The Art of Effective Handoff Communication Among Medical and Surgery Residents

End-of-shift handoffs occur when physicians transfer care responsibilities from one shift to another. Typically viewed as a straightforward exchange of information, we argue that several contextually relevant factors shape the communication behaviors of outgoing and incoming residents during handoffs. Digital recordings and transcripts of resident handoffs in medicine and surgery were made at three VA Medical Centers. They were triangulated with cognitive task interviews that elicited residents’ reconstructions of their work practices. Analyses revealed clear distinctions among “day-to-night,” “night-to-day,” and “double handoffs” that involve transitions between day and night teams. Although residents preferred handing off in dedicated, quiet spaces, few (16%) occurred in such settings; 28% contained significant interruptions. The quality handoff artifacts (notes and forms) influenced interactions, especially in cases where multiple residents from different teams were involved, requiring incoming residents to adjust “on the fly.” This study demonstrated that there are multiple contextual factors that affect, and are affected by, handoff interactions. The findings suggest that handoffs are less like the delivery of a telegram (unidirectional) and more like complex adaptive systems (products of interactional co-construction). Teaching communication practices based on interaction complexity may reduce errors and adverse outcomes for hospitalized patients.

ACTIVITY RECOGNITION FOR AMBIENT SENSING DATA AND RULE BASED ANOMALY DETECTION

After a brief look at the smart home, we conclude that to have a smart home, and it is necessary to have an intelligent management center. In this article, We have tried to make it possible for the smart home management center to be able to detect the presence of an abnormal state in the behavior of someone who lives in the house. In the proposed method, the daily algorithm examines the rate of changes of a person and provides a number which is henceforth called NNC (Number of normal changes) based on the person’s behavioral changes. We achieve the NNC number using a machine learning algorithm and performing a series of several simple statistical and mathematical calculations. NNC is a number that shows abnormal changes in residents’ behaviors in a smart home, i.e., this number is a small number for a regular person with constant planning and for a person who may not have any fixed principles and regular in personal life is a big number.To increase our accuracy in calculating NNC, we review all common machine learning algorithms and after tests we choose the decision tree because of its higher accuracy and speed and finally, NNC number is obtained by combining the Decision Tree algorithm with statistical and mathematical methods. In this method, we present a set of states and information obtained from the sensors along with the activities performed by the occupant of the house over a period of several days to the proposed algorithm. and the method ahead generates the main NNC number for those days for anyone living in a smart home. To generate this main NNC, we calculate each person’s daily NNC. That means we have daily NNCs for each person (based on his/her behaviors on that day) and the main NNC is the average of these daily NNC. We chose ARAS dataset (Human Activity Datasets in Multiple Homes with Multiple Residents) to implement our method and after tests and replications on the ARAS dataset, and to find anomalies in each person’s behavior in a day, we compare the main (average) NNC with that person’s daily NNC on that day. Finally, we can say, if the main NNC changes more than 30%, there is a possibility of an abnormality. and if the NNC changes more than 60% percent, we can say that an abnormal state or an uncommon event happened that day, and a declaration of an abnormal state will be issued to the resident of the house.

Beacon-Based Time-Spatial Recognition toward Automatic Daily Care Reporting for Nursing Homes

As the world’s population of senior citizens continues to grow, the burden on the professionals who care for them (carers) is also increasing. In nursing homes, carers often write daily reports to improve the resident’s quality of life. However, since each carer needs to simultaneously care for multiple residents, they have difficulty thoroughly recording the activities of residents. In this paper, we address this problem by proposing an automatic daily report generation system that monitors the activities of nursing home residents. The proposed system estimates the multiple locations (areas) at which residents are situated with a BLE beacon, using a variety of methods to analyze the RSSI values of BLE signals, and recognizes the activity of each resident from the estimated area information. The information of the estimated activity of residents is stored in a server with timestamps, and the server automatically generates daily reports based on them. To show the effectiveness of the proposed system, we conducted an experiment for five days with four participants in cooperation with an actual nursing home. We determined the proposed system’s effectiveness with the following four evaluations: (1) comparison of performance of different machine-learning algorithms, (2) comparison of smoothing methods, (3) comparison of time windows, and (4) evaluation of generated daily reports. Our evaluations show the most effective combination pattern among 156 patterns to accurately generate daily reports. We conclude that the proposed system has high effectiveness, high usability, and high flexibility.