Healthcare facilities are facing major issues and challenges. Hospitals continuously search approaches to improve operations quality, optimize performance, and minimize costs. Specifically, an efficient hospital sterilization process (HSP) allows reusable medical devices (RMDs) to be more quickly available for healthcare activities. In this context, this paper describes an integrated approach developed to analyze HSP and to identify the most critical improvement actions. This proposed approach integrates four quality tools and techniques. Firstly, a structured analysis and design technique (SADT) methodology is applied to describe HSP as a hierarchy of activities and functions. Secondly, the failure modes and effects analysis (FMEA) method is used as a risk assessment step to determine which activity processes need careful attention. Thirdly, a cause-effect analysis technique is used as a tool to help identify all the possible improvement actions. Finally, priority improvement actions are proposed using the quality function deployment (QFD) method. To validate the proposed approach, a real sterilization process used at the maternity services of Hedi-Cheker Hospital in the governorate of Sfax, Tunisia, was fully studied. For this specific HSP, the proposed approach results showed that the two most critical activities were (1) improving the coordination between the sterilization service and the surgery block and (2) minimizing the average duration of the sterilization process to ensure the availability of RMDs in time.
Keywords: cause and effect analysis (CEA); failure modes and effects analysis (FMEA); hospital sterilization process; process improvement; quality function deployment (QFD); reusable medical devices (RMD); structured analysis and design technique (SADT).