Devising a consensus definition and framework for non-technical skills in healthcare to support educational design: A modified Delphi study

Background Non-technical skills are a subset of human factors that focus on the individual and promote safety through teamwork and awareness. There is no widely adopted competency or outcome based framework for non-technical skills training in healthcare outside the surgical environment. The authors set out to devise such a framework and reach a consensus on a definition using a modified Delphi approach. Methods An exhaustive list of published and team suggested items was presented to the expert panel for ranking and to propose a definition. In the second round, a focused list was presented, as well as the proposed definition elements. The finalised framework was sent to the panel for review. Summary of results 16 experts participated (58% response rate). A total of 36 items of 105 ranked highly enough to present in round two. The final framework consists of 16 competencies for all and 8 specific competencies for team leaders. The consensus definition describes non-technical skills as ‘a set of social (communication and team work) and cognitive (analytical and personal behaviour) skills that support high quality, safe, effective and efficient inter-professional care within the complex healthcare system’. Conclusions The authors have produced a new competency framework, through the works of an international expert panel, which is not discipline specific. This consensus competency framework can be used by curriculum developers, educational innovators and clinical teachers to support developments in the field

Systemwide Clinical Ultrasound Program Development: An Expert Consensus Model.

Clinical ultrasound (CUS) is integral to the practice of an increasing number of medical specialties. Guidelines are needed to ensure effective CUS utilization across health systems. Such guidelines should address all aspects of CUS within a hospital or health system. These include leadership, training, competency, credentialing, quality assurance and improvement, documentation, archiving, workflow, equipment, and infrastructure issues relating to communication and information technology. To meet this need, a group of CUS subject matter experts, who have been involved in institution- and/or systemwide clinical ultrasound (SWCUS) program development convened. The purpose of this paper was to create a model for SWCUS development and implementation

Development, test and comparison of two Multiple Criteria Decision Analysis(MCDA) models: A case of healthcare infrastructure location

When planning a new development, location decisions have always been a major issue. This paper examines and compares two modelling methods used to inform a healthcare infrastructure location decision. Two Multiple Criteria Decision Analysis (MCDA) models were developed to support the optimisation of this decision-making process, within a National Health Service (NHS) organisation, in the UK. The proposed model structure is based on seven criteria (environment and safety, size, total cost, accessibility, design, risks and population profile) and 28 sub-criteria. First, Evidential Reasoning (ER) was used to solve the model, then, the processes and results were compared with the Analytical Hierarchy Process (AHP). It was established that using ER or AHP led to the same solutions. However, the scores between the alternatives were significantly different; which impacted the stakeholders‟ decision-making. As the processes differ according to the model selected, ER or AHP, it is relevant to establish the practical and managerial implications for selecting one model or the other and providing evidence of which models best fit this specific environment. To achieve an optimum operational decision it is argued, in this study, that the most transparent and robust framework is achieved by merging ER process with the pair-wise comparison, an element of AHP. This paper makes a defined contribution by developing and examining the use of MCDA models, to rationalise new healthcare infrastructure location, with the proposed model to be used for future decision. Moreover, very few studies comparing different MCDA techniques were found, this study results enable practitioners to consider even further the modelling characteristics to ensure the development of a reliable framework, even if this means applying a hybrid approach

'Across the pond'—a response to the NICE guidelines for management of multi-morbidity in older people

No abstract available

The Value of Information Technology-Enabled Diabetes Management

Reviews different technologies used in diabetes disease management, as well as the costs, benefits, and quality implications of technology-enabled diabetes management programs in the United States

Autonomic care platform for optimizing query performance

Background: As the amount of information in electronic health care systems increases, data operations get more complicated and time-consuming. Intensive Care platforms require a timely processing of data retrievals to guarantee the continuous display of recent data of patients. Physicians and nurses rely on this data for their decision making. Manual optimization of query executions has become difficult to handle due to the increased amount of queries across multiple sources. Hence, a more automated management is necessary to increase the performance of database queries. The autonomic computing paradigm promises an approach in which the system adapts itself and acts as self-managing entity, thereby limiting human interventions and taking actions. Despite the usage of autonomic control loops in network and software systems, this approach has not been applied so far for health information systems. Methods: We extend the COSARA architecture, an infection surveillance and antibiotic management service platform for the Intensive Care Unit (ICU), with self-managed components to increase the performance of data retrievals. We used real-life ICU COSARA queries to analyse slow performance and measure the impact of optimizations. Each day more than 2 million COSARA queries are executed. Three control loops, which monitor the executions and take action, have been proposed: reactive, deliberative and reflective control loops. We focus on improvements of the execution time of microbiology queries directly related to the visual displays of patients' data on the bedside screens. Results: The results show that autonomic control loops are beneficial for the optimizations in the data executions in the ICU. The application of reactive control loop results in a reduction of 8.61% of the average execution time of microbiology results. The combined application of the reactive and deliberative control loop results in an average query time reduction of 10.92% and the combination of reactive, deliberative and reflective control loops provides a reduction of 13.04%. Conclusions: We found that by controlled reduction of queries' executions the performance for the end-user can be improved. The implementation of autonomic control loops in an existing health platform, COSARA, has a positive effect on the timely data visualization for the physician and nurse

Health Informatics, Sustainable Health Care Development and Malnutrition in India

Health informatics aims at studying the principal computer applications related to technology in developing human health care and solving the existing problems to facilitate efficient management. It helps in decision making process, hospital administration and system management and in catering the needs of clients/patients and doctors. However, the inadequacy of skilled manpower, resources and economy are the major hurdles to exploit the full potential of the technology and medical health facilities. Malnutrition and related causes are adversely affecting the nation from several angles. An integral approach would be able to mitigate the human sufferings