Prospective risk analysis of health care processes: A systematic evaluation of the use of HFMEA™ in Dutch health care

The aim of this study was to evaluate the use of Healthcare Failure Mode and Effect Analysis (HFMEA™) in Dutch health care by means of user feedback. Thirteen HFMEA™ analyses of various health care processes were successfully concluded and on average took 69 person-hours (excluding reporting). These results show that HFMEA™ can successfully be applied in Dutch health care. However, the user feedback also uncovered several perceived drawbacks, such as the fact that HFMEA™ is very time-consuming and that, particularly, the risk assessment part of HFMEA™ is difficult to carry out. Moreover, a lack of guidance with regard to the identification of failure mode causes and effective actions might influence the quality of the outcomes of an HFMEA™ analysis. Several suggestions are put forward to improve the perceived utility and acceptance of HFMEA™. Nevertheless, future research is necessary to evaluate the actual effects of these recommendations. Error modelling and risk analysis, and their contribution to explaining human performance in socio-technical systems, traditionally belong to the field of ergonomics. The user feedback on HFMEA™ and the suggestions that are put forward may also be useful for (H)FMEA and hazard analysis and critical control point applications in sectors other than health care.