APPLICATION OF THE FAILURE MODE AND EFFECTS ANALYSIS METHOD IN HEALTHCARE: A CASE STUDY OF A UNIVERSITY MEDICAL CENTER IN KAZAKHSTAN.

BACKGROUND: Patient safety remains a major concern for healthcare systems worldwide, requiring proactive risk management approaches to prevent adverse events. Failure Mode and Effects Analysis (FMEA) is a well-recognized tool; however, published data on its application in healthcare settings in Central Asia are extremely limited. AIM OF STUDY: The aim of this study was to analyze the application of FMEA in the process of prescribing and administering medications at a University Medical Center in Kazakhstan and to evaluate the impact of FMEA-based interventions on the frequency of medication errors. MATERIAL AND METHODS: The study was conducted as a quality improvement project with two components. First, a narrative literature review was performed using the PubMed and Web of Science databases (2020-2026): of 917 identified records, 34 articles meeting the inclusion criteria were selected and analyzed. Second, a prospective FMEA study was conducted at the University Medical Center (UMC) in Astana, Kazakhstan, from December 2023 to March 2024. A multidisciplinary expert team, consisting of healthcare professionals and quality management specialists (medical director, head of the quality management unit, head of pharmaceutical services, head of nursing, and two clinical pharmacologists), assessed failure modes in the medication prescribing and administration process using standard scales of Severity (S), Occurrence (O), and Detectability (D) (each scored on a 10-point scale). Risk Priority Numbers (RPNs) were calculated, and targeted corrective actions were implemented for high-risk failure modes. A follow-up reassessment was conducted in January 2026. RESULTS: Seven failure modes were identified across six stages of the process. Baseline RPN values ranged from 150 to 400 (total RPN=1990). The highest risks were associated with discrepancies between medication orders in the medical record and the medication chart (RPN=400) and prescribing errors (RPN=350). Following the implementation of corrective measures-including electronic prescribing, physician self-check checklists, and mobile medication verification-the total RPN decreased by 57.8% to 840. The number of reported medication errors decreased by 49% in 2025 compared to 2024, while the proportion of errors detected before drug administration increased from 30% to 70%. CONCLUSIONS: FMEA demonstrated its effectiveness as a proactive tool for identifying and reducing medication safety risks at UMC. The findings support broader implementation of this method in healthcare systems across Central Asia; however, its generalizability to resource-limited settings requires further investigation.