Proactive Blindness: The Allure (and Costs) of Reaction. We always seem to have time to react, but rarely do we have time to prevent the need to react (or proact). The glory always seems to go to those that react the fastest and not to those who prevent the bad outcomes.
This article focuses on two (2) analytical tools that help laymen quantify risks in a system(using FMEA) as well as the annual costs of chronic failures that are often hidden in plain sight (using Opportunity Analysis). Learn how to easily make the business case as to why more attention should be given to high risks and low impact/high frequency failures. Lives could have been lost, as well as significant financial losses via claims and other related costs. However, a paradigm shift is necessary to recognize the greater benefits of “proac-tion,” a new approach that obviates the need to react in the first place. To make this happen, proaction must become a priority, and incentives will be needed to persuade people to become part of this new type of culture.
Figure 1 indicates how the candidates for root cause analysis (RCA) are selected in the reactive, versus the proactive, paradigm. There are two proactive, analytical tools discussed here:
(1 ) failure modes and effects analysis (FMEA) and (2) opportunity analysis (OA). Clinicians on the front lines can use these to make a business case for proaction. FMEA and OA are field-tested tools, in essence, two approaches to risk assessment and prioritization. They identify things that could go wrong, and they assign quantitative values to those potentials. This will be a measure of risk. At some point in this type of analysis, we will draw a line and say everything above that point is an unacceptable risk, and below it, is a risk we are willing to live with and mitigate if possible.
FMEA vs OA: What’s the Difference?
FMEA is not a foreign concept to high-hazard industries; it has been a regulatory requirement to formally assess risk for more than five decades. The requirements are quite rigid in the high-hazard industries and a critical step in any reliability and environment, health, and safety strategy. While variations of FMEA exist, Figure 2 is intended to express the basic concept.
The universal measure of Risk is Severity (S) x Probability (P) = Criticality (or Risk Prioritization Number [RPN] in healthcare).
Different industries use different value tables to measure these parameters. Regardless, they end up quantifying risk. An FMEA is a tool that puts a magnifying glass on a “process flow” (either new or already in place) and analyzes what could go wrong within each process step. It lets us determine the impact on the overall process if a given failure mode were to occur.