PMID- 25670543
OWN - NLM
STAT- MEDLINE
DCOM- 20150603
LR  - 20150402
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 91
IP  - 5
DP  - 2015 Apr 1
TI  - Practical implementation of failure mode and effects analysis for safety and 
      efficiency in stereotactic radiosurgery.
PG  - 1003-8
LID - S0360-3016(14)04533-7 [pii]
LID - 10.1016/j.ijrobp.2014.12.033 [doi]
AB  - PURPOSE: To improve the safety and efficiency of a new stereotactic radiosurgery 
      program with the application of failure mode and effects analysis (FMEA) 
      performed by a multidisciplinary team of health care professionals. METHODS AND 
      MATERIALS: Representatives included physicists, therapists, dosimetrists, 
      oncologists, and administrators. A detailed process tree was created from an 
      initial high-level process tree to facilitate the identification of possible 
      failure modes. Group members were asked to determine failure modes that they 
      considered to be the highest risk before scoring failure modes. Risk priority 
      numbers (RPNs) were determined by each group member individually and then 
      averaged. RESULTS: A total of 99 failure modes were identified. The 5 failure 
      modes with an RPN above 150 were further analyzed to attempt to reduce these 
      RPNs. Only 1 of the initial items that the group presumed to be high-risk 
      (magnetic resonance imaging laterality reversed) was ranked in these top 5 items. 
      New process controls were put in place to reduce the severity, occurrence, and 
      detectability scores for all of the top 5 failure modes. CONCLUSIONS: FMEA is a 
      valuable team activity that can assist in the creation or restructuring of a 
      quality assurance program with the aim of improved safety, quality, and 
      efficiency. Performing the FMEA helped group members to see how they fit into the 
      bigger picture of the program, and it served to reduce biases and preconceived 
      notions about which elements of the program were the riskiest.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Younge, Kelly Cooper
AU  - Younge KC
AD  - Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan. 
      Electronic address: kyounge@med.umich.edu.
FAU - Wang, Yizhen
AU  - Wang Y
AD  - Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
FAU - Thompson, John
AU  - Thompson J
AD  - Department of Radiation Oncology, Trillium Health Partners - Credit Valley 
      Hospital Site, Mississauga Halton/Central West Regional Cancer Program, 
      Mississauga, ON, Canada.
FAU - Giovinazzo, Julia
AU  - Giovinazzo J
AD  - Department of Radiation Oncology, Trillium Health Partners - Credit Valley 
      Hospital Site, Mississauga Halton/Central West Regional Cancer Program, 
      Mississauga, ON, Canada.
FAU - Finlay, Marisa
AU  - Finlay M
AD  - Department of Radiation Oncology, Trillium Health Partners - Credit Valley 
      Hospital Site, Mississauga Halton/Central West Regional Cancer Program, 
      Mississauga, ON, Canada.
FAU - Sankreacha, Raxa
AU  - Sankreacha R
AD  - Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
LA  - eng
PT  - Journal Article
DEP - 20150207
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - *Decision Trees
MH  - Humans
MH  - Medical Errors/*prevention & control
MH  - Probability
MH  - Quality Assurance, Health Care/*methods/organization & administration
MH  - Radiosurgery/*adverse effects/*standards
MH  - Risk Assessment/methods
MH  - Risk Management/*methods
MH  - *Safety
EDAT- 2015/02/12 06:00
MHDA- 2015/06/04 06:00
CRDT- 2015/02/12 06:00
PHST- 2014/10/28 00:00 [received]
PHST- 2014/12/04 00:00 [revised]
PHST- 2014/12/12 00:00 [accepted]
PHST- 2015/02/12 06:00 [entrez]
PHST- 2015/02/12 06:00 [pubmed]
PHST- 2015/06/04 06:00 [medline]
AID - S0360-3016(14)04533-7 [pii]
AID - 10.1016/j.ijrobp.2014.12.033 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2015 Apr 1;91(5):1003-8. doi: 
      10.1016/j.ijrobp.2014.12.033. Epub 2015 Feb 7.