173 research outputs found
Human Factors Considerations in System Design
Human factors considerations in systems design was examined. Human factors in automated command and control, in the efficiency of the human computer interface and system effectiveness are outlined. The following topics are discussed: human factors aspects of control room design; design of interactive systems; human computer dialogue, interaction tasks and techniques; guidelines on ergonomic aspects of control rooms and highly automated environments; system engineering for control by humans; conceptual models of information processing; information display and interaction in real time environments
Cloud enterprise resource planning development model based on software factory approach
Literature reviews revealed that Cloud Enterprise Resource Planning (Cloud ERP) is
significantly growing, yet from software developers’ perspective, it has succumbed to high management complexity, high workload, inconsistency software quality, and knowledge retention problems. Previous researches lack a solution that holistically addresses all the research problem components. Software factory approach was chosen to be adapted along with relevant theories to develop a model referred to as Cloud ERP Factory Model (CEF Model), which intends to pave the way in solving the above-mentioned problems. There are three specific objectives, those are (i) to develop the model by identifying the components with its elements and compile them into the CEF Model, (ii) to verify the model’s deployment technical feasibility, and (iii) to validate the model field usability in a real Cloud ERP production case studies. The research employed Design Science methodology, with a mixed method
evaluation approach. The developed CEF Model consists of five components; those are Product Lines, Platform, Workflow, Product Control, and Knowledge Management, which can be used to setup a CEF environment that simulates a process-oriented software production environment with capacity and resource planning features. The model was validated through expert reviews and the finalized model was verified to be technically feasible by a successful deployment into a selected commercial Cloud ERP production facility. Three Cloud ERP commercial deployment case studies were conducted using the prototype environment. Using the survey instruments developed, the results yielded a Likert score mean of 6.3 out of 7 thus reaffirming that the model is usable and the research has met its objective in addressing the problem components. The models along with its deployment verification processes are the main research contributions. Both items can also be used by software industry practitioners and academician as references in developing a robust Cloud ERP production facility
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Evaluating Evaluations of Clinical Decision Support Systems: Case Studies From NHS Clinical Settings
The NHS is under increasing pressure to cut costs while delivering high quality care. At the same time, the demand for healthcare services has grown, driven in part by the increasing number of older people in the population. NHS Trusts are adopting clinical decision support systems (CDSSs) to help decision making at the point of care. CDSSs are said to bring benefits such as improvements in guideline adherence, clinical processes and user performance but evidence of these benefits is not always available and their effectiveness in terms of improving patient outcomes is often open to question. This thesis presents research that was carried out in a large teaching NHS Trust looking at the evaluations of three CDSSs. Semi structured interviews were carried out with key informants who were involved in their adoption, use and evaluations. Documentary analysis and observations were also used to augment the interviews. Most evaluations were carried out informally by the developers and were primarily driven by external regulatory pressures rather than patient outcomes and organisational needs. Evaluation documentation was inadequate or missing, thus making it difficult to systematically assess these evaluations. This thesis contends that evaluations are important to provide decision makers in NHS Trusts with adequate information to make decisions about CDSSs and computerised healthcare information technologies in general. NHS Trusts need to build organisational capacity and readiness to enable them to effectively carry out evaluations that will provide meaningful information to gain better understanding of CDSSs and to inform their successful adoption, implementation, usage and to justify the resource allocation. This research shows that CDSS evaluations investigated took a predominantly narrow view. It thus provides evidence for the need for a more systemic approach to evaluation
Impact of implementing a computerised quality improvement intervention in primary healthcare
