While the prospective review process itself is well recognized, the practice of including patients/families as full members of a system-wide prospective Failure Modes Effects Analysis (FMEA) review team has not been previously established across a health care system. Recognizing that it is essential to engage with patients/families for this type of work to be truly successful, 2016 marked Nova Scotia Health Authority’s (NSHA) first system-wide FMEA to fully engage patient and family advisors (PFAs) as part of the review team with leaders, physicians and staff.
PFAs participated in the process from start to finish, assisting to: identify all potential failure modes and underlying effects; determine potential cause and priority of all failure modes; identify opportunities for process re-design; and develop recommendations for improvement.
Lessons learned included how to engage patients in future reviews, how patient participants brought a unique perspective and how they can effectively contribute to recommendations for improvement, reduction of risk and enhance positive patient experience. This work has resulted in system changes to improve quality and safety across all four management zones of NSHA and will further enable inclusion of PFAs as members of the team.
The first NSHA system-wide review took an existing practice and applied it in a significantly different manner to create a new way of reviewing potential patient safety issues. A 2017 FMEA was also completed with patient as FMEA team members, while a third FMEA has been initiated, further demonstrating collective ownership by patients/families and healthcare team members to improve services.