Mitigating the risk of COVID-19 infection in the operating room: Using healthcare failure mode and effect analysis

CONTEXT: The process of caring for patients requiring surgery exposes them to a high risk of COVID-19 infection during the pre-operative, operative, and post-operative phases, as these procedures are known to be modes of transmission for the virus. OBJECTIVE: We conducted this study to prevent the risk of COVID-19 infection by identifying potential failure modes during the patient care process, determining critical activities, and defining mitigation measures to reduce transmission. MATERIALS AND METHODS: Through a quality and a priori risk management method, which is Healthcare Failure Mode and Effect Analysis (HFMEA), applied in the patient care process in the Central Operating Room of Mohammed VI University Hospital in Morocco. RESULTS: We identified 38 potential failure modes in the patient care process during the three phases (preoperative, operative, and postoperative) that could increase the risk of COVID-19 infection. Of these, 61% are classified as critical, and we have identified all their possible causes. To reduce the risk of transmission, we have proposed 16 mitigation actions. CONCLUSION: The use of HFMEA has been effective in the new pandemic context, improving patient safety during the care process in the operating room and reducing the risk of COVID-19 infection.