A fuzzy multicriteria group decision approach for classification of failure modes in a hospital’s operating room

Abstract

The operating room (OR) is one of the most important departments of any hospital. Mismanagement can lead to severe problems with patient’s safety and satisfaction, costs, and profitability. The Failure Mode and Effects Analysis (FMEA) is a risk assessment tool used to identify potential failure modes (FM) which should be prioritized to be mitigated. To assess the risks of an OR, some important aspects cannot be neglected: it should be conducted by a team of experts from different functional areas; address the non-compensation between criteria; classify FM, instead of ranking it, since it is easier to understand and support decision making; address the subjectivity present on experts’ opinion; and consider the mitigation complexity, since hospital’s resources are limited. However, were not found studies in the literature which simultaneously covered all these aspects. Therefore, this paper proposes a new group decision model, which combines a consensus reaching process with ELECTRE TRI and double hierarchy hesitant fuzzy linguistic term sets (DHHFLTS). A pilot application of the model was conducted in an OR of a Brazilian hospital. The results have shown that the consensus technique, the mitigation complexity, and the non-compensation can modify the failure modes classification. Also, the DHHFLTS allowed the experts to use more complex linguistic terms to express their opinion. In addition, the pilot application was carried out during the covid-19 pandemic and the results have shown that due to the high number of elective surgeries being rescheduled to give space to urgent surgeries, the patients' health problems become even worst and they turn to urgent surgeries.