Healthcare facility design and risk assessment using FMEA approaches

Healthcare environments pose specific risks, including potential exposure to biohazards, toxic chemicals, and machinery. In addition to formal risk management policies and protocols, the physical design of healthcare environments can be managed to minimize risk and reduce hazards. In “Risk Assessment as Standard Work in Design,” Morrill (2013) discusses the importance of the Failure Mode and Effects Analysis (FMEA) and also and Six Sigma framework for reducing risk in healthcare environments. The author conducted workflow assessments at two different hospitals, also taking into account problem solving tactics and techniques using in-depth interviews with staff. The author’s intended audience is healthcare managers or administrators, or policymakers with vested interest in improving the safety of the healthcare workplace. Through the case study, the author shows that facility design does play an important role in risk management in the healthcare environment. Although the study is not experimental, it reveals some of the specific design elements and problem solving procedures that can maximize safety for both patients and staff. The author outlines the differential needs for patient and staff risk reduction. For example, the original FMEA process covers medication use risks, whereas issues related to healthcare leadership are broader concerns impacting the entire healthcare environment. The author’s arguments support her main point stressing the significance of formal risk assessment in both design and procedure. Furthermore, the author’s findings are supported by literature and assessment tools created by the Center for Health Design (2015), which offers roadmaps, toolkits, and process guides reflecting the principles of FMEA and Six Sigma. With the two hospitals covered in the case study, the author covers a broad spectrum of risk modeling and risk assessments, including procedural workflow, locations of intensive care units and other high-risk areas, problem-solving training and handling of hazardous materials within the hospital. It is not a matter of agreeing with the author, so much as it is applying the wisdom outlined here to improving hospital design and workflow. However, Morrill (2013) spends little time discussing the communications and human resources issues that also promote patient and staff safety. Effective, evidence-based healthcare environmental design is important for promoting safety, but it is equally as important to train staff effectively, update training when necessary, monitor compliance, and base all procedural decisions on the growing body of literature in risk assessment. The author does not cover issues like signage, which can also impact risk management. The two hospitals Morrill (2013) outlines the benefits and challenges of the FMEA process, which is effective in multiple work sectors. One of the benefits of using FMEA is improved efficiency as well as improved outcomes on measures of safety, which is also supported by the literature. For instance, Rana & Belokar (2017) point out that using FMEA can reduce costs and increase efficiency within all workplace environments. The challenges associated with the hospitals’ use of the FMEA process include altering faulty hospital design or changing operational procedures in ways that would prove disruptive, demanding an analysis of the factors leading to resistance to change. Change management in organizations can be integrated with the Six Sigma and FMEA process, helping healthcare managers to better inform their staff and provide supportive training and interventions with the goal of improving safety. Finally, the Morrill (2013) research has implications for future hospital and healthcare center design. Newer facilities can be designed in ways that create workflows that reduce risk and promote safety, including the reduction of preventable problems like medication errors or noncompliance with basic standards of hygiene such as placing hand washing stations in strategic locations.