Analysis of Clinical Risks in Home-Based Radiology Using the FMEA Method.

Abstract

INTRODUCTION

This study analyzes the safety risks associated with home radiology, a service that is growing due to increasing average age and chronic diseases and about which references in the literature are largely lacking.

MATERIALS AND METHODS

Through a preliminary SWOT analysis, the strengths, weaknesses, opportunities and threats of the service were identified. Strengths include the ability to perform diagnostic examinations directly at home, reducing inconvenience for patients with mobility difficulties and improving access to care. Weaknesses include organizational complexity, low adoption by general practitioners and lack of dedicated staff. Opportunities include service expansion and meeting the needs of a vulnerable population, while threats include logistical and data security issues. Next, an analysis of potential errors was performed using the proactive Failure Mode and Effects Analysis (FMEA) methodology.

RESULTS

52 failure modes were identified, mainly attributable to critical management, technical and communication issues. These included incorrect patient identification, inadequate assessment of suitability for a home examination, and misinterpretation of images. These errors are amplified by the environmental and organizational conditions typical of the home setting, such as the lack of automated patient identification systems and the presence of family members and/or caregivers.

DISCUSSION AND COCNLUSIONS

Improvement actions were proposed in the project, which include continuous and specific training for staff on safety risks to care in the home radiology process, active participation of patients and caregivers/family members, and simplification of the procedure in the pre-survey phase. The crucial role of patients and family members/caregivers in order to be able to ensure the safety of the diagnostic process was also emphasized: their awareness and active involvement can help reduce errors and improve the effectiveness of the service. As highlighted by the World Health Organization as early as 2013, if patients are informed about procedures, medical and non-medical, through the use of clear and understandable materials, such as using icons, pictures or diagrams, it increases awareness in them about the risks associated with the examination they are going to perform. In conclusion, the paper not only contributes to the attempt to fill an existing gap, but also emphasizes a proactive way of approaching clinical risk, bringing, as the main resolution, the patient to the center of care.