Evaluation and critique of Healthcare Failure Mode and Effect Analysis applied in a radiotherapy case study

Healthcare Failure Mode and Effect Analysis (HFMEA (R)) has been developed to support the proactive analysis of health care treatment processes. Its use has been reported in several studies with both positive and negative comments regarding the quality of the results and the efficacy of the method. This paper examines the HFMEA (R) methodology and discusses the challenges that were encountered during its application to a proactive analysis of radiotherapy patient record systems in a large public hospital. Several weaknesses in the HFMEA (R) method and particularly in the HFMEA Decision TreeTM are also discussed. Recommendations to support future HFMEA (R) studies and also for the re-design of the HFMEA Decision TreeTM to overcome the identified weaknesses are included. Based on these recommendations, a new decision tree is presented to guide future analyses. (c) 2012 Wiley Periodicals, Inc.