Question

Describe the difference between failure mode and effects analysis (FMEA) and fault tree analysis (FTA). Which one is more desirable? Justify your opinion. Quote one healthcare reference from your own search. Then, provide a solution to the following scenario: • A maintenance technician on the anesthesia equipment connects the oxygen supply hose to the nitrous oxide supply fitting. The patient can go into a coma. Include two references to support your opinions.

Answer 1

1. The differences between failure mode and effects analysis (FMEA) and fault tree analysis (FTA) are:

• a) The most important difference between FTA and FMEA is in system approach; FTA is a top-down approach whereas FMEA is a bottom-up approach.
• b).FTA is a deductive method, but FMEA assesses the different effects of single causes.
• c) FTA can show the system resistance to initiating faults, but can’t find all possible initiating faults. FMEA is good in classifying initiating faults and the identification of their local effects but is not good in examining multiple failures and/or effects of failures at the system level.
• d) FTA considers external events, FMEA doesn't consider external events.

2. FMEA is more desirable from the healthcare perspective. FMEA is applied in the case of a new process/function/service with an inherent hazard that has not been implemented. It is also applicable to an existing process/function/service that needs modifications due to past failure or sentinel events. Examples of some common sentinel events are unintentional retention of a foreign object, falls, anesthesia errors, performing procedures on the wrong patient/part etc. Another scenario of FMEA application is an existing process/function/service used in a similar or new location. It finds applications in all these scenarios because of its multifunctionality and effectiveness as a failure mode and effects analysis tool. It is good in classifying initiating faults and the identification of their local effects. It is a systematic method to evaluate a process as a whole to identify how and where it would fail. FMEA also assesses the impact of various failures to identify the process parts that need to be changed.

3. "A maintenance technician on the anesthesia equipment connects the oxygen supply hose to the nitrous oxide supply fitting. The patient can go into a coma." A solution to this scenario would be to conduct a failure mode and effects analysis. FMEA is applicable to an existing process, function, or service that needs modifications due to past failure or sentinel events. This scenario can be considered as an existing process/function/service that needs modifications due to a fault or failure that could lead to a sentinel event. Here failure mode was caused because the oxygen supply and nitrous oxide supply were not easily identifiable. The effect of this mode of connecting the oxygen supply hose to nitrous oxide supply would be a sentinel event like the coma stage of the patient. Here the solution will be to use separate easily identifiable colors for different gas supply fittings and to check it before giving it to the patient.

Reference:

1. HOW TO AVOID FAILURES-(FMEA and/or FTA)

https://www.dsiintl.com/wp-content/uploads/2017/04/HOW-TO-AVOID-FAILURES-FMEA-andor-FTA.pdf

2. Healthcare FMEA

https://quality-one.com/hfmea/