9/14/2015

InstituteforHealthcareImprovement:FailureModesandEffectsAnalysisToolProcessDataReport

FailureModesandEffectsAnalysis(FMEA)Tool

CopyofReducepatientcontacttimeforphysician
NoOrganization
GrandRapids,Michigan,UnitedStates
GroupPractice

Aim:Reducephysicianpatientcontacttime.
ProcessData
Date:05/22/2011
Step

Description

Patientschedulesapptwithphysician

FailureMode

Causes

Effects

Appointmenttimeincorrectly Employeeaccidentallyinputs Patientarrivesfor

enteredornotentered.
wronginformation.
appointmentanddoesnot
haveone.Frustratedpatient.
Disruptionofofficeroutine.
Step

Description

Patientbookedforhalfhourtimeblock.

FailureMode

Causes

Effects

Notenoughtimescheduled
forpatientcare.Delayin
providingcaretoother
patients.Subparcustomer
service.

Patienthasadditional
illnesseswhichwerenot
discussedatinitial
scheduling.Patient
embarassedtodiscussillness
duringscheduling.

Physicianispressedfortime
andmaygetbehind.
disruptioninofficeroutine.
Disgruntledstaff.

Step

Description

PatientArrivesandisgreetedby1stnurse

FailureMode

Causes

Effects

Shortageofstaff.
Miscommunicationamongst
staff.Lackoffundingtohire
tempstaff.Elderly/forgetful
patient.

Vacation,illnessesofstaff,
shortstaffed.Ineffective
communicationamongst
staff.

Patienthasalongwaittime.
Physicianscheduledelayed.
Disgruntled/disappointed
patient.

Step

Description

Patientisweighedandhadvitalstakenby2ndnurse

FailureMode

Causes

Nooneavailabletocomplete Shortstaffed,callins,
vitals.Inadequateresources
(i.e.bloodpressurecuffs,
equipment,ect...)

Step

Description

Firstnursedoesmedicalhistory.

Effects
Patientexperiences
increasedwaitingtime.
Physicianisbehind.Disrupts
officeroutine.

FailureMode

Causes

Effects

Ifnursedoesntcollect
sufficientinformationfrom
patient.

Nursenotaskingproper
questionsduringscreening.
nursecuttingcorners.

Visitwillbemorelengthyand
physicianwillnothave
requiredinformation.

Step

Description

Secondnurseentersanytestresultsorinfoforphysiciantohave
beforecontactwithpatient.

FailureMode

Causes

Effects

Ifnursedoesnotenterdata
correctlyordelaysentering
information.Lackof
communicationbetween
physicianandstaff.

Nursebecomesbusyor
distracted.Physicianbehind
schedule.Incompletehealth
records.

Patientwillhavealonger
visitandmaybemistreated
basedonincompleteor
inaacurateinformation.
frustratedstaff/physician.

Step

Description

Whilephysiciandoingassesmentsecondnurseisatcomputertyping
progressnotes.

FailureMode

Causes

Effects

Ifnurseisdistractedorbusy
withanothertasknursemay
notaccuratelytypephysician
commentsortreatments,
ect...

Nursebusy/distractedmay
notaccuratelytypein
informationgivenby
physician.

Patientmaybeperscribed
wrongtreatment,
medications,orfollowups.

Occ Det Sev RPN Actions

2

84 Havechecksandbalancesin
placetoaddress.

Occ Det Sev RPN Actions

6

384 Makesurethatscheduling
staffasksappropriate
questionsinitially.
satndardized,structured
patientschedulewithfixed
timeslotsforeachtypeof
visit.

Occ Det Sev RPN Actions

4

196 Allocatefundingtohire
resource(temp)staffwhen
necesscary.Crosstrain
administrativepersonnel.

Occ Det Sev RPN Actions

4

144 Initiateastudyonhowto
bettermanageresources.
Allocatemorefundingfor
resourcestaff.Institutea
rewardpolicyfor
attendance.

Occ Det Sev RPN Actions

4

256

Occ Det Sev RPN Actions

3

216 Ensurethateachpatienthas
completehealthrecords24
hoursbeforeappointment.A
EHRdatabasethatis
accurateanduptodate.

Occ Det Sev RPN Actions

3

http://app.ihi.org/Workspace/tools/fmea/ProcessDetailDataReport.aspx?ToolId=12627&ScenarioId=14382&Type=1

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9/14/2015

InstituteforHealthcareImprovement:FailureModesandEffectsAnalysisToolProcessDataReport

Step

Description

Ifpatienthasanymedicallynecesscaryinformationrequiredfirst
nursewillgatherrecordsforphy

FailureMode

Causes

Effects

Wronginformationprovided.
Informationrequestedis
incompletefromother
practice/specialist.HIPPA
regulations.

Specialist/otherpracticedoes
notsendaccurate/through
information.Secondnurse
notavailable

Patientwillnotbeseenuntil
correctrecordareprovided
requiringadditionalvisit.
Phsiciannotabletoprovide
qualityoraccuratecareto
patient.

Step

Description

Physicianconductsassesment.

FailureMode

Causes

Effects

Notenoughstaffnecesscary
toutilizetwostaffmembers.

Shortstaffed.Physiciannot
properlytrainedonCQI
initiative.Non
compliant/elderly/forgetful
patient.

Patientwaittimesincreased.
Physicianworksunderstress.
Physicianspendsmorethan
allocatedtimewithpatient.

Step

Description

10

Bothnursesworktogethertoensurethatpatientrecordsare
completed.

FailureMode

Causes

Miscommunicationamongst
Lackofcommunication,staff
staff.Patientinformationmay errors,andshortstaff.
getmixedupwithtwostaff
members.Lackof
communicationbetweenstaff
andpatient.

Effects
Patientinformationmixedup.
Increasedwaittime.Patient
providedwrongtreatment,
tests,followups.Ineffective
useofemployeetime.

Occ Det Sev RPN Actions

8

320 MaintainanEHRdatabase
thatisacurateandupto
date.Establishgood
relationshipswithother
providers.Properlytrained
administrativestaff.

Occ Det Sev RPN Actions

7

245 Morefundingallocatedto
resourcestaff.Properlytrain
physicianonprocessand
CQIinitiative.Keep
physiciansontrackby
providingreminders.

Occ Det Sev RPN Actions

3

189 Allocatenecesscaryfunding
toincreasestaff.Establish
methodsforstaffto
communicatemore
effectively.AnEHRdatabase
thatisacurateandupto
date.

CalculatedTotals
TotalRiskPriorityNumberfortheprocess

2181

Occ: LikelihoodofOccurrence(110)
Det: LikelihoodofDetection(110)
NOTE: 1=VerylikelyitWILLbedetected

10=VerylikelyitWILLNOTbedetected

Sev: Severity(110)
RPN:RiskPriorityNumber(OccDetSev)

Annotation
None

http://app.ihi.org/Workspace/tools/fmea/ProcessDetailDataReport.aspx?ToolId=12627&ScenarioId=14382&Type=1

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