NR533: Quality Improvement and Patient Safety

Week 06 Assignment – Failure modes and effects analysis (FMEA)
This assignment provides students with the opportunity to identify a high-risk process in the practice setting and then conduct a failure modes and effects analysis (FMEA).
The FMEA is a systematic, proactive approach to assess risk of failure and harm in a high-risk process, and identify areas for process improvement.

Use the FMEA Table as displayed in Figure 1 at the end of Week 5 lesson. A copy of the table is also available in an Excel Spreadsheet.
Steps in the process
Failure modes, failure causes, and failure effects
Likelihood of Occurrence (1-10)
Likelihood of Detection (1-10)
Severity (1-10)
Risk Profile Number (RPN)
Actions to Reduce Occurrence of Failure


Use the MS Excel table FMEA for High Risk Process to fill out your failure and effect analysis according to the IHI lesson.
Attach your Excel table below and ‘submit for grade’.

Week 6: Required Readings

Nash, Joshi, Ransom, & Ransom: Chapter      10.
Chassin, M. R., & Loeb, J. M.. (2011, April). The ongoing quality improvement journey: Next      stop, high reliability. Health Affairs, 30(4), 559-568. (Library Link)
TJC. (2021). 2021 National Patient Safety Goals. The Joint Commission.
Staines, A., Amalberti, R., Berwick, D.M., Braithwaite, J., Lachman, P., & Vincent, C. A.. (2020). Covid-19: Patient Safety and Quality Improvement skills to deploy during the surge. International Journal for Quality in Health Care, pp 1-3.
Thull-Feedman, J., Mondoux, S., Stang, A., & Chartier, L.B. (2020). Going to the COVID-19 Gemba: Using observation and high reliability strategies to achieve safety in a time of crisis. Canadian Journal of Emergency Medicine, 2020,      1-4.
     (Open Access Creative Commons NC-4.0)

Content in weeks Lesson

Federico, Frank. (2017). Bringing it all together: The journey to high reliability. Barnes Jewish      Hospital; Washington University in St. Louis Physicians. (Video)
Federico, Frank. (2021). Reliable Systems and Processes. IHI Open School. (Video)
MedStar Health. (2017, Sept.). Mindfulness in a High Reliability Organization. MedStar Health. (Video)
N.A. (2018, June). Understand the Science of Safety. Agency for Healthcare Research and      Quality. (Video)
N.A. (2021). Transforming Health Care into a High Reliability Industry. Joint Commission      Center for Transforming Healthcare. (Video)
Press Ganey Associates. (2018, Feb.). High Reliability: Improving the Safety, Quality and      Experience of Care. Press Ganey Associates, LLC. (Video)

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