scholarly journals Moving our Understanding of Team Dynamics from the Simulation Room to the Operating Room

2019 ◽  
Vol 63 (1) ◽  
pp. 227-229
Author(s):  
Trysha Gallowaya ◽  
Ron Stevensa ◽  
Steven Yulec ◽  
Jamie Gormane ◽  
Ann Willemsen-Dunlap ◽  
...  
Keyword(s):  
Operating Room ◽  
Ecological Validity ◽  
Lessons Learned ◽  
Healthcare Organizations ◽  
Biometric Data ◽  
Complex Processes ◽  
Macro Scale ◽  
Dynamic Perspective ◽  
And Performance ◽  
Live Patient

Healthcare organizations rely on simulations of complex processes to provide the training required for individuals and teams to evolve their skills and maintain high levels of competence in medical domains. Inherent in this process is the belief, generally founded on macro-scale measures such as observations and workplace-based assessments, that simulations provide the degree of psychological fidelity needed to accomplish this goal. A paradigm shift is underway toward a more dynamic perspective of teamwork to include psycho-physiological measures which will shape the creation of new forms of simulations, performance measures, and practices. Initially it is expected that these dynamic understandings will be derived from simulation studies. However, it is currently unknown at the neural / physiologic/ cognitive level how well simulation training elicits the types of dynamic thinking that is actually used by operating room teams during live-patient surgery, i.e. the ecological validity of simulation environments is unknown for dynamic neural and physiologic measures of team performance. This panel will describe efforts to address this question. Among the questions the panel will consider are: • To what extent do neurodynamic behaviors seen during simulations diverge from those in the operating room? • What are the implications for improving patient safety when communication, cognitive, and neurodynamic analysis become real-time? • Can biometric and communication measures better inform root cause analyses and best practices during live-patient encounters? The topics discussed anticipate the time when dynamic biometric data can contribute to our understanding of how to rapidly determine a team’s functional status, and how to use this information to optimize outcomes and training. The rapid, dynamic and task neutral measures will make the lessons learned in healthcare applicable to other complex group and team environments. They will also provide a foundation for incorporating these models into machines to support the training and performance of teams.

scholarly journals Preparedness and response to an emerging health threat—Lessons learned from Candida auris outbreaks in the United States

2021 ◽  
pp. 1-6
Author(s):  
Diane Meyer ◽  
Elena K. Martin ◽  
Syra Madad ◽  
Priya Dhagat ◽  
Jennifer B. Nuzzo
Keyword(s):  
United States ◽  
New York ◽  
Qualitative Interviews ◽  
The United States ◽  
Lessons Learned ◽  
Infection Prevention And Control ◽  
Healthcare Organizations ◽  
Candida Auris ◽  
Term Care ◽  
Healthcare Facilities

Abstract Objective: Candida auris infections continue to occur across the United States and abroad, and healthcare facilities that care for vulnerable populations must improve their readiness to respond to this emerging organism. We aimed to identify and better understand challenges faced and lessons learned by those healthcare facilities who have experienced C. auris cases and outbreaks to better prepare those who have yet to experience or respond to this pathogen. Design: Semi-structured qualitative interviews. Setting: Health departments, long-term care facilities, acute-care hospitals, and healthcare organizations in New York, Illinois, and California. Participants: Infectious disease physicians and nurses, clinical and environmental services, hospital leadership, hospital epidemiology, infection preventionists, emergency management, and laboratory scientists who had experiences either preparing for or responding to C. auris cases or outbreaks. Methods: In total, 25 interviews were conducted with 84 participants. Interviews were coded using NVivo qualitative coding software by 2 separate researchers. Emergent themes were then iteratively discussed among the research team. Results: Key themes included surveillance and laboratory capacity, inter- and intrafacility communication, infection prevention and control, environmental cleaning and disinfection, clinical management of cases, and media concerns and stigma. Conclusions: Many of the operational challenges noted in this research are not unique to C. auris, and the ways in which we address future outbreaks should be informed by previous experiences and lessons learned, including the recent outbreaks of C. auris in the United States.

