Does Telemedical Support of First Responders Improve Guideline Adherence in an Offshore Emergency Scenario? A Simulator-Based Prospective Study

OBJECTIVE: To investigate, in a simulator-based prospective study, whether telemedical support improves quality of emergency first response (performance) by medical non-professionals to being non-inferior to medical professionals. SETTING: In a simulated offshore wind power plant, duos (teams) of offshore engineers and teams of paramedics conducted the primary survey of a simulated patient. PARTICIPANTS: 38 offshore engineers and 34 paramedics were recruited by the general email invitation. INTERVENTION: Teams (randomised by lot) were supported by transmission technology and a remote emergency physician in Berlin. OUTCOME MEASURES: From video recordings, performance (17 item checklist) and required time (up to 15 min) were quantified by expert rating for analysis. Differences were analysed using two-sided exact Mann-Whitney U tests for independent measures, non-inferiority was analysed using Schuirmann one-sided test. The significance level of 5 % was Holm-Bonferroni adjusted in each family of pairwise comparisons. RESULTS: Nine teams of engineers with, nine without, nine teams of paramedics with and eight without support completed the task. Two experts quantified endpoints, insights into rater dependence were gained. Supported engineers outperformed unsupported engineers (p<0.01), insufficient evidence was found for paramedics (p=0.11). Without support, paramedics outperformed engineers (p<0.01). Supported engineers' performance was non-inferior (at one item margin) to that by unsupported paramedics (p=0.03). Supported groups were slower than unsupported groups (p<0.01). CONCLUSIONS: First response to medical emergencies in offshore wind farms with substantially delayed professional care may be improved by telemedical support. Future work should test our result during additional scenarios and explore interdisciplinary and ecosystem aspects of this support. TRIAL REGISTRATION NUMBER: DRKS0001437

Resilience markers for safer systems and organisations

If computer systems are to be designed to foster resilient performance it is important to be able to identify contributors to resilience. The emerging practice of Resilience Engineering has identified that people are still a primary source of resilience, and that the design of distributed systems should provide ways of helping people and organisations to cope with complexity. Although resilience has been identified as a desired property, researchers and practitioners do not have a clear understanding of what manifestations of resilience look like. This paper discusses some examples of strategies that people can adopt that improve the resilience of a system. Critically, analysis reveals that the generation of these strategies is only possible if the system facilitates them. As an example, this paper discusses practices, such as reflection, that are known to encourage resilient behavior in people. Reflection allows systems to better prepare for oncoming demands. We show that contributors to the practice of reflection manifest themselves at different levels of abstraction: from individual strategies to practices in, for example, control room environments. The analysis of interaction at these levels enables resilient properties of a system to be ‘seen’, so that systems can be designed to explicitly support them. We then present an analysis of resilience at an organisational level within the nuclear domain. This highlights some of the challenges facing the Resilience Engineering approach and the need for using a collective language to articulate knowledge of resilient practices across domains

Quality Checks Logit Human Reliability (LHR): A New Model to Evaluate Human Error Probability (HEP)

In the years, several approaches for human reliability analysis (HRA) have been developed. The aim of the present research is to propose a hybrid model to evaluate Human Error Probability (HEP). The new approach is based on logit-normal distribution, Nuclear Action Reliability Assessment (NARA), and Performance Shaping Factors (PSFs) relationship. In the research, shortcomings related to literature approaches are analyzed, especially the limitations of the working time. For this reason, PSFs after 8 hours (work standard) during emergency conditions were estimated. Therefore, the correlation between the advantages of these three methodologies allows proposing a HEP analysis during accident scenarios and emergencies; a fundamental issue to ensure the safety and reliability in industrial plants is emergency Mmnagement (EM). Applying EM methodology, two main aspects are analyzed: system reliability and human reliability. System reliability is strongly related to the reliability of its weakest component. During incidental situations, the weakest parts of the whole system are workers (human reliability) and accidental scenarios influence the operator’s ability to make decisions. This article proposes a new approach called Logit Human Reliability (LHR) that considers internal and external factors to estimate human reliability during emergencies. LHR has been applied in a pharmaceutical accident scenario, considering 24 hours of working time (more than 8 working hours). The results highlighted that the LHR method gives output data more in conformity with data banks than the conventional methods during the stress phase in an accident scenario

Systematic Human Reliability Analysis (SHRA): A New Approach to Evaluate Human Error Probability (HEP) in a Nuclear Plant

Emergency management in industrial plants is a fundamental issue to ensure the safety of operators. The emergency management analyses two fundamental aspects: the system reliability and the human reliability. System reliability is the capability of ensuring the functional properties within a variability of work conditions, considering the possible deviations due to unexpected events. However, system reliability is strongly related to the reliability of its weakest component. The complexity of the processes could generate incidental situations and the worker appears (human reliability) to be the weakest part of the whole system. The complexity of systems influences operator’s ability to take decisions during emergencies. The aim of the present research is to develop a new approach to evaluate human error probability (HEP), called Systematic Human Reliability Analysis (SHRA). The proposed approach considers internal and external factors that affect operator’s ability. The new approach is based on Nuclear Action Reliability Assessment (NARA), Simplified Plant Analysis Risk Human Reliability (SPAR-H) and on the Performance Shaping Factors (PSFs) relationship. The present paper analysed some shortcomings related to literature approaches, especially the limitations of the working time. We estimated HEP, after 8 hours (work standard) during emergency conditions. The correlations between the advantages of these three methodologies allows proposing a HEP analysis during accident scenarios emergencies. SHRA can be used to estimate human reliability during emergencies. SHRA has been applied in a nuclear accident scenario, considering 24 hours of working time. The SHRA results highlight the most important internal and external factors that affect operator’s ability

