Once these ratings have been done for each failure, multiply the severity and likelihood to get the criticality score. The higher the criticality score for a particular failure, the higher the priority that failure has for further examination. When deciding the order in which the failures are worked on:

• Ones with a criticality of 8 or more should be dealt with first
• Then ones with a severity of 3 or 4
• Then ones with a likelihood of 3 or 4
• And then ones with a detectability of 3 or 4.

Consider which part of the process the failure relates to. Is it something that involves a person at any point, either doing the whole process or, in the case of an automated process, monitoring it and intervening as necessary? If so, and the person’s actions could make a difference to the failure or its effects, then human factor issues should be considered as part of the investigation. A detailed explanation of human factors is beyond the scope of this module.

Once the first failure to look at in more detail has been identified, the next step is to think about how to control the risk, which will be discussed in a later part of this module.

The use of FMEA can be triggered by:

• Something that you identify as an issue in the process
• New process being introduced
• A patient safety incident
• A change in a process
• A scheduled plan for revisiting a process, e.g. every six months.

Ideally, mapping out and using FMEA on all processes would be carried out, but it can be useful to work as a team to identify which processes to prioritise.