Evaluations for New Healthcare Environment Commissioning and Operational Decision Making Using Simulation and Human Factors: A Case Study of an Interventional Trauma Operating Room

2021 ◽  
pp. 193758672199966
Author(s):  
Mirette Dubé ◽  
Jason Laberge ◽  
Elaine Sigalet ◽  
Jonas Shultz ◽  
Christine Vis ◽  
...  
Keyword(s):  
Decision Making ◽  
Human Factors ◽  
Operating Room ◽  
Healthcare Services ◽  
Healthcare Team ◽  
Healthcare Environment ◽  
New Process ◽  
Timely Access ◽  
Operational Decision Making

Purpose: The aim of this article is to provide a case study example of the preopening phase of an interventional trauma operating room (ITOR) using systems-focused simulation and human factor evaluations for healthcare environment commissioning. Background: Systems-focused simulation, underpinned by human factors science, is increasingly being used as a quality improvement tool to test and evaluate healthcare spaces with the stakeholders that use them. Purposeful real-to-life simulated events are rehearsed to allow healthcare teams opportunity to identify what is working well and what needs improvement within the work system such as tasks, environments, and processes that support the delivery of healthcare services. This project highlights salient evaluation objectives and methods used within the clinical commissioning phase of one of the first ITORs in Canada. Methods: A multistaged evaluation project to support clinical commissioning was facilitated engaging 24 stakeholder groups. Key evaluation objectives highlighted include the evaluation of two transport routes, switching of operating room (OR) tabletops, the use of the C-arm, and timely access to lead in the OR. Multiple evaluation methods were used including observation, debriefing, time-based metrics, distance wheel metrics, equipment adjustment counts, and other transport route considerations. Results: The evaluation resulted in several types of data that allowed for informed decision making for the most effective, efficient, and safest transport route for an exsanguinating trauma patient and healthcare team; improved efficiencies in use of the C-arm, significantly reduced the time to access lead; and uncovered a new process for switching OR tabletop due to safety threats identified.

The Implementation of Lean in Emergency Hospital Screening During the COVID-19 Pandemic

2021 ◽  
pp. 65-79
Author(s):  
Inês Veiga Pereira ◽  
Patricia Oliveira Faria ◽  
Amélia Maria Pinto da Cunha Brandão
Keyword(s):  
Healthcare Services ◽  
Lean Implementation ◽  
Emergency Hospital ◽  
Process Implementation ◽  
New Process ◽  
Hospital Culture ◽  
Before And After ◽  
Flow Charts ◽  
The City

Healthcare services, in particular, are one of the areas in which Lean can be applied and benefits can be reached through it. In order to analyze the suitability of Lean implementation in healthcare units, this research focused on a case study, namely in Hospital of Santo António emergency area, in the city of Porto, Portugal. The study was conducted in the year 2020, during the pandemic of COVID-19, which forced the change of screening processes. This research analyses and compares the new and previous sorting model and discusses if Lean methodology was applied. It was concluded, through data collected in the interview to the leading nurse, that despite de fact she is not familiar with the Lean concept and methodology, as process simplification and time reduction were taken into account, the new process can be considered Lean. The flow charts that reflect both the sorting structure used in the urgencies before and after were developed. Hospital culture, lack of communication before the new process implementation, and the facilities were some of the identified barriers.

scholarly journals Managing Human Factors to Reduce Organisational Risk in Industry

2018 ◽  
Vol 23 (4) ◽  
pp. 67 ◽  
Author(s):  
Silvia Carpitella ◽  
Fortunato Carpitella ◽  
Antonella Certa ◽  
Julio Benítez ◽  
Joaquín Izquierdo
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Risk Management ◽  
Human Factors ◽  
Risk Evaluation ◽  
Industrial Processes ◽  
Mathematical Framework ◽  
Multi Criteria Decision Making ◽  
Inference Engines

Human factors are intrinsically involved at virtually any level of most industrial/business activities, and may be responsible for several accidents and incidents, if not correctly identified and managed. Focusing on the significance of human behaviour in industry, this article proposes a multi-criteria decision-making (MCDM)-based approach to support organizational risk assessment in industrial environments. The decision-making trial and evaluation laboratory (DEMATEL) method is proposed as a mathematical framework to evaluate mutual relationships within a set of human factors involved in industrial processes, with the aim of highlighting priorities of intervention. A case study related to a manufacturing process of a real-world winery is presented, and the proposed approach is applied to rank human factors resulting from a previous organisational risk evaluation from which suitable inference engines may be developed to better support risk management.

