Quality Department, Biomedical Diagnostic Center, Hospital Clínic of Barcelona, Barcelona, Spain.
Biochemistry and Molecular Genetics Department, Biomedical Diagnostic Center, Hospital Clínic of Barcelona, Barcelona, Spain.
Biochem Med (Zagreb). 2020 Jun 15;30(2):020703. doi: 10.11613/BM.2020.020703. Epub 2020 Apr 15.
Laboratories minimize risks through quality control but analytical errors still occur. Risk management can improve the quality of processes and increase patient safety. This study aims to use the failure mode and effect analysis (FMEA) to assess the analytical performance and measure the effectiveness of the risk mitigation actions implemented.
The measurands to be included in the study were selected based on the measurement errors obtained by participating in an External Quality Assessment (EQA) Scheme. These EQA results were used to perform an FMEA of the year 2017, providing a risk priority number that was converted into a Sigma value (σ). A root-cause analysis was done when σ was lower than 3. Once the causes were determined, corrective measures were implemented. An FMEA of 2018 was carried out to verify the effectiveness of the actions taken.
The FMEA of 2017 showed that alkaline phosphatase (ALP) and sodium (Na) presented a σ of less than 3. The FMEA of 2018 revealed that none of the measurands presented a σ below 3 and that σ for ALP and Na had increased.
Failure mode and effect analysis is a useful tool to assess the analytical performance, solve problems and evaluate the effectiveness of the actions taken. Moreover, the proposed methodology allows to standardize the scoring of the scales, as well as the evaluation and prioritization of risks.
实验室通过质量控制将风险最小化,但仍会出现分析错误。风险管理可以提高流程质量,增加患者安全。本研究旨在使用失效模式和影响分析(FMEA)评估分析性能并衡量实施的风险缓解措施的有效性。
根据参与外部质量评估(EQA)计划获得的测量误差,选择要纳入研究的测量值。这些 EQA 结果用于对 2017 年进行 FMEA,提供风险优先数,将其转换为西格玛值(σ)。当 σ 低于 3 时,进行根本原因分析。确定原因后,实施纠正措施。进行了 2018 年的 FMEA 以验证所采取措施的有效性。
2017 年的 FMEA 表明碱性磷酸酶(ALP)和钠(Na)的 σ 小于 3。2018 年的 FMEA 显示,没有任何测量值的 σ 值低于 3,并且 ALP 和 Na 的 σ 值有所增加。
失效模式和影响分析是评估分析性能、解决问题和评估所采取措施有效性的有用工具。此外,所提出的方法允许对评分尺度进行标准化,以及对风险进行评估和优先级排序。