Table 1

Steps of HFMEA and persons selected to participate in this programme*

StepDescription of the tasksPersons selected to participate
1. Define the topic.

  1. Select high-risk or high-vulnerability area to review.

  2. Seek approval from the manager.

Quality expert, critical care expert, nursing supervisors.
2. Assemble the team.

  1. Select and invite subject matter experts, advisors and team leaders.

  2. Determine timeline of meeting and activities.

Quality expert, critical care expert, nursing supervisors, head nurses, respiratory therapists, radiology technicians.
3. Graphically describe the process.

  1. Develop and verify flow diagram of the focused process.

  2. Identify subprocess steps.

Quality expert, head nurses, respiratory therapists, radiology technicians.
4. Conduct a hazard analysis.

  1. List all possible or potential failure modes for each subprocess.

  2. Determine the severity and probability of failure modes.

  3. Determine whether the failure mode warrants further action by using decision tree analysis.

Quality expert, head nurses, nursing specialists, respiratory therapists, radiology technicians and supervisor.
5. Actions and outcome measures.

  1. Develop and describe actions to proceed for the failure modes.

  2. Identify outcome measures.

  3. Identify single person responsible.

Quality expert, head nurses, nursing specialists, respiratory therapists, radiology technicians and supervisor.

  • *Adapted from DeRosier et al [1] .

  • HFMEA, healthcare failure mode and effects analysis.