| Summary: | 碩士 === 靜宜大學 === 管理碩士在職專班 === 99 === The correct imaging diagnosis is the first step to cancer patient treatment. Due to the increasing complexity of contemporary medical workflow, it is important to conduct systematic analysis in order to improve the quality of imaging reports. Healthcare Failure Mode and Effects Analysis (HFMEA) is a prospective and structural risk analysis tool in medical practice, which allows further comprehensive investigation and discussion of current medial operating system. Furthermore, it can also assist medical institute managers to make prioritized decisions on medical problems by improving relevant systems, technology, tools or methods to avoid the occurrence of harmful incidences.
The purpose of this research is to introduce HFMEA into the radiological department in a regional teaching hospital in central Taiwan. By following the five steps of HFMEA, failure modes and causes were identified, which were most crucial in improving the process, developing strategies and improvement programs for cancer imaging reporting process. In this research, the causes of failure modes for the diagnostic process of cancer imaging reporting were categorized into five aspects as following:
1. Clinical information: the focus is to facilitate the flow and sharing of clinical information. The solution aims to simplify information accession, review and improve the handling process of abnormal cases, and establish a communication channel among clinical physicians.
2. Image quality: the focus is to obtain decent image quality. The solution includes setting up a standard imaging examination process, arranging image quality improvement meetings, establishing imaging supervision and assessment mechanisms, and improving skills and knowledge of technicians.
3. Imaging interpretation: Improvements are needed in the traditional imaging interpretation process. Therefore, a mechanism must be established to prevent or correct mistakes. The improving programs are to set up medical imaging report "review mechanism ","real-time feedback mechanism, "peer review meeting", and develop relevant monitoring indicators.
4. Image reporting: the focus is to set up standards according to the needs of the hospital, standardize and specify important information necessary for cancer imaging reports. The solution is to develop "cancer imaging reporting standard format", which can standardize the process of image report and improve the quality of cancer imaging reporting.
5. Feedback mechanisms: the focus is to set up a reminder and feedback mechanism between radiologists and clinicians to prevent information asymmetry between the two which may result in fatal human error. The goals of this mechanism are to establish "abnormal imaging report notification mechanism," to remind physicians paying attention to imaging results, and to develop "Imaging report feedback mechanism" to provide fast feedback channels for clinicians.
This study has shown that using HFMEA to improve the cancer imaging diagnostic process can find potential problems, establish group consensus, reduce harmful mistakes, increase accountability of our department. This method can achieve the purpose of improving patient safety and strengthening service quality of medical.
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