Using FMEA to Reduce the Risk of Delayed Reporting of Critical Radiological Results in Oncology: A Patient Safety Initiative

Abstract

BACKGROUND: Timely communication of critical radiological findings is vital in oncology, where delays may jeopardize treatment and patient safety. Despite existing protocols, challenges such as manual reporting, unclear escalation paths, and resource limitations still contribute to delays. PURPOSE: This study applied Failure Mode and Effects Analysis (FMEA) to identify and address high-risk failure points in reporting critical radiology results at an oncology center. METHODS: Conducted at a specialized oncology center in Amman, Jordan, this quality improvement project used a pre-and-post intervention design. A multidisciplinary team including radiologists, oncologists, IT staff, quality officers, and nurses applied the FMEA framework to assess the reporting process. Failure modes were scored using Severity, Occurrence, and Detection critera to calculate Risk Priority Numbers (RPNs). Key interventions included: 1. Automated alerts integrated with the Electronic Health Record (EHR), 2. Standardized escalation protocols, 3. Staff retraining, 4. Structured documentation, and 5. Enhanced interoperability across PACS-RIS-EHR systems. Compliance was monitored monthly over a 12 months period. RESULTS: Pre-intervention RPNs ranged from 280 to 350, with major risks identified in unrecognized findings (RPN=320), lack of physician notification (310), unclear protocols (330), and insufficient emergency coverage (350). Post-intervention analysis showed RPN reductions of 54-62%. Recognition of critical findings improved by 55%, notification by 58%, protocol adherence by 62%, and emergency staffing by 54%. Improvements were linked to automation, clearer workflows, and better system integration. Statistical testing confirmed significant compliance improvement and reduced monthly variation. CONCLUSION: FMEA effectively identified and mitigated critical failures in radiology reporting. Integrating technology and cross-disciplinary collaboration enhanced reporting timeliness, compliance, and patient safety in oncology care.

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