Systematic Human Reliability Analysis (SHRA): A New Approach to Evaluate Human Error Probability (HEP) in a Nuclear Plant

Emergency management in industrial plants is a fundamental issue to ensure the safety of operators. The emergency management analyses two fundamental aspects: the system reliability and the human reliability. System reliability is the capability of ensuring the functional properties within a variability of work conditions, considering the possible deviations due to unexpected events. However, system reliability is strongly related to the reliability of its weakest component. The complexity of the processes could generate incidental situations and the worker appears (human reliability) to be the weakest part of the whole system. The complexity of systems influences operator's ability to take decisions during emergencies. The aim of the present research is to develop a new approach to evaluate human error probability (HEP), called Systematic Human Reliability Analysis (SHRA). The proposed approach considers internal and external factors that affect operator's ability. The new approach is based on Nuclear Action Reliability Assessment (NARA), Simplified Plant Analysis Risk Human Reliability (SPAR-H) and on the Performance Shaping Factors (PSFs) relationship. The present paper analysed some shortcomings related to literature approaches, especially the limitations of the working time. We estimated HEP, after 8 hours (work standard) during emergency conditions. The correlations between the advantages of these three methodologies allows proposing a HEP analysis during accident scenarios emergencies. SHRA can be used to estimate human reliability during emergencies. SHRA has been applied in a nuclear accident scenario, considering 24 hours of working time. The SHRA results highlight the most important internal and external factors that affect operator's ability

A hybrid model to evaluate human error probability (HEP) in a pharmaceutical plant

The aim of the present research is to propose a hybrid model to evaluate Human Error Probability (HEP) called Logit Human Reliability (LHR). The new approach is based on logit normal distribution, Nuclear Action Reliability Assessment (NARA), and Performance Shaping Factors (PSFs) relationship. The present paper analyzed some shortcomings related to literature approaches, especially the limitations of the working time. We estimated PSFs after 8 hours (work standard) during emergency conditions. Therefore, the correlation between the advantages of these three methodologies allows proposing a HEP analysis during accident scenario and emergencies. The proposed approach considers internal and external factors that affect the operator's ability. LHR has been applied in a pharmaceutical accident scenario, considering 24 hours of working time (more than 8 working hours)

Quality Checks Logit Human Reliability (LHR): A New Model to Evaluate Human Error Probability (HEP)

In the years, several approaches for human reliability analysis (HRA) have been developed. The aim of the present research is to propose a hybrid model to evaluate Human Error Probability (HEP). The new approach is based on logit-normal distribution, Nuclear Action Reliability Assessment (NARA), and Performance Shaping Factors (PSFs) relationship. In the research, shortcomings related to literature approaches are analyzed, especially the limitations of the working time. For this reason, PSFs after 8 hours (work standard) during emergency conditions were estimated. Therefore, the correlation between the advantages of these three methodologies allows proposing a HEP analysis during accident scenarios and emergencies; a fundamental issue to ensure the safety and reliability in industrial plants is emergency Mmnagement (EM). Applying EM methodology, two main aspects are analyzed: system reliability and human reliability. System reliability is strongly related to the reliability of its weakest component. During incidental situations, the weakest parts of the whole system are workers (human reliability) and accidental scenarios influence the operator's ability to make decisions. This article proposes a new approach called Logit Human Reliability (LHR) that considers internal and external factors to estimate human reliability during emergencies. LHR has been applied in a pharmaceutical accident scenario, considering 24 hours of working time (more than 8 working hours). The results highlighted that the LHR method gives output data more in conformity with data banks than the conventional methods during the stress phase in an accident scenario

HSI for monitoring the critical safety functions status tree of a NPP

Critical safety function (CSF) is the most significant design concept for prioritize operator actions based on the potential threat to the three barriers (fuel cladding, primary coolant system boundary, and containment) and allows the operator to respond to these threats prior to event diagnosis. CSF has a hierarchical information structure that organizes the system variables affecting the plant safety in terms of goal-means relations. It is important that the operator should be aware of various success paths associated with each CSF in order to respond to unanticipated system failures quickly. When an emergency occurs in NPPs, the operator should monitor CSFs periodically and identify possible success paths as necessary, and try to stabilize or safely shut down the plant using emergency operating procedure (EOP) that includes steps to check the CSFs. This implies that safety function status check may become a cognitively burdensome task that needs to be supported by proper information display. The advanced human-system interface (HSI) in nuclear power plants provides an information environment that supports the operators’ burdensome cognitive tasks. This paper describes a CSFs interface design for supporting the operator’s tasks to monitor and identify the associated success path for Westinghouse 3-loops NPP