Development of a Situation Awareness Assessment Tool for Rail Signalers

Author(s):  
Birte Thomas-Friedrich ◽  
Jan Grippenkoven ◽  
Anja Naumann
2017 ◽  
Vol 27 (5) ◽  
pp. 365-372 ◽  
Author(s):  
Julian Edbrooke-Childs ◽  
Jacqueline Hayes ◽  
Evelyn Sharples ◽  
Dawid Gondek ◽  
Emily Stapley ◽  
...  

Background‘Situation Awareness For Everyone’ (SAFE) was a 3-year project which aimed to improve situation awareness in clinical teams in order to detect potential deterioration and other potential risks to children on hospital wards. The key intervention was the ‘huddle’, a structured case management discussion which is central to facilitating situation awareness. This study aimed to develop an observational assessment tool to assess the team processes occurring during huddles, including the effectiveness of the huddle.MethodsA cross-sectional observational design was used to psychometrically develop the ‘Huddle Observation Tool’ (HOT) over three phases using standardised psychometric methodology. Huddles were observed across four NHS paediatric wards participating in SAFE by five researchers; two wards within specialist children hospitals and two within district general hospitals, with location, number of beds and length of stay considered to make the sample as heterogeneous as possible. Inter-rater reliability was calculated using the weighted kappa and intraclass correlation coefficient.ResultsInter-rater reliability was acceptable for the collaborative culture (weighted kappa=0.32, 95% CI 0.17 to 0.42), environment items (weighted kappa=0.78, 95% CI 0.52 to 1) and total score (intraclass correlation coefficient=0.87, 95% CI 0.68 to 0.95). It was lower for the structure and risk management items, suggesting that these were more variable in how observers rated them. However, agreement on the global score for huddles was acceptable.ConclusionWe developed an observational assessment tool to assess the team processes occurring during huddles, including the effectiveness of the huddle. Future research should examine whether observational evaluations of huddles are associated with other indicators of safety on clinical wards (eg, safety climate and incidents of patient harm), and whether scores on the HOT are associated with improved situation awareness and reductions in deterioration and adverse events in clinical settings, such as inpatient wards.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Lamine ◽  
O Ammar ◽  
W Mrabet ◽  
M A Tlili ◽  
W Aouicha ◽  
...  

Abstract Background Teamwork is fundamental to ensuring the quality of care and patient safety in operating rooms. It has been shown that the occurrence of adverse events is closely linked to a poor quality of teamwork in these settings. Thus, this study aimed to assess teamwork in different operating rooms of the university hospital of Sahloul Sousse (Tunisia). Methods It is a descriptive cross-sectional study with convenience sampling, conducted in operating rooms of the university hospital of Sahloul Sousse (Tunisia) between February and April 2018. The measuring instrument was the validated observation grid 'Communication and Teamwork Skills Assessment Tool (CATS) '. Teamwork is assessed through 4 domains (Situation awareness, Coordination, Communication, Cooperation). Behaviors are marked in rows each time they occur and are rated for quality in columns labeled “Observed and Good,” “Variation in Quality” (meaning incomplete or of variable quality), and “Expected but not Observed.” Results A total of 51 interventions were observed. Good coordination between the team members was noted, as well as good cooperation within the teams. A variation of quality level of communication with the patient was noted in 31.4% of cases, also communication about the context, the situation and recommendation among caregivers is not quite good with a percentage of 39.2%. Moreover, the work environment was rated as good in 84.3% of cases. Conclusions Some failures in teamwork were noted, hence it is important to take corrective measures for better practice and better patient management in such a complex environment, the operating rooms, where there is a strong need for team coordination. Key messages There is a direct relationship between the quality of care and the effectiveness of teamwork. It is necessary to eliminate the barriers to communication, in order to prevent adverse events.


