First, the manager should not have to routinely attend Safety Briefings. The briefings should be designed for staff to conduct on their own. However, whether a manager attends or not, there are several ways to collect information. Use a form to write down issues or suggestions, and have a staff member complete the form, perhaps rotating the task among all staff. Another alternative is to use 3x5 index cards, on which each staff member can write items down themselves. Allow people to remain anonymous with either option.

The frequency should vary depending on the size of the unit or department. On large, busy units, where the staff and patients change often, Safety Briefings should be daily. However, on a small unit where the staff on duty or the patients may not vary much, weekly may work better. Talk with the staff and get their input as to a frequency for Briefings that is useful.

No. The purpose of Patient Safety Leadership WalkRounds™ should be to discuss issues about patient safety only. Senior leaders may want to talk about other issues, such as budget, but this will only dilute the message that safety is a high priority. Other forums, even additional rounds, should be scheduled to discuss these other important issues. However, to promote open communication senior leaders should try to answer any question from a staff member that may come up.

If the FMEA is complete, you should have a total Risk Priority Number (RPN) for each failure mode identified. Each step in the process may have more than one failure mode, so total the RPNs from each failure mode to determine the RPN for each step. Start with the steps that have the highest RPN, as they pose the greatest risk. Within each step, start first on the failure modes that have the highest individual RPN.

Before making a change to a process, estimate what you predict the new Risk Priority Number (RPN) will be. This will help you decide whether or not the change will be an improvement. Be sure to test the change first on a small scale to see if your predictions are correct. Once you decide to implement the change permanently, recalculate the RPN and report it in your data.

The interactive FMEA Tool is particularly useful in evaluating a new process prior to implementation and in assessing the impact of a proposed change to an existing process.