Research, on the application of FMEA to the health care field: Verification of a diagnosis and care index at the time of a natural birth

摘要

The purpose of this research was to clarify, using FMEA methodology, the difference in failure mode risks in the context of a diagnosis and care index compiled at the time of a natural birth, and to examine the measures required to ensure patient safety. The researcher's informants comprised the obstetricians and midwives in the delivery ward of a general hospital in Tokyo, and the results obtained by the use of worksheets in terms of identifying failure modes and formulating measures were clarified as follows: l) even in the same hospital, the degree of of each failure mode was different. In terms of high-risk failure modes and high-priority measures, the following 7 items were identified: check failure or misconception of the main complaint prior to hospitalization; pre-hospitalization unsuitable diagnosis; unsuitable response to a woman in labor; unsuitable response to persons in attendance; unsuitable diagnosis and observation in the first term of a delivery; entry into the delivery room at unsuitable time; unsuitable diagnosis and observation after discharge of the placenta; 2) the results obtained 3 months after implementation of measures targeted at the failure modes identified above showed that a degree of improvement was acknowledged in comparison with the situation before implementation. It was thought that the planning and implementation of measures using worksheets was effective in terms of patient safety.