Features of electronic Early Warning systems which impact clinical decision making

2012 ◽  
Author(s):  
Atieh Zarabzadeh ◽  
Mervyn O'Connell ◽  
John O'Donoghue ◽  
Tom O'Kane ◽  
Simon Woodworth ◽  
...  
Keyword(s):  
Decision Making ◽  
Early Warning ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Early Warning Systems ◽  
Warning Systems

scholarly journals Communication Structures and Decision Making Cues and Criteria to Support Effective Drought Warning in Central Malawi

2020 ◽  
Vol 2 ◽  
Author(s):  
Alexia Calvel ◽  
Micha Werner ◽  
Marc van den Homberg ◽  
Andrés Cabrera Flamini ◽  
Ileen Streefkerk ◽  
...  
Keyword(s):  
Decision Making ◽  
Early Warning ◽  
Warning System ◽  
Agricultural Practices ◽  
Early Warning Systems ◽  
Sudden Onset ◽  
Small Scale ◽  
Warning Systems ◽  
Structured Interviews ◽  
Early Action

Early warning systems trigger early action and enable better disaster preparedness. People-centered dissemination and communication are pivotal for the effective uptake of early warnings. Current research predominantly focuses on sudden-onset hazards, such as floods, ignoring considerable differences with slow-onset hazards, such as droughts. We identify the essential factors contributing to effective drought dissemination and communication using the people-centered approach advocated in the WMOs Multi-Hazard Early Warning System Framework (MHEWS). We use semi-structured interviews with key stakeholders and focus group discussions with small-scale farmers in the Mangochi and Salima Districts of Malawi. We show that the timely release of seasonal forecast, the tailoring of the drought warning content (and its timing) to agricultural decision making, and the provision of several dissemination channels enhance trust and improve uptake of drought warning information by farmers. Our analysis demonstrates that farmers seek, prepare, and respond to drought warning information when it is provided as advice on agricultural practices, rather than as weather-related information. The information was found to be useful where it offers advice on the criteria and environmental cues that farmers can use to inform their decisions in a timely manner. Based on our findings, we propose that by focusing on enhancing trust, improving information uptake and financial sustainability as key metrics, the MHEWS can be adapted for use in monitoring the effectiveness of early warning systems.

Gaps Between Alarm Capabilities and Decision-making Needs: An Observational Study of Detecting Patient Decompensation

2018 ◽  
Vol 7 (1) ◽  
pp. 112-116 ◽  
Author(s):  
Chelsea R. Horwood ◽  
Michael F. Rayo ◽  
Morgan Fitzgerald ◽  
E. Asher Balkin ◽  
Susan D. Moffatt-Bruce
Keyword(s):  
Decision Making ◽  
Early Warning ◽  
Clinical Decision Making ◽  
Vital Signs ◽  
Clinical Decision ◽  
Unintended Consequences ◽  
Warning Signs ◽  
Medical Setting ◽  
Mental Picture ◽  
Wide Range

Decompensation is a change in the overall ability to maintain physiological function in the presence of a stressor or disease. In the medical setting, clinicians utilize a wide range of technological tools to aid in their clinical decision making and to identify early warning signals for decompensation. However, many of these technologies have underperformed and are not aligned with the actual role of practitioners, resulting in unintended consequences and adverse events. The primary aim of this study is to explore how different nurses interpret early warning signs in order to anticipate decompensation. The secondary aim is to assess which technologies nurses rely on when anticipating decompensation, and if those technologies are adequately aiding them in their clinical decision making. Two researchers performed semi-structured ethnographic interviews that were recorded and transcribed during the summer of 2017. In total, 43 nurses were interviewed from different medical and surgical floors within the same hospital. Participants were asked questions focused on how they use and respond to alarms and how they anticipate patient decompensation. Constant Comparative Analysis was used to reveal patterns of responses between participants. Based on the qualitative analysis 6 major themes emerged:  1. Anticipating patient decompensation requires creating a complete mental “picture of the patient” by the nurses  2. Nurse-to-nurse communication and expertise is essential to understanding the patient’s history  3. Warning signs for decompensation were largely determined by a patient’s baseline  4. Change over time, or trends, is informative for anticipating decompensation. Numbers (regarding vital signs and labs) alone are not  5. Consistent care of patients improved nurse’s confidence in decision making  6. Anticipating decompensation requires “staying ahead of the machines Our research suggests that there is a gap between the information practitioners need to accurately anticipate patient decompensation, and the information current alarm technologies provide. Alarms are the primary tool provided to nurses to aid them in detecting hazardous events, however, current alarms are not well-suited in supporting signals that anticipate patient decompensation before it happens.

Early warning systems in biosecurity; translating risk into action in predictive systems for invasive alien species

2020 ◽  
Vol 4 (5) ◽  
pp. 453-462 ◽  
Author(s):  
James Rainford ◽  
Andrew Crowe ◽  
Glyn Jones ◽  
Femke van den Berg
Keyword(s):  
Decision Making ◽  
Alien Species ◽  
Early Warning ◽  
Invasive Alien Species ◽  
Early Warning Systems ◽  
Decision Makers ◽  
Working Environment ◽  
Digital Data ◽  
Warning Systems ◽  
Horizon Scanning

Invasive alien species (IAS) are one of the most severe threats to biodiversity and are the subject of varying degrees of surveillance activity. Predictive early warning systems (EWS), incorporating automated surveillance of relevant dataflows, warning generation and dissemination to decision makers are a key target for developing effective management around IAS, alongside more conventional early detection and horizon scanning technologies. Sophisticated modelling frameworks including the definition of the ‘risky’ species pool, and pathway analysis at the macro and micro-scale are increasingly available to support decision making and to help prioritise risks from different regions and/or taxa. The main challenges in constructing such frameworks, to be applied to border inspections, are (i) the lack of standardisation and integration of the associated complex digital data environments and (ii) effective integration into the decision making process, ensuring that risk information is disseminated in an actionable way to frontline surveillance staff and other decision makers. To truly achieve early warning in biosecurity requires close collaboration between developers and end-users to ensure that generated warnings are duly considered by decision makers, reflect best practice, scientific understanding and the working environment facing frontline actors. Progress towards this goal will rely on openness and mutual understanding of the role of EWS in IAS risk management, as much as on developments in the underlying technologies for surveillance and modelling procedures.

scholarly journals Design for Climate Services

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Mel WOODS ◽  
Raquel AJATES GONZALEZ ◽  
Drew HEMMENT ◽  
Drew HEMMENT
Keyword(s):  
Decision Making ◽  
Early Warning ◽  
Wicked Problems ◽  
Early Warning Systems ◽  
Warning Systems ◽  
Climate Services ◽  
Research And Innovation ◽  
The World

Droughts, floods and other climate-related hazards present critical challenges for communities across the world. Design is well-placed to respond to such wicked problems (Buchanan, 1992) however a user-led approach to the development of climate services is rare (Christel et al, 2017). Instead, scientists and governments rely on research and innovation between science and industry to develop climate services for early warning systems and decision-making. The design community is uniquely placed to contribute to such developments, particularly in proposing new perspectives where citizens are themselves potential users of such services and at the forefront of change-making practices.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

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