Clinical FMEA Worksheet

Find what could fail before it does.

No patient information. An FMEA analyzes a process, not a patient. Never enter patient names, record numbers, dates of birth, room numbers or event details that could identify anyone, even in notes. Use roles (for example "charge nurse") rather than patient details. Your data stays in this browser.

1. Analysis

Open analysis

Process being analyzed Scoring method Scope and boundaries (optional) Team roles (optional; roles, not patient details) Act on RPN at or above (your team's threshold) Also act on severity at or above (1–10; leave empty for none)

2. Process steps

List the steps of the process in order, the way the work is really done. Walk the process with front-line staff if you can.

No steps yet. Add the first step of the process, or load the fictional example to see how it works.

3. Failure modes

For each step, ask what could go wrong, why, and what would happen. Score each failure mode as a team.

Add a failure mode

Process step Failure mode: what could go wrong Causes: why it could happen Effects: what would happen Existing controls (what already prevents or catches it)

Score it (1–10 each)

Occurrence 10 = most likely to occur Detection 10 = most likely NOT detected Severity 10 = most likely to cause severe harm

Action plan and re-score (after the team decides what to do)

Action type Status Action (what will change) Owner (role or staff name) Target date Outcome measure (how you will know it worked) Rationale (why the team stopped or accepted the risk; shown in the register and export)

Score after the action

Occurrence after Detection after Severity after

No failure modes yet. Add a process step first, then the ways it could fail.

4. Action register

Show only failure modes that need action

Score failure modes to see them ranked here.

Risk by failure mode, before and after action

Scored failure modes appear here as bars.

Summary as text

Your data

Restore a backup

Everything is saved only in this browser (local storage). Nothing is sent to MedRise. Clearing your browser data, or the button above, deletes it, so back up before you switch devices. Restoring a backup adds its analyses next to the ones you have.

Education and workflow support only. This worksheet helps a team organize its own proactive risk assessment of a process. Scores and decisions are the team's judgments; the tool only does the arithmetic and applies the decision tree as described in the VA guidebook (2021). It does not assess individual patients, does not guarantee that an analysis meets any accreditation requirement, and is not affiliated with or endorsed by IHI, the VA or The Joint Commission. It is not for patient information: its identifier check catches common patterns only, so the content you enter is your responsibility. See the terms and disclaimer and privacy notice.