Summary
Where the failure modes fall
- Failure modes
- 0
- Score 8 or more
- 0
- Proceed to action
- 0
| Severity ↓ / Probability → | 1 Remote | 2 Uncommon | 3 Occasional | 4 Frequent |
|---|
Calculator Library / Patient Safety
HFMEA Hazard Scoring Tool
Score healthcare failure modes by severity and probability, run the simplified HFMEA decision tree, and see which hazards need action first.
Tool
List failure modes and score the hazard
Hazard score: Severity (1–4) × Probability (1–4). Scores of 8 or more go through the decision tree.
| Process step | Failure mode | Cause | Severity | Probability | Score | Single point weakness? | Effective control exists? | Easily detected? | Result |
|---|
Your work saves in this browser only. Nothing is sent to a server. Do not enter patient names or other identifying information.
Scoring key
Severity and probability
| Score | Severity | Probability |
|---|---|---|
| 4 | Catastrophic: death or major permanent harm | Frequent: may happen several times in a year |
| 3 | Major: permanent loss of function or additional intervention | Occasional: may happen once in 1–2 years |
| 2 | Moderate: increased length of stay or level of care | Uncommon: may happen once in 2–5 years |
| 1 | Minor: no injury or need for extra care | Remote: may happen once in 5–30 years |
Simplified from the HFMEA method published by the U.S. Department of Veterans Affairs National Center for Patient Safety. Your organization's policy and its own scale definitions take precedence.
Instructions
How to use this app
- Map the process first, then list each step where something could go wrong as one row.
- Describe the failure mode and its most likely cause in plain words.
- Score severity and probability as a team, using the key above.
- For scores of 8 or more, answer the three decision-tree questions to see whether the failure mode needs action.
- Use the Export CSV button to carry the list into your action plan.
What This HFMEA Tool Helps You Decide
Healthcare Failure Mode and Effect Analysis (HFMEA) is a proactive method for finding where a care process could fail before a patient is harmed. This tool handles the hazard-analysis step: you list failure modes, score severity and probability, and use a short decision tree to decide which ones need action.
It is designed for team use in a workshop. The score and result update as you change each answer, and the summary matrix shows at a glance where your failure modes cluster.
How the Scoring Works
| Step | Rule | Why it matters |
|---|---|---|
| Hazard score | Severity × Probability, each rated 1 to 4, giving 1 to 16 | Ranks failure modes so the team works on the worst first. |
| Threshold | A score of 8 or more goes to the decision tree | A common cut-off in the VA National Center for Patient Safety method. Your policy may differ. |
| Single point weakness | Failure of this step alone causes the harm | These need attention even when a control exists, because nothing else stands in the way. |
| Effective control | An existing barrier reliably prevents or catches the failure | If one exists, the team may document it and stop. |
| Detectability | The failure would be obvious before it reaches the patient | Easily detected failures are less dangerous than hidden ones. |
Worked Example: Pediatric Dose Ordering
The pre-loaded example follows a weight-based medication from order to discharge teaching. "Weight entered in pounds instead of kilograms" is scored severity 4 and probability 3, a hazard score of 12. It is not a single point weakness, but no effective control exists and the error is not easily detected, so the decision tree says Proceed.
"Wrong concentration drawn up" scores 4 × 2 = 8 and is a single point weakness, so it also proceeds, even though its score is lower. "Decimal point misread" scores 6, below the threshold, so it is set aside rather than worked on now. That is the kind of prioritization the method exists to force.
Limits and Good Practice
- This is a workshop aid, not a substitute for your organization's approved patient safety process or policy.
- Scores are team judgments. Use real incident, near-miss, and observation data whenever you have them.
- Do not enter patient names, record numbers, or other identifying information. Data stays in your browser only.
- Once failure modes are prioritized, define actions and outcome measures using the HFMEA Worksheet Template.
HFMEA Hazard Scoring Tool Frequently Asked Questions
What is HFMEA?
Healthcare Failure Mode and Effect Analysis is a proactive risk assessment method developed by the U.S. Department of Veterans Affairs National Center for Patient Safety. It adapts FMEA and hazard analysis to care processes, using a team, a process flowchart, hazard scoring, and a decision tree to prioritize what to fix before patients are harmed.
How is HFMEA different from a manufacturing FMEA?
A manufacturing FMEA scores severity, occurrence, and detection to produce a risk priority number. HFMEA scores severity and probability to produce a hazard score, then applies a decision tree that asks about single point weaknesses, existing controls, and detectability, which suits care processes with many human handoffs.
What hazard score is high enough to act on?
The VA method commonly uses a score of 8 or more to send a failure mode to the decision tree. That threshold is a convention, not a law, so use the one in your organization's own policy, and consider reviewing lower-scoring single point weaknesses as well.
Is my data stored anywhere?
No. The tool saves your rows in your own browser using local storage and does not send anything to a server. Clear your browser data or use the Clear all button to remove it, and do not enter patient-identifying information.