Yassine Eddahoumi, Ismail Bennani, Imane Belchhab, Mustapha Bouatia
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 10
Date of Publication: 2026/10/20
Background: Reception, storage and ordering of medicines in the hospital pharmacy are high-risk steps, yet quantitative evaluations of corrective actions are rare in Moroccan pediatric hospitals.
Objective: To identify and prioritize failure modes in the medication stock circuit using failure mode, effects and criticality analysis (FMECA), to quantify the change in criticality after preventive actions, and to explore determinants of risk reduction.
Methods: Before–after study (March–June 2025) in the pharmacy of the Children’s Hospital of Rabat. Failure modes were grouped into 17 operations (reception 8, storage 3, ordering 6) and scored for detectability, occurrence and severity (1–10; criticality = D × O × S; threshold 100) before and after preventive actions. Analyses comprised paired Wilcoxon and exact McNemar tests, univariate analysis (Kruskal–Wallis, Spearman, crude regression) and multivariable linear regression with robust standard errors of the relative reduction in criticality.
Results: Before actions, 14/17 operations (82.4%) were at or above the threshold (median criticality 168 [IQR 120–210]); none remained so afterwards (median 48 [36–63]; p < 0.001). The mean relative reduction was 69.7% (95% CI 65.0–74.3) and was explained by lower occurrence (50.2% of the log-reduction) and better detectability (46.0%), not severity (3.9%). The reduction was larger in ordering than in reception: crude +17.3 points (95% CI 9.4–25.1) and adjusted for baseline criticality +19.0 points (95% CI 9.2–28.8; p = 0.001). Results were robust to sensitivity analyses.
Conclusions: Targeted organizational actions markedly reduced criticality, especially in the ordering process, but residual risk remains bounded by severity. Given the small number of items and consensus-based scoring, findings are exploratory and warrant multicenter confirmation with objective indicators.
Failure mode and effects analysis, FMECA, Hospital pharmacy, Medication safety, Stock management, Risk management, Pediatric hospital, Morocco
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