Evidence map›Paper›PMID 36539703›Full record

ArticleBMC nephrology2022

Risk assessment of failure during transitioning from in-centre to home haemodialysis.

Sabrina-Wong-Peixin Haroon, Titus-Wai-Leong Lau, Gan Liang Tan, Eugene-Hern Choon Liu, Soh Heng Hui, Siao Luan Lim, Diana Santos, Robyn Hodgson, Lindsay Taylor, Jia Neng Tan and 2 more

Open access · goldAbstract read
In one paragraph

Article in BMC nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 2 countries.

Sabrina-Wong-Peixin HaroonDivision of Nephrology, National University Hospital Singapore, Level 10, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Republic of Singapore. Sabrina_haroon@nuhs.edu.sg.
Titus-Wai-Leong LauDivision of Nephrology, National University Hospital Singapore, Level 10, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Republic of Singapore.
Gan Liang TanDepartment of General Medicine, Sengkang General Hospital, Singapore, Singapore.
Eugene-Hern Choon LiuDepartment of Anaesthesia, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Soh Heng HuiRenal Centre, National University Hospital, Singapore, Singapore.
Siao Luan LimRenal Centre, National University Hospital, Singapore, Singapore.
Diana SantosMedical Affairs-Clinical Governance, National University Hospital Singapore, Singapore, Singapore.
Robyn HodgsonDepartment of Renal Medicine, University College London, Royal Free Hospital, London, United Kingdom.
Lindsay TaylorDepartment of Renal Medicine, University College London, Royal Free Hospital, London, United Kingdom.
Jia Neng TanDivision of Nephrology, National University Hospital Singapore, Level 10, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Republic of Singapore.
FH HHD
Andrew DavenportDepartment of Renal Medicine, University College London, Royal Free Hospital, London, United Kingdom.
National University Hospital · SGThe Royal Free Hospital · GBNational University of Singapore · SGSengkang General Hospital · SG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntroducing a de-novo home haemodialysis (HHD) program often raises safety concerns as errors could potentially lead to serious adverse events. Despite the complexity of performing haemodialysis at home without the supervision of healthcare staff, HHD has a good safety record. We aim to pre-emptively identify and reduce the risks to our new HHD program by risk assessment and using failure mode and effects analysis (FMEA) to identify potential defects in the design and planning of HHD.

methodsWe performed a general risk assessment of failure during transitioning from in-centre to HHD with a failure mode and effects analysis focused on the highest areas of failure. We collaborated with key team members from a well-established HHD program and one HHD patient. Risk assessment was conducted separately and then through video conference meetings for joint deliberation. We listed all key processes, sub-processes, step and then identified failure mode by scoring based on risk priority numbers. Solutions were then designed to eliminate and mitigate risk.

resultsTransitioning to HHD was found to have the highest risk of failure with 3 main processes and 34 steps. We identified a total of 59 areas with potential failures. The median and mean risk priority number (RPN) scores from failure mode effect analysis were 5 and 38, with the highest RPN related to vascular access at 256. As many failure modes with high RPN scores were related to vascular access, we focussed on FMEA by identifying the risk mitigation strategies and possible solutions in all 9 areas in access-related medical emergencies in a bundled- approach. We discussed, the risk reduction areas of setting up HHD and how to address incidents that occurred and those not preventable.

conclusionsWe developed a safety framework for a de-novo HHD program by performing FMEA in high-risk areas. The involvement of two teams with different clinical experience for HHD allowed us to successfully pre-emptively identify risks and develop solutions.

Indexed as

Healthcare Failure Mode and Effect AnalysisHemodialysis, HomeHumansRisk AssessmentRisk FactorsAdverse eventsFailure mode and effect analysisHome haemodialysisSafetyVascular access

Identifiers

PMID36539703
PMCPMC9768953
OpenAlexW4312114247

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.