scholarly journals Classification of Failures in the Perception of Conversational Agents (CAs) and Their Implications on Patient Safety

2021 ◽  
Author(s):  
Haris Aftab ◽  
Syed Hammad Hussain Shah ◽  
Ibrahim Habli
Keyword(s):  
Patient Safety ◽  
Insulin Dose ◽  
Conversational Agents ◽  
User Interactions ◽  
Safety Issues ◽  
Healthcare Settings ◽  
Medication Dose ◽  
Compromise Patient Safety ◽  
Administrative Tasks

The use of Conversational agents (CAs) in healthcare is an emerging field. These CAs seem to be effective in accomplishing administrative tasks, e.g. providing locations of care facilities and scheduling appointments. Modern CAs use machine learning (ML) to recognize, understand and generate a response. Given the criticality of many healthcare settings, ML and other component errors may result in CA failures and may cause adverse effects on patients. Therefore, in-depth assurance is required before the deployment of ML in critical clinical applications, e.g. management of medication dose or medical diagnosis. CA safety issues could arise due to diverse causes, e.g. related to user interactions, environmental factors and ML errors. In this paper, we classify failures of perception (recognition and understanding) of CAs and their sources. We also present a case study of a CA used for calculating insulin dose for gestational diabetes mellitus (GDM) patients. We then correlate identified perception failures of CAs to potential scenarios that might compromise patient safety.

scholarly journals Risks in Management of Enteral Nutrition in Intensive Care Units: A Literature Review and Narrative Synthesis

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 82
Author(s):  
Magdalena Hoffmann ◽  
Christine Maria Schwarz ◽  
Stefan Fürst ◽  
Christina Starchl ◽  
Elisabeth Lobmeyr ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Clinical Practice ◽  
Literature Review ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Rapid Review ◽  
Narrative Synthesis ◽  
Safety Issues

Critically ill patients in the intensive care unit (ICU) have a high risk of developing malnutrition, and this is associated with poorer clinical outcomes. In clinical practice, nutrition, including enteral nutrition (EN), is often not prioritized. Resulting from this, risks and safety issues for patients and healthcare professionals can emerge. The aim of this literature review, inspired by the Rapid Review Guidebook by Dobbins, 2017, was to identify risks and safety issues for patient safety in the management of EN in critically ill patients in the ICU. Three databases were used to identify studies between 2009 and 2020. We assessed 3495 studies for eligibility and included 62 in our narrative synthesis. Several risks and problems were identified: No use of clinical assessment or screening nutrition assessment, inadequate tube management, missing energy target, missing a nutritionist, bad hygiene and handling, wrong time management and speed, nutritional interruptions, wrong body position, gastrointestinal complication and infections, missing or not using guidelines, understaffing, and lack of education. Raising awareness of these risks is a central aspect in patient safety in ICU. Clinical experts can use a checklist with 12 identified top risks and the recommendations drawn up to carry out their own risk analysis in clinical practice.

Evaluation of patient safety culture in a private general hospital: a case study in Brazil

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Cassiana Gil Prates ◽  
Rita Catalina Aquino Caregnato ◽  
Ana Maria Müller de Magalhães ◽  
Daiane Dal Pai ◽  
Janete de Souza Urbanetto ◽  
...  
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Patient Safety Culture ◽  
Administrative Staff ◽  
Management Support ◽  
Content Type ◽  
Administrative Services ◽  
Graduate Degrees ◽  
Brazilian Version

PurposeThe purpose is to assess the patient safety culture perceived by healthcare and administrative staff in a Brazilian hospital and examine whether education and experience are related to positive perceptions.Design/methodology/approachA descriptive–analytical case study was carried out at Ernesto Dornelles Hospital, a private Brazilian institution. The Brazilian version of the Hospital Survey on Patient Safety Culture was used to assess the perceptions of 618 participants, of whom 315 worked in healthcare assistance and 303 in administrative services. The main outcome was the percentage of positive responses, and the independent variables included the type of work, schooling and length of experience.FindingsNone of the twelve dimensions was strengthened. The percentage of positive responses was the highest for “Hospital management support for patient safety” (67.5%), and the lowest was for “Nonpunitive response to error” (29%). The healthcare staff had a slightly higher average than the administrative staff. The percentage of positive responses from professionals with undergraduate or graduate degrees was higher for the eight dimensions of safety culture. The length of hospital experience was not associated with any dimensions.Originality/valueThis study explored the influence of education and professional experience on the perception of patient safety in healthcare and administrative staff from a private institution. These approaches allow to know with greater depth and clarity factors that are related to the patient safety culture and, thus, have more consistent evidence to support interventions in specific needs.

