摘要目的:探讨医疗失效模式与效应分析（HFMEA）在降低急诊候诊风险管理中的应用效果。方法:采用整群抽样法选取2020年5月至2021年4月安徽医科大学第一附属医院急诊候诊患者87 902例为对照组，实施常规急诊候诊巡回管理模式；2021年5月至2022年4月急诊候诊患者80 594例为观察组，采用基于医疗失效模式与效应分析的急诊候诊风险管理模式。比较2组管理模式流程的风险优先指数（RPN）值及候诊风险管理指标。结果:观察组流程RPN均值为（98.48 ± 8.27）分，显著低于对照组RPN均值（251.27 ± 16.95）分，观察组的急诊候诊病情变化和不良反应的预先识别率分别为10.77%（8 680/80 594）和13.37%（10 775/80 594），均高于对照组的5.77%（5 072/87 902）和8.12%（7 134/87 902），差异均有统计学意义（ χ2=1 402.32、1 221.66，均 P<0.05）。 结论:应用HFMEA有助于优化急诊候诊风险管理流程，降低急诊候诊风险，提升急诊候诊风险管理水平。

abstractsObjective:To explore the application of effect of healthcare failure mode and effect analysis (HFMEA) in emergency waiting risk management.Methods:From May 2020 to April 2021, totally 87 902 emergency waiting patients from the First Affiliated Hospital of Anhui Medical University were assigned to control group by cluster sampling method. From May 2021 to April 2022, 80 594 emergency waiting patients were assigned to observed group. The patients in the control group received routine emergency waiting of itinerant management mode. In contrast, the patients in the observed group received emergency waiting risk management mode based on HFMEA. The process risk priority number (RPN) and waiting risk management index between two groups were compared.Results:The mean RPN of the observed group was (98.48 ± 8.27) points, significantly lower than that of the control group (251.27 ± 16.95) points. The nurses′ pre-identification rates of changes in the condition and adverse reaction in the observed group were 10.77%(8680/80 594) and 13.37%(10 775/80 594), which were higher than those in the control group, 5.77%(5072/87 902) and 8.12%(7134/87 902), the differences were statistically significant ( χ2 values were 1402.32 and 1221.66, all P<0.05). Conclusions:The application of HFMEA to optimize the emergency waiting management process can effectively reduce the risk of emergency waiting and improve the quality of emergency waiting management.