2005 ◽  
Vol 100 (3) ◽  
pp. 649-658 ◽  
Author(s):  
Jarle Eid ◽  
Nils Tore Meland ◽  
Michael D. Matthews ◽  
Bjørn Helge Johnsen

The current study examined the relationship between dispositional optimism and situation awareness. A sample of 77 Royal Norwegian Naval Academy and 57 Royal Norwegian Army Academy cadets were administered the Life Orientation Test prior to participating in a field-training exercise involving a series of challenging missions. Following an infantry mission component of the exercise, situation awareness was measured using the Mission Awareness Rating Scale (MARS), a self-assessment tool. The analysis indicated that dispositional optimism correlated negatively with situation awareness under these conditions. The role of intrapersonal variables in mediating situation awareness and decision-making in stressful situations is discussed.


Author(s):  
Brenda Hiu Yan Law ◽  
Po-Yin Cheung ◽  
Sylvia van Os ◽  
Caroline Fray ◽  
Georg M Schmölzer

ObjectivesTo compare situation awareness (SA), visual attention (VA) and protocol adherence in simulated neonatal resuscitations using two different monitor positions.DesignRandomised controlled simulation study.SettingsSimulation lab at the Royal Alexandra Hospital, Edmonton, Canada.ParticipantsHealthcare providers (HCPs) with Neonatal Resuscitation Program (NRP) certification within the last 2 years and trained in neonatal endotracheal intubations.InterventionHCPs were randomised to either central (eye-level on the radiant warmer) or peripheral (above eye-level, wall-mounted) monitor positions. Each led a complex resuscitation with a high-fidelity mannequin and a standardised assistant. To measure SA, situation awareness global assessment tool (SAGAT) was used, where simulations were paused at three predetermined points, with five questions asked each pause. Videos were analysed for SAGAT and adherence to a NRP checklist. Eye-tracking glasses recorded participants’ VA.Main outcome measureThe main outcome was SA as measured by composite SAGAT score. Secondary outcomes included VA and adherence to NRP checklist.ResultsThirty simulations were performed; 29 were completed per protocol and analysed. Twenty-two eye-tracking recordings were of sufficient quality and analysed. Median composite SAGAT was 11.5/15 central versus 11/15 peripheral, p=0.56. Checklist scores 46/50 central versus 46/50 peripheral, p=0.75. Most VA was directed at the mannequin (30.6% central vs 34.1% peripheral, p=0.76), and the monitor (28.7% central vs 20.5% peripheral, p=0.06).ConclusionsSimulation, SAGAT and eye-tracking can be used to evaluate human factors of neonatal resuscitation. During simulated neonatal resuscitation, monitor position did not affect SA, VA or protocol adherence.


2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e28-e29
Author(s):  
Brenda Hiu Yan Law ◽  
Po-Yin Cheung ◽  
Sylvia van Os ◽  
Caroline Fray ◽  
Georg Schmölzer

Abstract BACKGROUND Decision-making in neonatal resuscitation depends on clinical evaluation, oxygen saturation and heart-rate. However, the position of vital signs monitors varies between institutions and might lead to obstructed or difficult to see displays, which might affect Health Care Provider (HCP) performance. OBJECTIVES To compare Situation Awareness (SA), Neonatal Resuscitation (NRP) checklist score, Visual Attention (VA) and participant satisfaction during simulated neonatal resuscitations using two vital signs monitors locations. DESIGN/METHODS NRP-trained HCPs were recruited from a tertiary Neonatal Intensive Care Unit and randomized to either central (eye-level on the radiant warmer) or peripheral (left of the warmer) monitor placement. Following an orientation scenario, each HCP lead a resuscitation requiring intubation and chest compressions with a high-fidelity manikin (Newborn HAL, Gaumard Scientific, Miami, FL) and a standardized assistant. Each scenario was paused at 3 predetermined points and the HCP was asked 5 SA questions at each pause, per the Situation Awareness Global Assessment Tool (SAGAT) format. Simulations were video-recorded to analyze SAGAT responses and performance rating using a modified NRP checklist. VA was recorded using eye-tracking glasses (Tobii Pro, Tobii Technology Inc., Falls Church, VA) worn by participants. Statistical analysis was performed using Mann-Whitney U test. A post-simulation survey examined user preference. RESULTS We randomized 30 HCPs; all were analyzed for SA and NRP checklist scores. Twenty-two eye-tracking recordings were of sufficient quality and analyzed. SAGAT scores (median 11/15 vs. 12/15, p=0.52) and NRP Checklist Scores (median 46/50, p=0.75) were similar between groups. Distribution of VA was also similar in both groups. In the post-simulation survey, all HCPs found central monitor placement convenient, compared with only 8/15 in peripheral placement. CONCLUSION During simulated neonatal resuscitation, HCPs found central monitor placement more convenient. However, no differences in accuracy of situation awareness responses, NRP checklist scores, or visual attention were found. Hi-fidelity simulation, SAGAT, and eye-tracking can be used to evaluate physical ergonomics of neonatal resuscitation.


