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Using risk analysis to ensure patients’ medication safety during hospital relocations and evacuations
  1. Laurence Schumacher1,2,
  2. Florian Berthaudin2,
  3. Anne-Laure Blanc1,
  4. Cédric Blatrie1,
  5. Anthony Staines3,4,
  6. Pascal Bonnabry2,5,
  7. Nicolas Widmer1,2
  1. 1Pharmacy of Eastern Vaud Hospitals, Rennaz, Switzerland
  2. 2Specialised Centre for Emergency and Disaster Pharmacy, Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
  3. 3Vaud Hospital Federation, Prilly, Switzerland
  4. 4Université Jean Moulin Lyon 3 IFROSS, Lyon, Auvergne-Rhône-Alpes, France
  5. 5Pharmacy of the Geneva University Hospitals, Geneva, Switzerland
  1. Correspondence to PD Dr Nicolas Widmer, Specialised Centre for Emergency and Disaster Pharmacy, Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland; Nicolas.Widmer{at}unige.ch

Abstract

Objectives To ensure patient safety and the preparedness of medication processes during hospital relocations and evacuations by using Failure Modes, Effects, and Criticality Analysis (FMECA).

Methods The relocation of six regional hospitals to a single building, resulting in 400 beds being moved, could be compared with an emergency evacuation. An FMECA was performed on the hospital group’s internal medicine and intensive care units (IMU and ICU), examining how medication processes would be affected by a hospital relocation or evacuation.

Results We identified 59 hospital relocation and 68 evacuation failure modes. Failure modes were ranked based on their criticality index (CI; range 1–810). The higher the CI, the greater the patient-related risk. Average initial IMU and ICU hospital relocation CI scores were 160 (range 105–294) and 201 (range 125–343), respectively, subsequently reduced to 32 (−80%) and 49 (−76%) after mitigation measures. Average initial IMU and ICU evacuation CI scores were 319 (range 245–504) and 592 (range 441–810), respectively, subsequently reduced to 194 (−39%) and 282 (−52%). Most mitigation measures (17/22), such as for example checklists, could be implemented in both situations. Due to their unpredictable nature, five measures were specific to evacuation situations.

Conclusions This study highlights the value of using an FMECA on medication processes to anticipate potential negative impacts on patient safety during hospital relocations or evacuations. Preparation for a hospital relocation can provide useful knowledge and an opportunity to test mitigation measures that might prove useful in evacuations.

  • emergency medicine
  • facility design and construction
  • organization and administration
  • quality of health care
  • safety

Data availability statement

Raw data are available upon reasonable request.

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