Journal of Cystic Fibrosis
Volume 9, Issue 4 , Pages 284-287, July 2010

Opportunities for quality improvement in cystic fibrosis newborn screening☆

  • Molly K. Groose

      Affiliations

    • Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, United States
    • Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, United States
    • Philip Farrell and Molly Groose were supported by the Robert Turrell Professorship in Medical Leadership of the University of Wisconsin.
    • ,
  • Richard Reynolds

      Affiliations

    • Reynolds Management Services, Middleton, WI 53562, United States
    • ,
  • Zhanhai Li

      Affiliations

    • Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, United States
    • ,
  • Philip M. Farrell

      Affiliations

    • Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, United States
    • Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, United States
    • Corresponding Author InformationCorresponding author. 610 Walnut Street, 785 WARF, Madison, WI 53726-2397, United States. Tel.: +1 608 263 9094.
    • Philip Farrell and Molly Groose were supported by the Robert Turrell Professorship in Medical Leadership of the University of Wisconsin.
    • Dr. Farrell also serves as the Cystic Fibrosis Foundation's national facilitator for implementation of cystic fibrosis newborn screening.

Received 21 January 2010; received in revised form 9 April 2010; accepted 19 April 2010.

Abstract 

Background

With the rapid implementation of cystic fibrosis (CF) newborn screening (NBS), quality improvement (QI) has become essential to identify and prevent errors. Using Process Failure Modes and Effects Analysis (PFMEA), we adapted this method to determine if it could be applied to discover and rank high priority QI opportunities.

Methods

Site visits to three programmes were conducted, and PFMEA exercises were accomplished in Colorado, Massachusetts and Wisconsin with 23 experienced professionals. During each of these comprehensive sessions, participants identified and ranked potential failures based on severity, occurrence and detection to calculate risk priority number (RPN) values.

Results

A total of 96 failure modes were generated and ranked in a list of the 20 riskiest problems that show no significant discordances by site, although there were differences by profession of the rater, particularly nurses.

Conclusions

Our results illustrate that the PFMEA method applies well to CF NBS and that steps requiring communication and information transfer are perceived to be the highest risks. The number of identified failures makes and their potential impact demonstrate considerable overall risk and a need for ongoing QI.

Keywords: Cystic fibrosis, Quality improvement, Newborn screening, Communication, Risk, PFMEA

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☆ This project was presented by invitation from the European Cystic Fibrosis Society at the 2009 European Cystic Fibrosis Conference in Brest, France on 12 June 2009 and is published as an abstract in J Cystic Fibrosis 2009;8:S9.

PII: S1569-1993(10)00039-1

doi:10.1016/j.jcf.2010.04.001

Journal of Cystic Fibrosis
Volume 9, Issue 4 , Pages 284-287, July 2010

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