ISQua 2015 Abstract Submission

ISQua 2015 Abstract Submission Specific topic: Quality and Safety in Developing Countries ISQUA15-1434 FAILURE MODE AND EFFECT ANALYSIS (FMEA) FOR IMPLEMENTATION OF CLINICAL PRACTICE GUIDELINES AT A TERTIARY CARE TEACHING HOSPITAL IN SAUDI ARABIA A. M. I. Babiker 1 2,*, Y. S. Amer 2 3 4, H. A. A. Wahabi 4 5, K. A. Alswat 6 7 1Pediatrics, King Saud University College of Medicine, 2Pediatrics Department Quality Team, 3Quality Management Department, 4Clinical Practice Guidelines Steering Committee, King Saud University Medical City, 5Research Chair for Evidence-Based Health Care and Knowledge Translation, 6Medicine, King Saud University College of Medicine, 7Hospital Quality Committee, King Saud University Medical City, Riyadh, Saudi Arabia Preferred presentation method: 15 min oral presentation Are you a first time presenter at an ISQua conference?: Yes I confirm that the submission has been approved by all authors: Yes I give ISQua the permission to publish this abstract on the ISQua website: Yes What year was the study conducted?: 2014 Objectives: Implementation of evidence-based clinical practice guidelines (CPGs) has been proven to decrease variation of practice, support informed clinical decisions, and improve healthcare quality and patient safety. The CPG adaptation and implementation program was launched in 2009 in all clinical departments at King Saud University Medical City (KSUMC). FMEA is a tool used for process evaluation to identify different potential failures and their relative impacts on the process in order to anticipate areas for change and/or further improvement in the process. The aim of this work is to demonstrate the usefulness of using FMEA in the evaluation of CPG implementation. Methods: Generic FMEA Steps were used to assess implementation of CPGs by a multidisciplinary team in the Pediatrics Department at KSUMC, including; (i) process review and recording of the steps and activities, (ii) Hazard analysis by recording activity-related failure modes and their effects, identification of actions required, assigned severity, occurrence and detection scores for each failure mode and calculated the risk priority number (RPN) by multiplying the 3 scores and the total RPN was calculated by adding the single failure mode RPN using the Institute for Healthcare Improvement online interactive FMEA tool, (iii) Planning: RPNs prioritization based on the 3 scores and failure mode causes were analyzed, recommendations made and planning of the new actions needed, (iv) Monitoring: after reduction or elimination of the failure mode. Furthermore, the calculated RPN will be compared with the subsequent ones. Results: The CPG program resulted in the adaptation of 25 CPGs in different departments (including 6 CPGs finalized and 4 in progress in the department of Pediatrics). The identified potential failure modes in the CPGs implementation process with the highest RPN (≥ 80) were in the awareness/training activities, accessible printed and electronic implementation tools, advocates from clinical champions, auditing of the CPGs including the data management process. Actions taken included (i) regular awareness activities, (ii) printed and electronic copies made available and accessible to healthcare providers at points of care, (iii) consultants and senior practitioners were encouraged to get involved in the CPG adaptation and implementation process, (iv) the auditing was followed by the Pediatrics Department Quality Team and the Quality management department as a part of the quality sustainability plan and the CPG program in KSUMC. Conclusion: Application of FMEA helps to identify potential failures and monitor barriers in CPGs implementation. It also identifies the most important and relevant critical activities that need to be adopted in order to achieve a successful outcome. It is vital to address these recommendations and actions that result from the FMEA. References: Acknowledgments: Mohammed El Faki Osman, Farheen Shaikh, Lubna Al-Ansary, Abdelrahman Al-Nemri, Ayman Aleyadhy, Solafa Fatani, Fadi El-Jardali I do not want to receive other promotional material from ISQua: No Disclosure of Interest: None Declared

Keywords: Clinical Practice Guidelines, FMEA, implementation strategies