An integrated HFMEA-DES model for performance improvement of general hospitals: a case study

Purpose: Today, quality improvement is one of the crucial key success factors in every hospital due to the growth of demands and limitation of resources. Healthcare Failure Mode and Effect Analysis (HFMEA) is the most important method in healthcare systems to identify potential risks. HFMEA is suitable for defining preventive actions to reduce the effects of risks. In addition, a Discrete Event Simulation (DES) model can be designed to evaluate the effects of every improvement scenarios. Consequently, in this paper, an integrated model using HFMEA and DES is presented for quality improvement in a general hospital.
Design/ methodology/ approach: In the proposed model, HFMEA is implemented first. As any risk in the hospital is important and that there are many departments and different related risks, all defined risk factors are evaluated using the Risk Priority Number (RPN) for which related corrective actions are defined based on experts’ knowledge. Then, a DES model is designed to determine the effects of some corrective actions before implementation in the hospital under investigation.
Findings: Results show that the proposed integrated model not only supports different steps of HFMEA but also is highly in accordance with the determination of real priorities of the risk factors. This model predicts the effects of corrective actions before implementation and helps hospital managers to improve hospital performances.
Practical implications: This research is based on a case study in a well-known general hospital in Iran to help the managers for improving the performances of different departments. 
Originality/ Value: This study takes the advantages of an integrated HFMEA-DES model in supporting the limitation of HFMEA in a general hospital with a large number of beds and patients. The case study proves the effectiveness of the proposed approach for improving the performances of the hospital resources.