Patient waiting time management through fuzzy based failure mode and effect analysis

Abstract

The amount of time patients spends on services to be delivered in clinics, still is a major problem of some health centers. To solve this problem, various methods proposed by researchers. Failure Mode and Effects Analysis (FMEA) is one of the most used approaches to identify influential failure modes in prolongation of waiting time. In the FMEA method, numeric scores assign to failure modes, using the Risk Priority Number (RPN), but RPN criticized for its shortcoming and leads to unreal results. In this paper, to cover the conventional FMEA shortcoming, firstly, eleven risk factors result in prolongation of waiting time introduced by experts. Secondly, integration of the triangular fuzzy number (TFN) with the Best Worth Method (fuzzy-BWM) was utilized to determine the weights of effective criteria. In the following, failure modes ranked through fuzzy Multi-Objective Optimization by Ratio Analysis (fuzzy-MOORA). Finally, the ranks of eleven failure modes compared in three different methods (Conventional FMEA, conventional MOORA, and fuzzy-MOORA). The potential usage of this method is covering the shortcoming of previous methods and contribute certainty in identifying significant failure modes of the patient waiting time reduction in Out-Patient Departments (OPD). According to the analysis, three main failures for managing waiting time are: the patients never follow up for a later date by the center which can result in chaos in OPD, because of phone or in-person referrals. Secondly, unable to manage canceling/postponing an appointment in emergency cases, Thirdly, office visit not done in the estimated time, which results in a disordering in the center.