2020 ◽  
Vol 63 (4) ◽  
pp. 1071-1082
Author(s):  
Theresa Schölderle ◽  
Elisabet Haas ◽  
Wolfram Ziegler

Purpose The aim of this study was to collect auditory-perceptual data on established symptom categories of dysarthria from typically developing children between 3 and 9 years of age, for the purpose of creating age norms for dysarthria assessment. Method One hundred forty-four typically developing children (3;0–9;11 [years;months], 72 girls and 72 boys) participated. We used a computer-based game specifically designed for this study to elicit sentence repetitions and spontaneous speech samples. Speech recordings were analyzed using the auditory-perceptual criteria of the Bogenhausen Dysarthria Scales, a standardized German assessment tool for dysarthria in adults. The Bogenhausen Dysarthria Scales (scales and features) cover clinically relevant dimensions of speech and allow for an evaluation of well-established symptom categories of dysarthria. Results The typically developing children exhibited a number of speech characteristics overlapping with established symptom categories of dysarthria (e.g., breathy voice, frequent inspirations, reduced articulatory precision, decreased articulation rate). Substantial progress was observed between 3 and 9 years of age, but with different developmental trajectories across different dimensions. In several areas (e.g., respiration, voice quality), 9-year-olds still presented with salient developmental speech characteristics, while in other dimensions (e.g., prosodic modulation), features typically associated with dysarthria occurred only exceptionally, even in the 3-year-olds. Conclusions The acquisition of speech motor functions is a prolonged process not yet completed with 9 years. Various developmental influences (e.g., anatomic–physiological changes) shape children's speech specifically. Our findings are a first step toward establishing auditory-perceptual norms for dysarthria in children of kindergarten and elementary school age. Supplemental Material https://doi.org/10.23641/asha.12133380


2020 ◽  
Vol 29 (4) ◽  
pp. 1944-1955 ◽  
Author(s):  
Maria Schwarz ◽  
Elizabeth C. Ward ◽  
Petrea Cornwell ◽  
Anne Coccetti ◽  
Pamela D'Netto ◽  
...  

Purpose The purpose of this study was to examine (a) the agreement between allied health assistants (AHAs) and speech-language pathologists (SLPs) when completing dysphagia screening for low-risk referrals and at-risk patients under a delegation model and (b) the operational impact of this delegation model. Method All AHAs worked in the adult acute inpatient settings across three hospitals and completed training and competency evaluation prior to conducting independent screening. Screening (pass/fail) was based on results from pre-screening exclusionary questions in combination with a water swallow test and the Eating Assessment Tool. To examine the agreement of AHAs' decision making with SLPs, AHAs ( n = 7) and SLPs ( n = 8) conducted an independent, simultaneous dysphagia screening on 51 adult inpatients classified as low-risk/at-risk referrals. To examine operational impact, AHAs independently completed screening on 48 low-risk/at-risk patients, with subsequent clinical swallow evaluation conducted by an SLP with patients who failed screening. Results Exact agreement between AHAs and SLPs on overall pass/fail screening criteria for the first 51 patients was 100%. Exact agreement for the two tools was 100% for the Eating Assessment Tool and 96% for the water swallow test. In the operational impact phase ( n = 48), 58% of patients failed AHA screening, with only 10% false positives on subjective SLP assessment and nil identified false negatives. Conclusion AHAs demonstrated the ability to reliably conduct dysphagia screening on a cohort of low-risk patients, with a low rate of false negatives. Data support high level of agreement and positive operational impact of using trained AHAs to perform dysphagia screening in low-risk patients.


Sign in / Sign up

Export Citation Format

Share Document