Assume that in problem 10.2 strict adherence to antibiotic administration one hour prior to thoracic surgery has reduced the rate of infection to 0% and severity to 2.0. How did this improvement affect the priority list? Which surgery should be the primary target for improvement?

1. An FMEA will be performed on postoperative infections. Data is available by surgery type on the frequency, severity, and detectability of these infections. The director of quality improvement wants you to prepare a priority list giving the order in which the various surgeries should be examined, to produce the greatest potential benefit for the organization Calculate the frequency ranking from high (5) to very low (1) based on the number of infections and cases shown in the following and the RPNs for each type of surgery. Which surgery should be examined first? Which surgery should be examined last? What is the maximum possible risk score for this analysis?

2. Instead of the ordinal ranking of frequency, 1 to 5, used in problem 10.1, the director of quality improvement has collected data on the number of each type of surgery and the number of patients that contracted a postoperative infection. The director wants you to recalculate the RPN using the actual incidence rate of infection. Infection severity and detectability are ranked the same as in problem 10.1. How does the use of incidence rate change the improvement worklist? Which surgery should be examined last? What is the maximum possible risk score for this analysis?

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Risk Priority Detectablity Mumber Surgery Number of Number of Severity of Frequency Infections Types Infections Cases Thorack 200 3 3 Neuro 1 100 4 3 Orthopedic 50 2,000 2 2 Plastk 32 800 1 2 Oral 25 500 1 1 General 100 5,000 2 1 Risk Priority Detectablity Mumber Surgery Number of Number of Severity of Frequency Infections Types Infections Cases Thorack 200 3 3 Neuro 1 100 4 3 Orthopedic 50 2,000 2 2 Plastk 32 800 1 2 Oral 25 500 1 1 General 100 5,000 2 1