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      Application of the healthcare failure mode and effects analysis system to reduce the incidence of posture syndrome of thyroid surgery

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          Abstract

          This study aimed to investigate the application of the healthcare failure mode and effect analysis (HFMEA) to reduce the incidence of posture syndrome of thyroid surgery (PSTS).

          Subjects before (n = 78, July 2017–December 2017) and after (n = 114, January 2018–June 2018) HFMEA implementation (The Second Hospital of Nanjing, Nanjing University of Chinese Medicine) were selected. The training for PSTS was optimized using HFMEA.

          The occurrence of PSTS was reduced from 59% to 18% after HFMEA ( P < .001). Symptoms of pain and nausea and vomiting were also decreased after HFMEA (all P < .001). The critical thinking ability of 34 medical personnel to evaluate the reduction of thyroid postoperative posture syndrome increased from 246 ± 19 to 301 ± 14 ( P < .001) after HFMEA.

          HFMEA was used to create preoperative posture training procedures for PSTS, bedside cards for training, innovative preoperative posture training equipment, and a diversified preoperative posture training health education model.

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          Most cited references20

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          Cost-of-illness of neck pain in The Netherlands in 1996.

          J Borghouts, H Vondeling, B Koes … (1999)
          The prevalence of neck pain in the general population ranges from 10 to 15%. The complaints can result in substantial medical consumption, absenteeism from work and disability. In this study we investigated the costs of neck pain in the Netherlands in 1996 to assess the financial burden to society. The study was based on prevalence data. Data sources included national registries, reports of research institutes and health care authorities. Direct health care costs were estimated for hospital care, general practice care and paramedical care. These costs were calculated using fees. Calculation of indirect costs (absenteeism and disability) was based on the Human Capital Method (HCM). As an alternative approach the Friction Cost Method (FCM) was used. The total cost of neck pain in The Netherlands in 1996 was estimated to be US $686 million. The share of these costs was about 1% of total health care expenditures and 0.1 % of the Gross Domestic Product (GDP) in 1996. Direct costs were $160 million (23%). Paramedical care accounted for largest proportion of direct costs (84%). When applying the HCM for calculating indirect costs, these costs amounted to $527 million (77%). The total number of sick days related to neck pain were estimated to be 1.4 million with a total cost of $185.4 million in 1996. Disability for neck pain accounted for the largest proportion (50%) of the total costs related to neck pain in 1996 ($341). When applying the FCM for calculating the indirect costs, these costs were reduced to $96 million. The costs related to neck pain in 1996 in The Netherlands were substantial. Some caution should be taken in interpretation, as a number of assumptions had to be made in order to estimate the total costs. The cost structure shown in this study, with high indirect costs, has also been found in other studies. From an economical point of view it seems to be important to prevent patients from having to take sick leave and disability. One way in achieving this goal is to develop and investigate more effective treatments for acute neck pain, in order to prevent patients developing chronic pain and disability. Another option is to protect chronic patients from sick leave and disability by careful management. Thus, also in the area of direct medical costs, there may be room for cost savings by stimulating and improving cost-efficiency and cost-effectiveness of the (para)medical care. In order to deal with the lack of specific disease information, more detailed information of medical consumption, sick leave and disability is required for future cost analysis.
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            Exercises for mechanical neck disorders.

            Anita R Gross, Theresa M Kay, Jean-Philippe Paquin … (2015)
            Neck pain is common, disabling and costly. Exercise is one treatment approach.
            Article 0 comments Cited 73 times – based on 0 reviews     Review now
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              Exercises for mechanical neck disorders: A Cochrane review update.

              A.R. Gross, J.P. Paquin, G Dupont … (2016)
              Neck pain (NP) is disabling and costly.
              Article 0 comments Cited 50 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Medicine (Baltimore)
                Journal ID (iso-abbrev): Medicine (Baltimore)
                Journal ID (publisher-id): MEDI
                Title: Medicine
                Publisher: Wolters Kluwer Health
                ISSN (Print): 0025-7974
                ISSN (Electronic): 1536-5964
                Publication date Collection: December 2019
                Publication date (Electronic): 20 December 2019
                Volume: 98
                Issue: 51
                Electronic Location Identifier: e18309
                Affiliations
                [a ]Department of Nursing, The Second Hospital of Nanjing
                [b ]Department of Breast Surgery, The Second Hospital of Nanjing
                [c ]School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
                Author notes
                [∗ ]Correspondence: Qinwen Hang, School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Nanjing University of Chinese Medicine Xianlin Campus, B12, Nanjing 210046, China (e-mail: 602252753@ 123456qq.com ).
                Article
                Publisher ID: MD-D-19-03437 Accession ID: 18309
                DOI: 10.1097/MD.0000000000018309
                PMC ID: 6940133
                PubMed ID: 31860980
                SO-VID: cbd94765-142d-479f-b004-91dd23bcea39
                Copyright © Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

                History
                Date received : 28 April 2019
                Date revision received : 08 October 2019
                Date accepted : 06 November 2019
                Categories
                Subject: 4300
                Subject: Research Article
                Subject: Observational Study
                Custom metadata
                OPEN-ACCESS TRUE

                Keywords: healthcare failure mode and effects analysis,postural syndrome,risk control,thyroid postoperative posture,thyroid surgery
                Data availability:
                Keywords: healthcare failure mode and effects analysis, postural syndrome, risk control, thyroid postoperative posture, thyroid surgery

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