Healthcare failure mode and effect analysis combined service blueprint – Mitigating mass casualty triage in emergency units: A qualitative study

IF 1.8 4区 医学 Q2 NURSING International Emergency Nursing Pub Date : 2024-09-04 DOI:10.1016/j.ienj.2024.101508
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Abstract

Introduction

The 24-hour operation of medical emergency units involves crucial first-hand information and medical treatments, which could involve potential complications and disputes if not handled with the utmost professionalism. Effective logistical support and timely activation are crucial in mass casualty triage to prevent systematic treatment issues and chaos.

Objective

This study explores the integration of Healthcare Failure Mode and Effect Analysis (HFMEA) with a service blueprint to mitigate medical risks and enhance mass casualty triage efficiency in emergency units.

Method

An expert team analyzed emergency unit standard operating procedure cases using a service blueprint to visually represent mass casualty triage scenarios. The HFMEA identified potential hazards and failure risks in healthcare service delivery during mass casualty triage.

Results

Fifteen high-risk hazard indexes exceeding the standard score of eight were identified among three main processes and thirty-one potential failure reasons. The initial operational time for mass casualty triage was approximately 104 min, significantly reduced to 34 min after process revision (p = 0.043, <0.05).

Conclusions

This study demonstrates effective time management in mass casualty triage, potentially saving up to an hour. Improved operational efficiency allows for focused resuscitation efforts, alleviating concerns about timely patient flow initiation.

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医疗失效模式与效应分析组合服务蓝图 - 减少急诊室的大规模伤亡分流:定性研究
导言医疗急救单位的 24 小时运作涉及重要的第一手信息和医疗处理,如果不以最专业的态度处理,可能会引起潜在的并发症和纠纷。本研究探讨了如何将医疗失效模式与效应分析(HFMEA)与服务蓝图相结合,以降低医疗风险并提高急救单位的大规模伤员分流效率。方法专家小组利用服务蓝图对急救单位标准操作程序案例进行分析,以直观呈现大规模伤员分流场景。结果在三个主要流程和 31 个潜在故障原因中,有 15 个高风险危害指标超过了 8 分的标准分。大规模伤员分流的初始操作时间约为 104 分钟,流程修订后显著缩短至 34 分钟(p = 0.043,<0.05)。操作效率的提高使抢救工作更加集中,减轻了人们对及时启动病人流的担忧。
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来源期刊
CiteScore
3.20
自引率
11.10%
发文量
85
期刊介绍: International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care. The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.
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