Payesh
2010; 9: 117-130
Accepted for publication: 26 November 2006
[EPub a head of print-25 May 2010]

Objective(s): In this paper, an integrated approach including QFD and FMEA is proposed in healthcare systems. The main objective is to improve the quality of healthcare services and activities in order to maximum customers’ satisfaction and minimize costs.
Methods: To develop the mentioned approach following stages have been done:
1- Identifying the most importance service characteristics with regard to customer expectations. 2- Identifying the most importance measurable functions and activities and their target values with regard to the service characteristics determined from pervious stage. 3- Identifying the relative potential failures and their importance rate with regard to the output of previous stage. After determining the most important functions to carry out into the system, some potential failures will be happen into the system. The occurrences of these failures decrease the quality of healthcare services and finally the customer satisfactions. Then, to prevent the occurrence of them, the relative failures and their weights are identified in this stage. 4- To complete the proposed approach and also increase the customer satisfactions more, the corrective and preventive actions to prevent the failures from happening are suggested by the FMEA team.
Results:  To understand the proposed structure, an illustrative example has been surveyed in this paper. Due to the space limitation, a small part of information is given. In this example, customers consist of patients and their families, doctors, hospital manager, employers, assurance concerns and government. The main results of the paper are the following: Identifying the different group of customers by the excellent approach, determining the importance rate of customers' requirements by means of the correlation rates between customers' requirements, identifying the qualitative functions and activities and also calculating the target value for healthcare, determining the potential failures and their weights with regard to the importance rate of healthcare functions and using the FMEA tool in healthcare systems to increase the customer satisfaction.
Conclusion: Hospitals and other healthcare systems have problem creating and improving the quality in their systems. As the service systems have special characteristics, considering the QFD and FMEA models like what is done in industrial systems is impossible to create and improve the quality in such systems. Also, due to high healthcare services costs, there is a high competitive between healthcare system to provide services to meet the customers' requirements. Therefore, in this paper, an integrated approach in the healthcare system in accordance with QFD/ FMEA is suggested.