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Failure Modes and Effects Analysis (FMEA) Tool

Copy (2) of Access to Prosthetic Dental Services

United States Public Health Service
Detroit Lakes, Minnesota, United States
Public Health


Aim: Reduce the Risk Priority numer, eliminate problems associated with patient access to prosthetic dental services by 100 percent in six months.

Process Data

Date: 05/16/2008

Step Description
1 patient presents for prosthesis
Failure Mode Causes Effects Occ Det Sev RPN Actions
No appointment available Shortage of Dentists Negatively affects : ability to eat-nutritional concerns,self esteem, and speaking or enunciation. 1 1 5 5 1.Recruit Dentists. 2.Continue to accept American Dental Association volunteer Dentists. 3. Accept JRCOSTEP and COSTEP Dentists. 4. Patient education regarding prosthetic procedure; including keeping appointments. 5. Follow IHS Dental procedure prioritiza
Step Description
2 Dental prosthethesis/ exam required
Failure Mode Causes Effects Occ Det Sev RPN Actions
Prosthetic exam appointment not available 1.IHS treatment policy outlines prosthetics are low on priority list. 2. Patients cancel or break appointments without notice. 3.Prosthetic exams scheduled only on specific week-days. 1. extractions, restorations, emergencies are scheduled before prosthetic appointments. 2. cancelled and broken appointments impede potential prosthetic appointments. 3. Patient unavailable for a prosthetic appoint on a specific week day. 1 1 5 5 1. Recruit Dentists, maintain volunteer Dentists participation. 2. Patient education regarding value of keeping multiple appointment sequence in prosthetic treatment. 3. Revise schedule; allow for exam-prosthetic appointments to be available all clinic da
Step Description
3 Complete restorative needs prior to prosthetic fabrication
Failure Mode Causes Effects Occ Det Sev RPN Actions
Patient unable to be appointed for restorative needs (prior to prosthetic fabrication) 1.Dentist shortage 2. Existing schedule is filled with Level I,II, and III appointments. 1.Prosthetic fabrication is delayed an unacceptable length of time. 2. Negative affects upon nutrition, speech, and self-esteem. 1 1 5 5 1. Continue to recruit Dentists. 2. Continue volunteer Dentists/ Student Dentists programs. Improve clinical efficiency via a myriad of opportunities including but not limited to: seating scheduled patients upon arrival to clinic, utilize EFDA dental asst
Step Description
4 Prosthesis fabrication
Failure Mode Causes Effects Occ Det Sev RPN Actions
Dental laboratory delays laboratory is overworked patient prosthesis treatment completion delayed: affects nutrition, speech, self-esteem, patient satisfaction 1 1 5 5 1. Aquire new dental laboratory with improved reliability. Lab changed in December 2006.
Delay of prosthesis completion "in-house" delays : cases not being sent to laboratory in timely manner. Shortage of available Dentists. Overload of prosthetic cases patient treatment delayed. Reduced patient satisfaction 1 1 5 5 1. Provide outgoing mail processing training update to receptionists 2. Dental assistant involved with prosthetic treatment will collect any required fees from patient and prepare case for same day mailing to laboratory 3. Limit number of prosthetic cases
2. Lab bill is higher than quoted to patient. Lab estimates cost according to standardized non-individualized patient needs Patient pays up-front lab fees, outstanding balances unexpextedly due are a surprise to patient; additional expense presents hardship for patient, White Earth absorbs additional fees 1 1 5 5 Research and begin to utilize dental lab that can provide reliable and accurate fee schedule.

Calculated Totals
Total Risk Priority Number for the process 30

Occ:   Likelihood of Occurrence (1-10)
Det:   Likelihood of Detection (1-10)
NOTE:  = Very likely it WILL be detected
 10 = Very likely it WILL NOT be detected
Sev:   Severity (1-10)
RPN:   Risk Priority Number (Occ × Det × Sev)

Change: Access to prosthesis treatment has improved relevant to improved patient satisfaction