Roohollah Askari, Milad Shafii, Sima Rafiei, Mohammad Sadegh Abolhassani and Elaheh Salarikhah
Failure modes and effects analysis (FMEA) is a practical tool to evaluate risks, discover failures in a proactive manner and propose corrective actions to reduce or eliminate…
Abstract
Purpose
Failure modes and effects analysis (FMEA) is a practical tool to evaluate risks, discover failures in a proactive manner and propose corrective actions to reduce or eliminate potential risks. The purpose of this paper is to apply FMEA technique to examine the hazards associated with the process of service delivery in intensive care unit (ICU) of a tertiary hospital in Yazd, Iran.
Design/methodology/approach
This was a before-after study conducted between March 2013 and December 2014. By forming a FMEA team, all potential hazards associated with ICU services – their frequency and severity – were identified. Then risk priority number was calculated for each activity as an indicator representing high priority areas that need special attention and resource allocation.
Findings
Eight failure modes with highest priority scores including endotracheal tube defect, wrong placement of endotracheal tube, EVD interface, aspiration failure during suctioning, chest tube failure, tissue injury and deep vein thrombosis were selected for improvement. Findings affirmed that improvement strategies were generally satisfying and significantly decreased total failures.
Practical implications
Application of FMEA in ICUs proved to be effective in proactively decreasing the risk of failures and corrected the control measures up to acceptable levels in all eight areas of function.
Originality/value
Using a prospective risk assessment approach, such as FMEA, could be beneficial in dealing with potential failures through proposing preventive actions in a proactive manner. The method could be used as a tool for healthcare continuous quality improvement so that the method identifies both systemic and human errors, and offers practical advice to deal effectively with them.
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Abbas Naeimi, Mohammad Hossein Ahmadi, Milad Sadeghzadeh and Alibakhsh Kasaeian
This paper aims to determine the optimum arrangement of a reverse osmosis system in two methods of plug and concentrate recycling.
Abstract
Purpose
This paper aims to determine the optimum arrangement of a reverse osmosis system in two methods of plug and concentrate recycling.
Design/methodology/approach
To compare the optimum conditions of these two methods, a seawater reverse osmosis system was considered to produce fresh water at a rate of 4,000 m3/d for Mahyarkala city, located in north of Iran, for a period of 20 years. Using genetic algorithms and two-objective optimization method, the reverse osmosis system was designed.
Findings
The results showed that exergy efficiency in optimum condition for concentrate recycling and plug methods was 82.6 and 92.4 per cent, respectively. The optimizations results showed that concentrate recycling method, despite a 36 per cent reduction in the initial cost and a 2 per cent increase in maintenance expenses, provides 6 per cent higher recovery and 19.7 per cent less permeate concentration than two-stage plug method.
Originality/value
Optimization parameters include feed water pressure, the rate of water return from the brine for concentrate recycling system, type of SW membrane, feedwater flow rate and numbers of elements in each pressure vessel (PV). These parameters were also compared to each other in terms of recovery (R) and freshwater unit production cost. In addition, the exergy of all elements was analyzed by selecting the optimal mode of each system.