Investigating the safety and health risks ranking in the hospital using the integrated approach of failure modes and effects analysis (FMEA) and Fuzzy-based Multiple Criteria Decision Making (MCDM) method

Introduction: Hospitals are considered as one of the most risky and stressful work environments. Given the importance of the issue, it is necessary to evaluate the various occupational hazards factors to hospital staff in order to make appropriate decisions regarding their management and control. Nowadays, the use of Multiple Criteria Decision Making (MCDM) methods has become widespread in risk assessment and ranking. Therefore, the present study was conducted to determine the importance of occupational hazards and to rank the most important potential health and safety risks in the hospital. Methods: In the present study, potential failure cases were identified in all wards of Shahid Beheshti Hospital in Yasouj (Yasouj, Iran) using the opinions of experts. The method of analysis of failure factors and its effects is one of the most widely used and traditional methods in risk assessment and management. However, there are limitations such as the same weight of severity indicators, the probability of occurrence and the ability to detect, as well as the same risk priority score. To eliminate the shortcomings in calculating the definite risk score and reduce inconsistencies in decision making as well as achieve more accurate results, the fuzzy TOPSIS method was used and then, the order of priority of different risks was determined using the fuzzy TOPSIS method. Results: A total of 112 important risks were identified for the 14 main wards of the studied hospital (nursing and clinical wards, laboratory, operating room, CSR, radiology, MRI, kitchen, pharmacy, laundry, facilities, services, waste and administration), which threatens the safety and health of hospital staff. The highest significance of health risks was related to airborne pathogens, blood and other body fluids (including bacteria, viruses and parasites, 35.42% critical). The highest importance of safety risks was related to cuts caused by sharp tools (needle, angiocatheter, suture, razor, knife, 35.09% critical). Conclusion: Using an integrated approach of failure analysis and its effects along with MCDM methods increases the speed of this process and obtains more reliable results.