A Risk Control Method in the Hospital Environment Sawsen Maalej LOGIQ. Road Mharza Km 1.5-B.P 954 3018 Sfax. Tunisia sawsen1maalej@yahoo.fr Habib Chabchoub IHEC of Sfax. Road Sidi Mansour Km.10-B.P 1170 3018 Sfax. Tunisia habib.chabchoub@fsegs.rnu.tn Abstract—Conventional process conception emphasizes the performance and economic considerations. However, risk control is left behind. In many contexts, risk management in process making is of great importance. Such is the case in the healthcare world where risk is very important. In this paper, we propose a risk control method in the hospital environment called RQFD (Reliable Quality Function Deployment). It purports to understand and prevent risks to reduce their outbreak. Its main contribution is to present a combined analysis of risks, reliability and security highlighting the complementary points between the fields of quality and those of security. A real case study is achieved in the dialysis service using the proposed method. Keywords-risk; reliability; QFD (Quality Function Deployment); FMEA (Failure Mode effects Analysis); RQFD I. INTRODUCTION For reasons of efficiency, the risk management in industry has long allowed important progress of safety. In many sectors, it reached the stage of maturity even if the risk can never be eliminated. Recent research uses various approaches to implement steps of risk management in the field of hospital logistics. It is in this context that this paper is appears. Its purpose is to define a new approach called RQFD based on the coupling of the FMEA and QFD to select the alternatives of the processes which fulfill the quality requirements of the hospital process. The COSO (Committee of Sponsoring Organizations) defines the risk management of risk for companies as: “A process, effected by an entity’s board of directors, management and other personnel, applied in strategy setting and across the enterprise, designed to identify potential events that may affect the entity, and manage risk to be within its risk appetite, to provide reasonable assurance regarding the achievement of entity objectives” [1]. More simply, it will be said that the strategies, the personnel, the processes, technology and knowledge are aligned to manage the risks of the company. The first methodologies [2] of risk management are found in the industrial world largely impelled by the insurance companies. In the Seventies, a new generation of the risk specialists appears in the field of financial risks. In parallel, a reflection on the technological risks has begun in the chemistry, nuclear power, aerospace…sectors. The hospital horizon will gradually seem a field concerned about risk management. For instance, in the seventies USA many medical incidents took place. A new generation of risks appears: the medical risk which will be largely taken over by the insurance companies which get interested in investing in this new field. The concept of risk management then develops in the training of the health professionals. Management integrating risk management not only aims to reduce the rate of dysfunctions which is the origin of prejudicial complications for the patient and thus to improve the quality of the care, but also to rationalize the use of human resources to improve profitability and the productivity, which reduces the cost of a service [3]. A number of works were carried out on proactive risk reduction methodologies. It comes out from the work [4] that method FMEA is one of the industrial methods which can be applied to the health sector. A number of practical applications of the FMEA [5] also showed its relevance in the reliability improvement of health care critical processes. In reference [6] a House of Quality Analysis is established for the obstetric service of Fayazbakhsh hospital in Iran. The authors used the requirements of the patients who were converted with performance indices in order to ensure the quality of the processes of service operation. In reference [7] the authors propose an analysis of all the scenarios which can generate failures in the operating room process. The authors presented the various risks according to the gravity intensity for the patients and this according to the following decreasing order: • Death or disability • Reversible incidence • Abnormal prolongation of the hospitalization’s foreseeable duration • Delay with disorganization of patient acceptance of financial liability (the delay that can induce stress and dissatisfaction of the patients) • Simple delay II. THE PROPOSED METHOD We noticed that the approaches which are based on the coupling of two FMEA and QFD are rather used in the industrial sector. In reference [8] the authors propose a methodology which makes possible the interaction of the two methods QFD and FMEA and they stress their complementary characteristics. Reference [9] proposes a tool of decision- making aid in the car manufacturing processes: the QFD is used to identify the most adapted alternatives of manufacture, 978-1-61284-4577-0324-9/11/$26.00 ©2011 IEEE 180