Entrustment, autonomy, and performance in the operating room

Surgery ◽  
2015 ◽  
Vol 158 (4) ◽  
pp. 1113-1115 ◽  
Author(s):  
Rajesh Aggarwal
Keyword(s):  
Operating Room ◽  
And Performance

Compositional and Performance Mapping in Computer Chamber Music: A Case Study

2014 ◽  
Vol 38 (3) ◽  
pp. 64-75 ◽  
Author(s):  
Eric Lyon ◽  
R. Benjamin Knapp ◽  
Gascia Ouzounian
Keyword(s):  
Chamber Music ◽  
Musical Instruments ◽  
Lessons Learned ◽  
Mapping Problem ◽  
Software Interfaces ◽  
Digital Synthesis ◽  
The Rich ◽  
Physical Gestures ◽  
And Performance ◽  
Musical Interaction

The mapping problem is inherent to digital musical instruments (DMIs), which require, at the very least, an association between physical gestures and digital synthesis algorithms to transform human bodily performance into sound. This article considers the DMI mapping problem in the context of the creation and performance of a heterogeneous computer chamber music piece, a trio for violin, biosensors, and computer. Our discussion situates the DMI mapping problem within the broader set of interdependent musical interaction issues that surfaced during the composition and rehearsal of the trio. Through descriptions of the development of the piece, development of the hardware and software interfaces, lessons learned through rehearsal, and self-reporting by the participants, the rich musical possibilities and technical challenges of the integration of digital musical instruments into computer chamber music are demonstrated.

Health Services Research at United HealthCare Corporation: The Role of the Center for Health Care Policy and Evaluation

1996 ◽  
Vol 53 (1_suppl) ◽  
pp. 65-76 ◽  
Author(s):  
Eileen Peterson ◽  
Deborah Shatin ◽  
Douglas Mccarthy
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Services Research ◽  
Health Services ◽  
Health Care Policy ◽  
Research Priorities ◽  
Research Capacity ◽  
Lessons Learned ◽  
Services Research ◽  
And Performance

This article describes collaborative health services research and performance evaluation activities at United HealthCare Corporation, a national health care management services company. We outline the development of a research capacity within our company, the principal data sources used, and the types of research conducted. The importance of health services research within a managed care system is illustrated using two projects as examples. finally, we discuss issues faced by organizations such as ours in defining appropriate research priorities, ensuring health plan participation, and disseminating research findings. Lessons learned should be of interest to health services researchers working in or collaborating with managed care organizations as well as others seeking to understand the dynamics of research in private-sector health care companies.

scholarly journals Watching television in a home environment: effect on children’s attention, comprehension and behavior

2019 ◽  
Author(s):  
Sarah E Rose ◽  
Alexandra Lamont ◽  
Nicholas Reyland
Keyword(s):  
Problem Solving ◽  
Ecological Validity ◽  
Experimental Studies ◽  
Tv Viewing ◽  
Facilitation Effect ◽  
Environment Effect ◽  
And Performance ◽  
And Behavior ◽  
Harmful Effects ◽  
Problem Solving Task

Correlational studies have suggested some harmful effects of television (TV) viewing in early childhood, especially for the viewing of fast-paced entertainment programs. However, this has not been consistently supported by experimental studies, many of which have lacked ecological validity. The current study explores the effects of pace of program on the attention, problem solving and comprehension of 41 3- and 4-year-olds using an ecologically valid experimental design. Children were visited twice at home; on each visit they were shown an episode of a popular animated entertainment program which differed in pace: one faster paced, one slower paced. Children’s behavior was coded for attention and arousal during viewing, attention, effort and performance after viewing during a problem-solving task, and comprehension of the program. The faster paced program was attended to more, but this had no impact on comprehension. Although 3-year-olds showed more attention and effort on the problem-solving task after watching the slower program, both 3- and 4-year-olds completed more problems successfully after watching the faster program. The results provide evidence to counter the ‘harm’ perceived in young children watching fast-paced entertainment programs as where differences were found it was the fast-paced program which appeared to have a cognitive facilitation effect.

