The application of healthcare failure mode and effect analysis in reducing medication errors in the emergency department of Regional Public Hospital

Abstract

Introduction: Medication or medication error is an essential issue in the world of health, both in the world and in Indonesia. The emergency department is a health service unit that provides emergency services 24 hours non-stop, which is very likely for medication errors to occur. Most medication incident errors can be prevented. One method that can be used is of healthcare failure mode and effect analysis (HFMEA). Applying HFMEA in hospitals helps avoid and identify possible or potential problems or errors in healthcare services. Methods: This qualitative study used the HFMEA approach to conduct risk analysis regarding medication events and errors in the emergency department (ER), at Regional Public Hospital, Central Java. Brainstorming and focus group discussion were conducted with all members of the HFMEA team at the regional public hospitals’ ER in Central Java following HFMEA guidelines. Results: Four process flows in ER drug or medication administration services were identified, encompassing 14 service sub-processes and 57 failure modes. Of the 57 failure modes, only 34 were subjected to hazard analysis, and only 24 failure modes required control measures. From these data, four control strategies were obtained. Conclusion: This study found 24 failure modes need to be addressed and suggested four control strategies, including enterprise risk management formats according to the needs of ER’ health workers, improving ER service management, improving standard operational procedures for medical services, and improving pharmacy management.