Applying HFMEA to prevent chemotherapy errors

J Med Syst. 2012 Jun;36(3):1543-51. doi: 10.1007/s10916-010-9616-7. Epub 2010 Nov 11.


To evaluate risk and vulnerability in the chemotherapy process using a proactive risk analysis method. Healthcare failure mode and effect analysis (HFMEA) was adopted to identify potential chemotherapy process failures. A multidisciplinary team is formed to identify, evaluate, and prioritize potential failure modes based on a chemotherapy process flowchart. Subsequently, a decision tree is used to locate potential failure modes requiring urgent improvement. Finally, some recommended actions are generated and executed to eliminate possible risks. A total of 11 failure modes were identified with high hazard scores in both inpatient and outpatient processes. Computerized physician order entry was adopted to eliminate potential risks in chemotherapy processes. Chemotherapy prescription errors significantly decreased from 3.34% to 0.40%. Chemotherapy is regarded as a high-risk process. Multiple errors can occur during ordering, preparing, compounding, dispensing, and administering medications. Subsequently, these can lead to serious consequences. HFMEA is a useful tool to evaluate potential risk in healthcare processes.

MeSH terms

  • Drug Therapy*
  • Hospitals, General
  • Humans
  • Medical Order Entry Systems*
  • Medication Errors / prevention & control*
  • Pharmacy Service, Hospital / standards
  • Risk Assessment / methods
  • Taiwan
  • User-Computer Interface