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Research Article
Application of Failure Mode Effect Analysis (FMEA) to Improve Medication Safety in the Dispensing Process – A Study at A Teaching Hospital, Sri Lanka
Nithushi Samaranayake
University of Sri Jayewardenepura
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Failure Mode Effect Analysis (FMEA) is a prospective, team based, structured process used to identify system failures of high risk processes before they occur. Medication dispensing is a risky process that should be analysed for its inherent risks using FMEA.
Objectives: The objective of this study was to identify possible failure modes, their effects and causes in the dispensing process of a selected tertiary care hospital using FMEA.
Methods: Two independent teams (Team A and Team B) of pharmacists conducted the FMEA for two months in the Department of Pharmacy of a selected teaching hospital, Colombo, Sri Lanka. Each team had five meetings of two hours each, where the dispensing process and sub processes were mapped, and possible failure modes, their effects, and causes, were identified. A score for potential severity (S), frequency (F) and detectability (D) was assigned for each failure mode. Risk Priority Numbers (RPNs) were calculated (RPN=SxFxD) to prioritise identified failure modes.
Results: Team A identified 48 failure modes while Team B identified 42. Among all 90 failure modes, 69 were common to both teams. Using the RPN, Team A prioritised one failure mode, while Team B prioritised three (having identical RPNs). Both teams identified overcrowded dispensing counters as a cause for 57 failure modes. Redesigning of, dispensing tables, dispensing labels, the dispensing and medication re-packing processes, and establishing a patient counseling unit were the major suggestions for correction.
Conclusion: FMEA was successfully used to identify and prioritise possible failure modes of the dispensing process through active involvement of pharmacists.
Keywords
Failure Mode Effect Analysis, FMEA, Pharmacists, Dispensing process, Sri Lanka
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Reviewer #7 agreed
On 11 Jan, 2021
Reviewer #1 agreed
On 11 Jan, 2021
Reviewer #9 agreed
On 11 Jan, 2021
Reviewer #2 agreed
On 11 Jan, 2021
Reviewer #11 agreed
On 11 Jan, 2021
Reviewer #10 agreed
On 11 Jan, 2021
Reviewer #6 agreed
On 11 Jan, 2021
Reviewer #4 agreed
On 11 Jan, 2021
Reviewer #8 agreed
On 11 Jan, 2021
Reviewer #12 agreed
On 11 Jan, 2021
Reviewer #5 agreed
On 11 Jan, 2021
Reviewer #15 agreed
On 11 Jan, 2021
Reviewer #14 agreed
On 11 Jan, 2021
Reviewer #3 agreed
On 11 Jan, 2021
Reviewer #13 agreed
On 11 Jan, 2021
Reviewers invited
Invitations sent on 11 Jan, 2021
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On 09 Jan, 2021
Editor invited
On 08 Jan, 2021
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First submitted
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Application of Failure Mode Effect Analysis (FMEA) to Improve Medication Safety in the Dispensing Process – A Study at A Teaching Hospital, Sri Lanka
Nithushi Samaranayake
University of Sri Jayewardenepura
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 12 Jan, 2021
No community comments so far
Review #6 received
Received 11 Jan, 2021
Review #2 received
Received 11 Jan, 2021
Review #4 received
Received 11 Jan, 2021
Review #8 received
Received 11 Jan, 2021
Review #1 received
Received 11 Jan, 2021
Review #11 received
Received 11 Jan, 2021
Review #10 received
Received 11 Jan, 2021
Review #9 received
Received 11 Jan, 2021
Reviewer #7 agreed
On 11 Jan, 2021
Reviewer #1 agreed
On 11 Jan, 2021
Reviewer #9 agreed
On 11 Jan, 2021
Reviewer #2 agreed
On 11 Jan, 2021
Reviewer #11 agreed
On 11 Jan, 2021
Reviewer #10 agreed
On 11 Jan, 2021
Reviewer #6 agreed
On 11 Jan, 2021
Reviewer #4 agreed
On 11 Jan, 2021
Reviewer #8 agreed
On 11 Jan, 2021
Reviewer #12 agreed
On 11 Jan, 2021
Reviewer #5 agreed
On 11 Jan, 2021
Reviewer #15 agreed
On 11 Jan, 2021
Reviewer #14 agreed
On 11 Jan, 2021
Reviewer #3 agreed
On 11 Jan, 2021
Reviewer #13 agreed
On 11 Jan, 2021
Reviewers invited
Invitations sent on 11 Jan, 2021
Editor assigned
On 09 Jan, 2021
Editor invited
On 08 Jan, 2021
Submission checks complete
On 08 Jan, 2021
First submitted
On 24 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Failure Mode Effect Analysis (FMEA) is a prospective, team based, structured process used to identify system failures of high risk processes before they occur. Medication dispensing is a risky process that should be analysed for its inherent risks using FMEA.
Objectives: The objective of this study was to identify possible failure modes, their effects and causes in the dispensing process of a selected tertiary care hospital using FMEA.
Methods: Two independent teams (Team A and Team B) of pharmacists conducted the FMEA for two months in the Department of Pharmacy of a selected teaching hospital, Colombo, Sri Lanka. Each team had five meetings of two hours each, where the dispensing process and sub processes were mapped, and possible failure modes, their effects, and causes, were identified. A score for potential severity (S), frequency (F) and detectability (D) was assigned for each failure mode. Risk Priority Numbers (RPNs) were calculated (RPN=SxFxD) to prioritise identified failure modes.
Results: Team A identified 48 failure modes while Team B identified 42. Among all 90 failure modes, 69 were common to both teams. Using the RPN, Team A prioritised one failure mode, while Team B prioritised three (having identical RPNs). Both teams identified overcrowded dispensing counters as a cause for 57 failure modes. Redesigning of, dispensing tables, dispensing labels, the dispensing and medication re-packing processes, and establishing a patient counseling unit were the major suggestions for correction.
Conclusion: FMEA was successfully used to identify and prioritise possible failure modes of the dispensing process through active involvement of pharmacists.
Figure 1
Figure 2
Figure 3