scholarly journals Leveraging Professional Sports Teams to Encourage Healthy Behavior: A Review of 4 Years of Calgary Flames Health Training Camp Events

2020 ◽  
Vol 8 ◽  
Author(s):  
Elaine M. Ori ◽  
Tanya R. Berry ◽  
Gavin R. McCormack ◽  
Kelly R. Brett ◽  
George A. Lambros ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Lessons Learned ◽  
Self Report ◽  
Medical Attention ◽  
Local Health ◽  
Biometric Data ◽  
Health Training ◽  
Healthy Behavior ◽  
Training Camp

Professional sporting teams may be well-positioned to act as promoters of health behaviors given their fixture within a community, and association with physical activity, nutrition, and other healthy behaviors. Over 4 years, the Calgary Flames Sport and Entertainment Corporation in conjunction with local health promotion professionals, delivered a health promotion event to the public, The Calgary Flames Health Training Camp (FHTC) in Calgary, Alberta, Canada. The purpose of these annual events has been to inspire and encourage healthy behavior uptake and adherence. A description of the FHTC over each of 4 years (2015–2018), lessons learned, and some evaluative work done alongside the event on 2 of the 4 years. In 2017, self-report surveys were administered to event attendees to assess current health status including physical activity, socio-cognitive variables, health information preference, and intention to make healthful behavior change based on event attendance. Biometric data was collected including blood pressure, height, weight, and resting heart rate. Evaluations of the four consecutive events showed that the Calgary Flames Sport and Entertainment Corporation has an ability to attract substantial numbers of the general public to attend FHTC events. Self-report measures from 2017 suggest that already-active populations may be most interested in attending however, the events do appear to inspire attendees to consider behavioral changes for health. The events helped to identify individuals with health risks requiring medical attention but has not yet resulted in known behavior changes. Positive community health impacts may arise from collaboration between health promoters and professional sporting organizations.

Communication Metrics for Human-Autonomy Teaming: Lessons Learned from us Army Gunnery Field Experiments

2021 ◽  
Vol 65 (1) ◽  
pp. 1157-1161
Author(s):  
Anthony L. Baker ◽  
Sean M. Fitzhugh ◽  
Daniel E. Forster ◽  
Kristin E. Schaefer
Keyword(s):  
Field Experiments ◽  
Autonomous Systems ◽  
Lessons Learned ◽  
Critical Window ◽  
Us Army ◽  
Communication Assessment ◽  
Human Autonomy ◽  
Communication Flow ◽  
And Performance ◽  
Carry Over

The development of more effective human-autonomy teaming (HAT) will depend on the availability of validated measures of their performance. Communication provides a critical window into a team’s interactions, states, and performance, but much remains to be learned about how to successfully carry over communication measures from the human teaming context to the HAT context. Therefore, the purpose of this paper is to discuss the implementation of three communication assessment methodologies used for two Wingman Joint Capabilities Technology Demonstration field experiments. These field experiments involved Soldiers and Marines maneuvering vehicles and engaging in live-fire target gunnery, all with the assistance of intelligent autonomous systems. Crew communication data were analyzed using aggregate communication flow, relational event models, and linguistic similarity. We discuss how the assessments were implemented, what they revealed about the teaming between humans and autonomy, and lessons learned for future implementation of communication measurement approaches in the HAT context.

Transcending Distance in Long-Term Care: Can Serious Games Increase Resident Resilience?