Health systems worldwide experience large evidence practice gaps with underuse of proven therapies, overuse of inappropriate treatments and misuse of treatments due to medical error. Quality improvement (QI) initiatives have been shown to overcome some of these gaps. Computerised interventions, in particular, are potential enablers to improving system performance. However, implementation of these interventions into routine practice has resulted in mixed outcomes and those that have been successfully integrated into routine practice are difficult to sustain. The objective of this thesis is to understand how a multifaceted, computerised QI intervention for cardiovascular disease (CVD) prevention and management was implemented in Australian general practices and Aboriginal Community Controlled Health Services and assess the implications for scale-up of the intervention. The intervention was implemented as part of a large cluster-randomised controlled trial, the TORPEDO (Treatment of Cardiovascular Risk using Electronic Decision Support) study. The intervention was associated with improved guideline recommended cardiovascular risk factor screening rates but had mixed impact on improving medication prescribing rates. In this thesis, I designed a multimethod process and economic evaluation of the TORPEDO trial. The aims were to: i. Develop a theory-informed logic model to assist in the design of the overall evaluation to address study aims (Chapter 3). ii. Conduct a post-trial audit to quantify changes in cardiovascular risk factor screening and prescribing to high risk patients over an 18-month post-trial period and understand the impact of the intervention outside of a research trial setting (Chapter 4). vi iii. Use normalisation process theory to identify the underlying mechanisms by which the intervention did and did not have an impact on trial outcomes (Chapter 5). iv. Use video ethnography to explore how the intervention was used and cardiovascular risk communicated between patients and healthcare providers (Chapter 6). v. Conduct an economic evaluation to inform policy makers for delivering the intervention at scale through Primary Health Networks in New South Wales (Chapter 7). vi. Use a new theory to explain the factors that drove adoption and non-adoption of the intervention and assess what modifications may be needed to promote spread and scale-up (Chapter 8). I found variable outcomes during the post-trial period with a plateauing of improvements in guideline recommended screening practices but an ongoing improvement in prescribing to high risk patients. The group that continued to have the most benefit was patients at high CVD risk who were not receiving recommended medications at baseline. The delay in prescribing recommended medication suggests healthcare providers adopt a cautious approach when introducing new treatments. Six intervention primary healthcare services participated as case studies for the process evaluation. Qualitative and quantitative data sources were combined at each primary healthcare service to enable a detailed examination of intervention implementation from multiple perspectives. The process evaluation identified the complex interaction between several underlying mechanisms that influenced the implementation processes and explained the mixed trial outcomes: (1) organisational mission; (2) leadership; (3) the role of teams; (4) technical competence and dependability of the software tools. Further, there were different ‘active ingredients’ vii necessary during the initial implementation compared to those needed to sustain use of the intervention. In the video ethnography and post-consultation patient interviews, important insights were gained into how the intervention was used, and its interpretation by the doctor and patient. Through ethnographic accounts, the doctor’s communication of cardiovascular risk was not sufficient in engaging patients and having them act upon their high-risk status; effective communication required interactions be assessed, discussed and negotiated. The economic evaluation identified the cost implications of implementing the intervention as part of a Primary Health Network program in the state of New South Wales, Australia; and modelled data looked at the impact of small but statistically significant reductions in clinical risk factors based on the trial data. When scaled to a larger population the intervention has potential to prevent major CVD events at under AU$50,000 per CVD event averted largely due to the low costs of implementing the intervention. However, the clinical risk factor reductions were small and a stronger case for investment would be made if the effects sizes could be enhanced and sustained over time. The findings from chapters 4-6 provide insight into the intricacy of the barriers influencing implementation processes and adoption of the intervention. Taken together, these studies provide a detailed explanation of the processes that may be required to implement such an intervention at scale and the factors that might influence its impact and sustainability. The findings are expected to assist policy makers, administrators and health professionals in developing multiple interdependent QI strategies at the organisational, provider and consumer levels to improve primary healthcare system performance for cardiovascular disease management and prevention
Human factors aspects of control room design: Guidelines and annotated bibliography
A human factors analysis of the workstation design for the Earth Radiation Budget Satellite mission operation room is discussed. The relevance of anthropometry, design rules, environmental design goals, and the social-psychological environment are discussed
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