2020/12

Y1 - 2020/12

N2 - PURPOSE: Patients and staffs are endangered by different failure modes during clinical routine in radiation oncology and risks are difficult to stratify. We implemented the method of failure mode and effects analysis (FMEA) via questionnaires in our institution and introduced an adapted scale applicable for radiation oncology.METHODS: Failure modes in physical treatment planning and daily routine were detected and stratified by ranking occurrence, severity, and detectability in a questionnaire. Multiplication of these values offers the risk priority number (RPN). We implemented an ordinal rating scale (ORS) as a combination of earlier published scales from the literature. This scale was optimized for German radiation oncology. We compared RPN using this ORS versus use of a rather subjective visual analogue rating scale (VRS).RESULTS: Mean RPN using ORS was 62.3 vs. 67.5 using VRS (p = 0.7). Use of ORS led to improved completeness of questionnaires (91 vs. 79%) and stronger agreement among the experts, especially concerning failure modes during radiation routine. The majority of interviewed experts found the analysis by using the ORS easier and expected a saving of time as well as higher intra- and interobserver reliability.CONCLUSION: The introduced rating scale together with a questionnaire survey provides merit for conducting FMEA in radiation oncology as results are comparable to the use of VRS and the process is facilitated.

AB - PURPOSE: Patients and staffs are endangered by different failure modes during clinical routine in radiation oncology and risks are difficult to stratify. We implemented the method of failure mode and effects analysis (FMEA) via questionnaires in our institution and introduced an adapted scale applicable for radiation oncology.METHODS: Failure modes in physical treatment planning and daily routine were detected and stratified by ranking occurrence, severity, and detectability in a questionnaire. Multiplication of these values offers the risk priority number (RPN). We implemented an ordinal rating scale (ORS) as a combination of earlier published scales from the literature. This scale was optimized for German radiation oncology. We compared RPN using this ORS versus use of a rather subjective visual analogue rating scale (VRS).RESULTS: Mean RPN using ORS was 62.3 vs. 67.5 using VRS (p = 0.7). Use of ORS led to improved completeness of questionnaires (91 vs. 79%) and stronger agreement among the experts, especially concerning failure modes during radiation routine. The majority of interviewed experts found the analysis by using the ORS easier and expected a saving of time as well as higher intra- and interobserver reliability.CONCLUSION: The introduced rating scale together with a questionnaire survey provides merit for conducting FMEA in radiation oncology as results are comparable to the use of VRS and the process is facilitated.

KW - Germany

KW - Healthcare Failure Mode and Effect Analysis/methods

KW - Humans

KW - Neoplasms/radiotherapy

KW - Radiation Oncology/methods

KW - Radiotherapy Planning, Computer-Assisted/methods

KW - Surveys and Questionnaires

KW - Workflow

U2 - 10.1007/s00066-020-01686-w

DO - 10.1007/s00066-020-01686-w

M3 - SCORING: Journal article

C2 - 32951162

VL - 196

SP - 1128

EP - 1134

JO - STRAHLENTHER ONKOL

JF - STRAHLENTHER ONKOL

SN - 0179-7158

IS - 12

ER -