scholarly journals From a healthcare perspective: How to preserve person-centered care using video meetings to follow up with patients during the Covid-19 pandemic (Preprint)

2020 ◽  
Author(s):  
Line Silsand ◽  
Gro-Hilde Severinsen ◽  
Gro Berntsen
Keyword(s):  
Information Exchange ◽  
Healthcare Services ◽  
Cognitive Capacity ◽  
Healthcare Personnel ◽  
Healthcare Team ◽  
Main Mode ◽  
Face To Face ◽  
Rapid Transfer

BACKGROUND This study reports the experiences faced by a multi-disciplinary healthcare team (PACT), on shifting rapidly from face-to-face care to using video meetings(s) (VM) for clinical and collaborative services during the initial phase of the Covid-19 pandemic. PACT focuses on the transitional phase between hospital and primary care, for elderly patients in Northern Norway with complex and long-term needs (CLN). PACT emphasises the patient-centred care (PCC) approach whereby the sharing of power, and the patients ‘answer to “what matters to you?” drives care decisions. However, during the Covid-19 (novel coronavirus) pandemic VM was the only option for assessing, planning, coordinating, and performing treatment and care. This study explores how PACT managed to maintain PCC under these conditions. OBJECTIVE In this paper, we address the following research questions: How do we preserve a PCC focus for persons with CLN in care services, when VM becomes the main mode of clinical communication, due to social distancing measures during the Covid-19 pandemic? What are the challenges and possibilities for healthcare personnel in PACT when a rapid transfer from face-to-face care to video meetings is needed? METHODS This case study has a qualitative approach based on four semi-structured focus group interviews, from May and June 2020, with 18 PACT members and leaders. RESULTS From the case study, we learn that VMs are not a good solution for all persons with CLN. Healthcare personnel in PACT had divided opinions on the potential of using VM to preserve PCC for this heterogeneous patient group. Some found it difficult to digitally assess and communicate with patients with hearing disabilities and reduced cognitive capacity. Whereas others reported the opposite, namely that VM made it possible to include even the most fragile patients. The study outlines that using VM presented the opportunity for more efficient use of healthcare personnel, reduced travelling time for patients, and improved the information exchange between healthcare levels. This implied that integration of VM contributed to preservation of the PCC focus during the Covid-19 pandemic. There was an overall agreement in PACT that face-to-face care had to be the core foundation for a PCC approach, and VM was mainly useful to reinforce follow-up and coordination. CONCLUSIONS The rapid transfer from face-to-face care generated a need for time to practice and define guidelines for using the technology amongst the different healthcare actors. In addition, technical support to healthcare personnel and patients was important to highlight. Scaling up the use of VM made it important in defining overall agreements between the different healthcare organisations for rearranging healthcare services.

scholarly journals UNCERTAINTY MODELLING OF CITIZEN-CENTERED GROUP DECISION MAKING USING FUZZY-VIKOR CASE STUDY: SITE SELECTION OF HEALTHCARE SERVICES

2019 ◽  
Vol XLII-4/W18 ◽  
pp. 809-814
Author(s):  
Z. Neisani Samani ◽  
A. A. Alesheikh
Keyword(s):  
Decision Making ◽  
Urban Planning ◽  
Expert Knowledge ◽  
Healthcare Services ◽  
Fuzzy Vikor ◽  
Case Study Site ◽  
Decision Making Processes ◽  
Comparison Of The Results ◽  
Selection Of

Abstract. The participation of citizens in decision-making processes is one of the main concerns in urban planning. People’s contributions increase the usability and efficiency of urban facilities. Hospitals and healthcare services are among the most important public facilities that citizens require. This paper aims to improve an approach that could locate the hospitals according to the citizens’ preferences. Decision-making process in this situation should consider the uncertainties exist in any steps of decisions-making. In this regard, this paper applied Fuzzy-VIKOR method that is appropriate to model such kind of uncertainty. The proposed method was accomplished in Districts 6 of Tehran province. The achieved results were compared with each other in two different scenario (using expert knowledge and citizens’ satisfaction). The comparison of the results showed that the more suitable distribution and density of proposed sites for hospitals must be observed if the citizens’ perspectives were considered. Also, the proposed sites with experts follow urban planning principals rather than the second case.

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