2021 ◽  
Vol 65 (1) ◽  
pp. 1362-1366
Author(s):  
Trevor Hall ◽  
Monika Kastner ◽  
Susan Woollard ◽  
Christine Ramdeyol ◽  
Julie Makarski ◽  
...  
Keyword(s):  
Human Factors ◽  
Serious Games ◽  
Long Term Care ◽  
Health Centre ◽  
Lessons Learned ◽  
Healthcare Organizations ◽  
Physical Frailty ◽  
Term Care ◽  
Resident Resilience

In Canada, over 15,000 residents of long-term care have died from COVID-19 since the start of the pandemic representing 59 percent of all COVID-19 deaths (National Institute of Ageing, 2021). Urgent research and subsequent applied action are needed to save life and quality of life including the presence of family (CFHI, 2020). Social and physical frailty are major systemic patient safety gaps and are challenges for most healthcare organizations. This practitioner-led panel of experienced human factors, implementation science and healthcare experts used a case study of a project at North York General Hospital’s Seniors’ Health Centre in Toronto to discuss how these challenges can be addressed with serious games. The project discussed used games that aim to reduce social and physical frailty through exercise while interacting with remote families. Lessons learned to-date and challenges observed, in rapidly implementing safety and human factors programs intended to create resilient residents in a real healthcare context were discussed.

Significant Performance Improvement with MPD in HPHT Narrow Drilling Window Campaign in the North Sea

2021 ◽  
Author(s):  
Babar Kamal ◽  
Abdul Saboor ◽  
Graeme MacFarlane ◽  
Frank Kernche
Keyword(s):  
Precise Determination ◽  
Lessons Learned ◽  
Overburden Pressure ◽  
The North ◽  
Fracture Pressure ◽  
Open Hole ◽  
Infill Drilling ◽  
Significant Performance ◽  
And Performance ◽  
Formation Pore Pressure

Abstract Significant depletion in reservoir pressure, huge uncertainties in pore and fracture pressure, high overburden pressure on top of reservoir, Narrow Mud Weight Window (NMWW) and Partial/Total losses whilst entering the reservoir made these HPHT (High Pressure High Temperature) wells conventionally un-drillable. Due to these substantial challenges these wells were considered not only costly but also carry a high probability of failure to reach well TD (Total Depth). MPD (Managed Pressure Drilling) is a safer and more effective drilling technique as compared to conventional drilling, especially in wells with NMWW and downhole hazards. The precise determination and dynamic downhole pressure management was imperative to complete these wells without well control incidents. The Constant Bottom Hole Pressure (CBHP) variant in combination of automated MPD system was deployed with a mud weight statically underbalanced while dynamically managed above formation pore pressure to minimize the overbalance across the open hole. MPD enabled the operator to efficiently navigate Equivalent Circulation Density (ECD) through the pore and fracture pressure window, allowed significant improvements throughout the entire campaign. This paper discusses the challenges faced during the last three wells drilled in the campaign which includes equipment issues, commissioning delays, losses whilst drilling, Managed Pressure Cementing (MPC), 7" drill-in-liner and plugged/blocked lines due to weather and mud conditions. The paper describes HPHT infill drilling experience, specific techniques, practices as well as lessons learned from each well during the campaign were implemented to address challenges and to improve performance. The MPD system commissioning was optimized by repositioning the lines which saved significant critical rig time. The blowdown points were added on the lines that were not operational continuously therefore a procedure was developed for flushing to avoid plugging. Optimized drilling strategy was also developed where MW was further reduced to avoid losses as observed in previous wells and CBHP was maintained by manipulating Surface Back Pressure (SBP) from surface. This paper also discusses continuous improvements /upgrades in MPD operating software which assisted the operator in accurate monitoring of flow, SBP and BH-ECD to save significant rig cost in terms of invisible Non-Productive Time (NPT). MPD is a drilling enabler and performance enhancer which saved 80 days of Authorization for Expenditure (AFE) on this challenging HPHT campaign.

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