The application of healthcare failure mode and effect analysis in enhanced recovery after thoracic surgery in thoracic surgery

Abstract

Objective To evaluate the efficacy of healthcare failure mode and effect analysis in enhanced recovery after surgery(ERAS) in thoracic surgery. Methods Establish the healthcare failure mode and effect analysis group and evaluate the possible healthcare failure modes in implementation of ERAS. Calculate the odds ratio and make a decision tree in order to find out the failure modes and make safe schemes for bowel preparation, peri-operative pain monitoring and evaluation, vein thrombosis screening and management, early mobilization and food-taking after surgery and catheter removal for patients with benign prostate hyperplasia. Results Before and after the implementation of ERAS, 237 patients were selected. The risk priority number after the implementation of ERAS had been reduced, all less than 8 points. After the implementation of ERAS, the rate of initial pain score greater than 4 was 53.2%(126/237), the incidence of nausea and vomiting was 13.5%(32/237), and incidences of thrombosis and constipation were all 6.8%(16/237), the urinating patency rate after pulling-out the tube was 100.0%(237/237). Before the implementation of ERAS, the indicators was 96.6%(229/237), 43.0%(102/237), 30.0%(71/237), 36.7%(87/237), 79.7%(189/237). There was significant difference before and after the implementation of ERAS (χ2=5.455-15.022, P<0.05). Conclusions The application of healthcare failure mode and effect analysis can reduce the incidence of adverse reaction and complications after thoracic surgery and ensure a secure and high-quality implementation of ERAS, which is worth using widely. Key words: Thoracic surgery; Healthcare failure mode and effect analysis; Enhanced recovery after surgery