Heavyweight extension to the UML class diagram metamodel for modeling context aware systems in ubiquitous computing

2017 ◽  
Vol 13 (3) ◽  
pp. 238-251 ◽  
Author(s):  
Haider Boudjemline ◽  
Mohamed Touahria ◽  
Abdelhak Boubetra ◽  
Hamza Kaabeche
Keyword(s):  
Fundamental Problem ◽  
Unified Modeling Language ◽  
Class Diagram ◽  
Context Aware ◽  
User Interactions ◽  
Content Type ◽  
Unified Modeling ◽  
Development Processes ◽  
Uml Class Diagram

Purpose The development of context-aware applications in ubiquitous environments depends not only on the user interactions but also on several context parameters. The handling of these parameters is a fundamental problem in these systems. The key purpose of this work is to enrich the unified modeling language (UML) class diagram with new constructs to provide a universal model capable of coping with the context-awareness concerns. Design/methodology/approach The authors provide a review of existing context handling approaches. Afterward, they relied on the UML extensibility mechanisms to propose a heavyweight extension for the UML class diagram. This generic approach allows describing the different context parameters since the modeling phase. Findings Existing solutions for context handling apply the contextual constraints on finished applications or tend to be dependent on a specific development process. This paper presents a solution based on UML, which allows dealing with context since the modeling phase, and independently of development processes. This proposal is implemented as an eclipse editor and illustrated through a case study in the healthcare field. Originality/value This paper addresses the problem of context handling, and it presents a review of the foremost existing solutions. The paper also presents a heavyweight extension for the UML class diagram, which consists in enriching it with additional constructs, capable of monitoring how applications are linked to context parameters and how the values of these parameters may affect the application behavior.

scholarly journals Surveillance, anticipation and firefighting: Perspectives of patient safety from a New Zealand case study

2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
New Zealand ◽  
Health Care Professionals ◽  
Nuclear Power ◽  
High Reliability ◽  
Health Care Systems ◽  
Tertiary Hospital ◽  
Structured Interviews

© 2018 John Wiley & Sons Ltd Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety. Background: Despite health care systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by health care professionals with concerns raised about clinician engagement. Design: Instrumental, embedded case study design using qualitative methods. Methods: The study used purposeful sampling, and data was collected using focus groups and semi-structured interviews with doctors (n = 31); registered nurses (n = 19); and senior organisational managers (n = 3) in a New Zealand tertiary hospital. Results: Safety was described as a core organisational value. Clinicians appreciated proactive safety approaches characterized by anticipation and vigilance, where they expertly recognized and adapted to safety risks. Managers trusted evidence-based safety rules and approaches that recorded, categorized and measured safety. Conclusion and Implications for Nursing Management: It is important that nurse managers hold a more refined understanding about safety. Organisations are more likely to support safe patient care if cultural complexity is accounted for. Recognizing how different occupational groups perceive and respond to safety, rather than attempting to reinforce a uniform set of safety actions and responsibilities, is likely to bring together a shared understanding of safety, build trust and nurture safety culture.

scholarly journals Policy Analysis of Used Capital Fund of National Health Insurance (JKN) To Increase Employee Performance on Primary Healthcare (FKTP)Puskesmas in Pacitan

2021 ◽  
Vol 06 (01) ◽  
Author(s):  
Galuh Panji Rakasiwi ◽  
Keyword(s):  
Performance Evaluation ◽  
Health Service ◽  
Work Performance ◽  
Employee Performance ◽  
Group Discussion ◽  
Capitation Payment ◽  
Incentive Payment ◽  
Administrative Tasks ◽  
Depth Interviews

Under the ministerial regulation no 21/2016 the payment of JKN service to the FKTP used capitation payment system. The payment given to the primary care is in the form of health service payment (minimum 60%). The allocation is based on types of workforce (profession, administrative tasks, person in charge of programs, and years of service) and attendance. This study investigates the possibility of adding employee performance as a variable in giving health service point for employees at FKTP Puskesmas. This study is a qualitative study in nature using case study design. The data were collected through in-depth interviews, focus group discussion, and triangulation. Incentive payment increases the employee performance at work. The amount of incentives should line up with the employees performances. Incentives will not be effective if they are fixed and do not count the employees performances. In the ministerial regulation no 21/2016, healthcare service is not included as a variable in employee performance evaluation. The head of FKTP Puskesmas can use the results of employee performance evaluation to determine the amount of incentives received. One of the ways to improve employee performance is through reward and punishment system. Employee performance in Puskesmas can be increased by adding work performance evaluation as a variable capitation payment of BPJS Kesehatan to Puskesmas based on ministerial regulation (Permenkes) no 21/ 2016.

Sign in / Sign up

Export Citation Format

Share Document