scholarly journals Tasks, multitasking and interruptions among the surgical team in an operating room: a prospective observational study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026410 ◽  
Author(s):  
Camilla Göras ◽  
Karolina Olin ◽  
Maria Unbeck ◽  
Karin Pukk-Härenstam ◽  
Anna Ehrenberg ◽  
...  
Keyword(s):  
Observational Study ◽  
Operating Room ◽  
Prospective Observational Study ◽  
Adaptive System ◽  
Complex Adaptive System ◽  
Professional Communication ◽  
Direct Care ◽  
Future Research ◽  
Surgical Team ◽  
Complex Adaptive

ObjectivesThe work context of the operating room (OR) is considered complex and dynamic with high cognitive demands. A multidimensional view of the complete preoperative and intraoperative work process of the surgical team in the OR has been sparsely described. The aim of this study was to describe the type and frequency of tasks, multitasking, interruptions and their causes during surgical procedures from a multidimensional perspective on the surgical team in the OR.DesignProspective observational study using the Work Observation Method By Activity Timing tool.SettingAn OR department at a county hospital in Sweden.ParticipantsOR nurses (ORNs) (n=10), registered nurse anaesthetists (RNAs) (n=8) and surgeons (n=9).ResultsThe type, frequency and time spent on specific tasks, multitasking and interruptions were measured. From a multidimensional view, the surgical team performed 64 tasks per hour. Communication represented almost half (45.7%) of all observed tasks. Concerning task time, direct care dominated the surgeons’ and ORNs’ intraoperative time, while in RNAs’ work, it was intra-indirect care. In total, 48.2% of time was spent in multitasking and was most often observed in ORNs’ and surgeons’ work during communication. Interruptions occurred 3.0 per hour, and the largest proportion, 26.7%, was related to equipment. Interruptions were most commonly followed by professional communication.ConclusionsThe surgical team constantly dealt with multitasking and interruptions, both with potential impact on workflow and patient safety. Interruptions were commonly followed by professional communication, which may reflect the interactions and constant adaptations in a complex adaptive system. Future research should focus on understanding the complexity within the system, on the design of different work processes and on how teams meet the challenges of a complex adaptive system.Trial registration number2016/264.

scholarly journals Health and Disease Are Dynamic Complex-Adaptive States Implications for Practice and Research

2021 ◽  
Vol 12 ◽  
Author(s):  
Joachim P. Sturmberg
Keyword(s):  
Clinical Medicine ◽  
Adaptive System ◽  
Complex Adaptive System ◽  
Physiological State ◽  
Future Research ◽  
Layered System ◽  
Health State ◽  
Research Perspectives ◽  
Complex Adaptive ◽  
Health And Disease

Interoception, the ability to convey one's overall physiological state, allows people to describe their health along an experiential continuum, from excellent, very good, good, fair to poor. Each health state reflects a distinct pattern of one's overall function. This assay provides a new frame of understanding health and disease as complex-adaptive system states of the person as-a-whole. It firstly describes how complex patterns can emerge from simple equations. It then discusses how clinical medicine in certain domains has started to explore the pattern characteristics resulting in the heterogeneity of disease, and how this better understanding has improved patient management. The experiential state of health can be surprising to the observer—some are in good health with disabling disease, others are in poor health without the evidence of any. The main part of the assay describes the underlying complexity principles that contribute to health, and synthesizes available evidence from various research perspectives to support the philosophic/theoretical proposition of the complex-adaptive nature of health. It shows how health states arise from complex-adaptive system dynamics amongst the variables of a hierarchically layered system comprising the domains of a person's macro-level external environment to his nano-level biological blueprint. The final part suggests that the frame of health as a dynamic complex-adaptive state defines a new paradigm, and outlines ways of translating these expanded understandings to clinical practice, future research, and health system design.

Hybridität als Motor und als Ergebnis von Sprachwandel

Glottotheory ◽  
2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Csaba Földes
Keyword(s):  
Language Development ◽  
Cultural Production ◽  
Language Change ◽  
Adaptive System ◽  
Complex Adaptive System ◽  
Explanatory Variable ◽  
Essential Factor ◽  
Language Functions ◽  
Complex Adaptive ◽  
Linguistic Innovation

AbstractThis paper deals with constellations in which, as consequences of linguistic interculturality, elements of two or more languages encounter each other and result in something partially or completely new, an – occasionally temporary – “third quality”, namely hybridity. The paper contributes to the meta-discourse and theory formation by questioning the concept, term and content of “linguistic hybridity”. It also submits a proposal for a typology of linguistic-communicative hybridity that consists of the following prototypical main groups, each with several subtypes: (1) language-cultural, (2) semiotic, (3) medial, (4) communicative, (5) systematic, (6) paraverbal and (7) nonverbal hybridity. At last, the paper examines hybridity as an explanatory variable for language change. In conclusion, hybridity is generally a place of cultural production, with special regard to communication and language it is potentially considered as an incubator of linguistic innovation. Hybridity can be seen as the engine and as the result of language change, or language development. It represents an essential factor by which language functions and develops as a complex adaptive system. Hybridity operates as a continuous cycle. By generating innovation, it triggers language change, which in turn, leads to further and new hybridizations. The processuality of hybridity creates diversity, while at the same time it can cause the vanishing of diversity.

Application of Complex Adaptive System Theory to Water Resources Allocation in Dianchi Basin

2012 ◽  
Vol 212-213 ◽  
pp. 536-542
Author(s):  
Qiong Su ◽  
Shi Hua He
Keyword(s):  
System Theory ◽  
Water Resources ◽  
Adaptive System ◽  
Complex Adaptive System ◽  
Resources Allocation ◽  
Water Resources Allocation ◽  
Evolutionary Mechanisms ◽  
Reservoir Water ◽  
Allocation System ◽  
Complex Adaptive

Based on complex adaptive system theory, the characteristics of water resources allocation system of river basin are analyzed. Evolutionary mechanisms and process of complex adaptive water resources allocation system in Dianchi basin are researched, and also characteristics of "learning". A complex adaptive system model of water-resource allocation is established during analyzing the influence factors and the reaction rules of water consumer agents and water provider agents. And based on this model, water resources in Dianchi basin is allocated only under Dianchi water provider and Zhangjiu river Yunlong reservoir water provider by using the platform of matlab. Finally, corresponding calculation results and conclusions are concluded.

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