The Implementation of HFMEA in a Primary Care Emergency Service of the Portuguese National Health System

A case study

Authors

  • José Mario Coelho Macedo a FP-I3ID – Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS – Biomedical and Health Sciences Research Unit, FFP – Fundação Fernando Pessoa, Porto, Portugal; HE-FP – Hospital Fernando Pessoa, CECLIN – Center of Clinical Studies, Gondomar, Portugal; Faculty of Biology, Department of Functional Biology and Health Sciences, University of Vigo, Spain https://orcid.org/0000-0002-1185-0401
  • Álvaro Gestoso FP-I3ID – Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS – Biomedical and Health Sciences Research Unit, FFP – Fundação Fernando Pessoa, Porto, Portugal; HE-FP – Hospital Fernando Pessoa, CECLIN – Center of Clinical Studies, Gondomar, Portugal https://orcid.org/0009-0003-2835-3115
  • Susana Ramalho FP-I3ID – Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS – Biomedical and Health Sciences Research Unit, FFP – Fundação Fernando Pessoa, Porto, Portugal; HE-FP – Hospital Fernando Pessoa, CECLIN – Center of Clinical Studies, Gondomar, Portugal;Faculty of Biology, Department of Functional Biology and Health Sciences, University of Vigo, Spain https://orcid.org/0000-0002-5216-8126
  • Carla Luís FP-I3ID – Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS – Biomedical and Health Sciences Research Unit, FFP – Fundação Fernando Pessoa, Porto, Portugal; &HE-FP – Hospital Fernando Pessoa, CECLIN – Center of Clinical Studies, Gondomar, Portugal;&FCS – Faculty of Health Sciences, Fernando Pessoa University, Porto, Portugal; https://orcid.org/0000-0002-5292-6337
  • Daniela Martins-Mendes FP-I3ID – Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS – Biomedical and Health Sciences Research Unit, FFP – Fundação Fernando Pessoa, Porto, Portugal; HE-FP – Hospital Fernando Pessoa, CECLIN – Center of Clinical Studies, Gondomar, Portugal;FCS – Faculty of Health Sciences, Fernando Pessoa University, Porto, Portugal; https://orcid.org/0000-0001-9709-9948
  • Ana Cláudia Pereira FP-I3ID – Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS – Biomedical and Health Sciences Research Unit, FFP – Fundação Fernando Pessoa, Porto, Portugal; HE-FP – Hospital Fernando Pessoa, CECLIN – Center of Clinical Studies, Gondomar, Portugal;FCS – Faculty of Health Sciences, Fernando Pessoa University, Porto, Portugal; https://orcid.org/0000-0003-1727-8255
  • Rúben Fernandes FP-I3ID – Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS – Biomedical and Health Sciences Research Unit, FFP – Fundação Fernando Pessoa, Porto, Portugal; HE-FP – Hospital Fernando Pessoa, CECLIN – Center of Clinical Studies, Gondomar, Portugal;Faculty of Biology, Department of Functional Biology and Health Sciences, University of Vigo, Spain; https://orcid.org/0000-0001-8933-3984
  • Pilar Baylina School of Health - Polytechnic Institute of Porto https://orcid.org/0000-0002-3740-862X

DOI:

https://doi.org/10.56226/124

Keywords:

Healthcare Management, patient safety, Public Health, Quality

Abstract

Background: One of the main priorities for healthcare institutions is to provide better and more advanced services that contribute to prolonging the lives of those who seek their care, as well as improving their quality of life as long as it lasts. Both their patients and the professionals who work in those institutions need to feel protected against adverse effects that may affect them physically, mentally, or socially. As such, both at national and international levels, healthcare governing bodies have made decisions and implemented measures aimed at reducing the risk of adverse effects for the patients who use their services.

Objectives: The main objective of this work was to develop and implement a risk management system based on HFMEA in a basic emergency service (primary care), to promote patient safety and the safety of healthcare professionals.

Methods: A prospective, explanatory, and descriptive case study was applied to a basic emergency service, using ISO 31000 – risk management in organisations, and the healthcare failure mode and effects analyses (HFMEA) support tool.

Results: There were identified 57 possible failures associated with 88 different effects, with risk magnitudes classified as severe (1 cases), very severe (18 cases), and intolerable (38 cases). Failures whose effects impact patients were mentioned 2,6 times more than those primarily affecting professionals.

Conclusions: The study allowed the identification of different failures in some of its work processes, for which corrective measures were determined to be carried out by the team and the governing entities of the service, to be implemented as soon as possible, ensuring greater safety in its services.

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Published

31-07-2025

How to Cite

Coelho Macedo, J. M., Gestoso, Álvaro, Ramalho, S., Luís, C., Martins-Mendes, D., Pereira, A. C., Fernandes, R., & Baylina, P. (2025). The Implementation of HFMEA in a Primary Care Emergency Service of the Portuguese National Health System: A case study. International Healthcare Review (online). https://doi.org/10.56226/124

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