<![CDATA[Medication errors remain one of the most significant preventable threats to patient safety, particularly in outpatient settings where medication-use processes involve multiple healthcare professionals and depend heavily on electronic medical record (EMR) systems. Conventional incident reporting is largely reactive and often fails to detect latent system vulnerabilities before adverse events occur. This study aimed to identify and evaluate potential failure modes in outpatient medication-use processes using the Healthcare Failure Mode and Effect Analysis (HFMEA) approach at an Indonesian university hospital. This study employed a qualitative prospective risk assessment design conducted between March and May 2025 in the outpatient pharmacy department of a university hospital in Indonesia. An interdisciplinary HFMEA team consisting of 11 healthcare professionals performed process mapping through focus group discussions, semi-structured interviews, and direct observations. Potential failure modes were analyzed using severity–probability scoring and HFMEA decision-tree analysis to determine priority risks requiring corrective action. The analysis identified six major medication-use processes, 22 subprocesses, and 75 potential failure modes, of which 23 required immediate intervention. The highest-priority risks were associated with EMR and network accessibility, electronic prescription entry, medication administration, prescription review and labeling, and medication preparation. The principal contributing factors included unstable digital infrastructure, incomplete electronic prescriptions, inconsistent adherence to standard operating procedures, ineffective interprofessional communication, and inadequate pharmacy facilities. HFMEA proved to be an effective proactive risk assessment tool for identifying latent failures before patient harm occurs. Strengthening digital infrastructure, standardizing medication workflows, enhancing multidisciplinary collaboration, and reinforcing patient safety practices are essential to improve medication safety and healthcare quality in outpatient services.]]>
