Healthcare failure mode and effect analysis combined service blueprint - Mitigating mass casualty triage in emergency units: A qualitative study

Int Emerg Nurs. 2024 Dec:77:101508. doi: 10.1016/j.ienj.2024.101508. Epub 2024 Sep 4.

Abstract

Introduction: The 24-hour operation of medical emergency units involves crucial first-hand information and medical treatments, which could involve potential complications and disputes if not handled with the utmost professionalism. Effective logistical support and timely activation are crucial in mass casualty triage to prevent systematic treatment issues and chaos.

Objective: This study explores the integration of Healthcare Failure Mode and Effect Analysis (HFMEA) with a service blueprint to mitigate medical risks and enhance mass casualty triage efficiency in emergency units.

Method: An expert team analyzed emergency unit standard operating procedure cases using a service blueprint to visually represent mass casualty triage scenarios. The HFMEA identified potential hazards and failure risks in healthcare service delivery during mass casualty triage.

Results: Fifteen high-risk hazard indexes exceeding the standard score of eight were identified among three main processes and thirty-one potential failure reasons. The initial operational time for mass casualty triage was approximately 104 min, significantly reduced to 34 min after process revision (p = 0.043, <0.05).

Conclusions: This study demonstrates effective time management in mass casualty triage, potentially saving up to an hour. Improved operational efficiency allows for focused resuscitation efforts, alleviating concerns about timely patient flow initiation.

Keywords: Healthcare Delivery; Healthcare Failure Mode and Effect Analysis; Mass Casualty Incidents; Professionalism; Triage.

MeSH terms

  • Emergency Service, Hospital* / organization & administration
  • Healthcare Failure Mode and Effect Analysis* / methods
  • Humans
  • Mass Casualty Incidents*
  • Qualitative Research*
  • Triage* / methods