Document Type : Original Article


1 Health Information Management, School of Health Management and Information Sciences, Tehran University of Medical Sciences

2 Baghiateallah University of Medical Sciences, Tehran, Iran

3 Department of Medical Information Management, Isfahan University of Medical Sciences, Isfahan


Introduction: Cognizance of any error-prone professional activities has a great impact on
the continuity of professional organizations in the competitive atmosphere, particularly in
health care industry where every second has critical value in patients’ life saving. Considering
invaluable functions of medical record department — as legal document and continuity
of health care — “failure mode and effects analysis (FMEA)” utilized to identify the ways
a process can fail, and how it can be made safer. Materials and Methods: The structured
approach involved assembling a team of experts, employing a trained facilitator, introducing
the rating scales and process during team orientation and collectively scoring failure modes.
The probability of the failure-effect combination was related to the frequency of occurrence,
potential severity, and likelihood of detection before causing any harm to the staff or patients.
Frequency, severity and detectability were each given a score from 1 to 10. Risk priority
numbers were calculated. Results: In total 56 failure modes were identified and in subsets
of Medical Record Department including admission unit dividing emergency, outpatient and
inpatient classes, statististic, health data organizing and data processing and Medical Coding
units. Although most failure modes were classified as a high risk group, limited resources
were, as an impediment to implement recommended actions at the same time. Conclusion:
Proactive risk assessment methods, such as FMEA enable health care administrators to
identify where and what safeguards are needed to protect against a bad outcome even
when an error does occur.


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