Motivation and contingency planning

Introduction Electronic health record (EHR) downtime is any period during which the EHR system is fully or partially unavailable. These periods are operationally disruptive and pose risks to patients. EHR downtime has not sufficiently been studied in the literature, and most hospitals are not adequately prepared. Objective The objective of this study was to assess the operational implications of downtime with a focus on the clinical laboratory, and to derive recommendations for improved downtime contingency planning. Methods A hybrid qualitative–quantitative study based on historic performance data and semistructured interviews was performed at two mid-Atlantic hospitals. In the quantitative analysis, paper records from downtime events were analyzed and compared with normal operations. To enrich this quantitative analysis, interviews were conducted with 17 hospital employees, who had experienced several downtime events, including a hospital-wide EHR shutdown. Results During downtime, laboratory testing results were delayed by an average of 62% compared with normal operation. However, the archival data were incomplete due to inconsistencies in the downtime paper records. The qualitative interview data confirmed that delays in laboratory result reporting are significant, and further uncovered that the delays are often due to improper procedural execution, and incomplete or incorrect documentation. Interviewees provided a variety of perspectives on the operational implications of downtime, and how to best address them. Based on these insights, recommendations for improved downtime contingency planning were derived, which provide a foundation to enhance Safety Assurance Factors for EHR Resilience guides. Conclusion This study documents the extent to which downtime events are disruptive to hospital operations. It further highlights the challenge of quantitatively assessing the implication of downtimes events, due to a lack of otherwise EHR-recorded data. Organizations that seek to improve and evaluate their downtime contingency plans need to find more effective methods to collect data during these times.

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UNNECESSARILY NEGLECTED IN PLANNING: ILLUSTRATION OF A PRACTICAL APPROACH TO IDENTIFY HUMAN DIMENSION IMPACTS OF MARINE OIL SPILLS

Journal of Environmental Assessment Policy and Management ◽

10.1142/s1464333212500123 ◽

2012 ◽

Vol 14 (02) ◽

pp. 1250012 ◽

Cited By ~ 2

Author(s):

FABIENNE LORD ◽

SETH TULER ◽

THOMAS WEBLER ◽

KIRSTIN DOW

Keyword(s):

Emergency Response ◽

Oil Spill ◽

Damage Assessment ◽

Oil Spills ◽

Social Systems ◽

Human Dimensions ◽

Contingency Planning ◽

Human Dimension ◽

Contingency Plans ◽

Negative Impacts

Technological hazards research, including that on oil spills and their aftermath, is giving greater attention to human dimension impacts resulting from events and response. While oil spill contingency planners recognize the importance of human dimension impacts, little systematic attention is given to them in contingency plans. We introduce an approach to identifying human dimensions impacts using concepts from hazard and vulnerability assessment and apply it to the Bouchard-120 oil spill in Buzzards Bay, MA. Our assessment covers the spill, emergency response, clean-up, damage assessment, and mid-term recovery. This approach, while still exploratory, did demonstrate that the spill produced a range of positive and negative impacts on people and institutions and that these were mediated by vulnerabilities. We suggest ways in which the framework may help spill managers to learn from events and improve contingency planning by anticipating risks to social systems and identifying strategies to reduce impacts.

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(N-1) contingency planning in radial distribution networks using genetic algorithms

2010 IEEE/PES Transmission and Distribution Conference and Exposition: Latin America (T&D-LA) ◽

10.1109/tdc-la.2010.5762896 ◽

2010 ◽

Cited By ~ 6

Author(s):

Alexandre Mendes ◽

Natashia Boland ◽

Patrick Guiney ◽

Carlos Riveros

Keyword(s):

Genetic Algorithms ◽

Radial Distribution ◽

Distribution Networks ◽

Contingency Planning ◽

Radial Distribution Networks

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Fair training

Progress in Development Studies ◽

10.1177/146499340800900107 ◽

2009 ◽

Vol 9 (1) ◽

pp. 81-86 ◽

Cited By ~ 4

Author(s):

Tim O'Dempsey

Keyword(s):

Global Climate Change ◽

Global Climate ◽

Contingency Planning ◽

Poor People ◽

Disaster Prevention ◽

Timely Manner ◽

Sustainable Solutions ◽

Trained Personnel ◽

Local Access ◽

Mega Cities

Major catastrophes appear to be inevitable given the current demographic transition, the growth of mega-cities in disaster hotspots, the predicted effects of global climate change, and the crucial relationship between natural disasters and complex political emergencies. Disaster prevention, preparedness and contingency planning will be effective only if trained personnel are available to develop these plans and implement them in a timely manner. Workforce migration, driven by poverty, insecurity and lack of opportunity, creates a leadership and skills vacuum that further increases the vulnerability of those who remain. Sustainable solutions to the problems of disasters and development will only be achieved when poor people have local access to Fair Training.

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Minimizing supply chain disruption risk through enhanced flexibility

International Journal of Physical Distribution & Logistics Management ◽

10.1108/09600030910973742 ◽

2009 ◽

Vol 39 (5) ◽

pp. 404-427 ◽

Cited By ~ 102

Author(s):

Joseph B. Skipper ◽

Joe B. Hanna

Keyword(s):

Supply Chain ◽

Multiple Regression ◽

Planning Process ◽

Research Effort ◽

Risk Exposure ◽

Contingency Planning ◽

Management Support ◽

Supply Chain Disruption ◽

Content Type ◽

Disruption Risk

PurposeThe purpose of this paper is to examine the use of a strategic approach (contingency planning) to minimize risk exposure to a supply chain disruption. Specifically, the relationship between several attributes of a contingency planning process and flexibility are examined.Design/methodology/approachThis effort develops a model that will provide both researchers and practitioners a means of determining the attributes with the highest relationship to flexibility. The model is then tested using multiple regression techniques.FindingsBased on the sample used in this survey, top management support, resource alignment, information technology usage, and external collaboration provide the largest contributions to flexibility. Flexibility has been shown to enhance the ability to minimize risk exposure in the event of a supply chain disruption.Research limitations/implicationsIn this research effort, the multiple regression results produced an R2 of 0.45, indicating that additional variables of interest may need to be identified and investigated. Furthermore, a wider range of respondents could make the results more generalizable.Practical implicationsThis effort will help to allow managers at multiple levels to understand the primary planning attributes to use to increase flexibility.Originality/valueThe paper develops a model that can be used to identify the specific areas that can lead to improved flexibility. Based on the model, managers, and planners can develop appropriate strategies for minimizing risk exposure in the event of a supply chain disruption.

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