Requirements Engineering (RE) Process for The Adaptation of The Hospital Information System (HIS)

Requirements Engineering (RE) process is an initial stage for any software development process. In this research, we adopted the RE process into a system adaptation software project for a Hospital Information System (HIS) in a Saudi Arabian hospital.  Instead of developing from scratch, the adaptation of an existing system enables a working system to be configured into use in a similar situation in another organization, or use it in a different organization in a different geographical area. Nonetheless, the approach of systems adaptation has its own issues and challenges. This research considers investigating culture-specific behaviors when adapting a system to another environment. The research is motivated by the challenges faced by real-life cases of implementation of a HIS developed in South Korea at one of Kingdom of Saudi Arabian (KSA) hospital. The cultural behavioral requirements were identified using focus group technique and the outcomes were analyzed and represented using Unified Modelling Language (UML). The outcome of the research is validated through evaluation of feedback from a review session and academic experts. This work investigates cultural and behavioral features that have the potentials to support software engineers, who are considering new systematic techniques and approaches to improve systems adaptation processes, especially in HIS domain. This work could be used as a reference to guide developers to adapt similar systems in similar culture and environment settings. In addition to an adaptation to a specific environment, the outcome could also be useful for designing system for-reuse facet from the perspective of reusability

Requirements engineering (RE) process for the adaptation of hospital information system (HIS)

Requirements Engineering (RE) process is an initial stage for any software development process. In this research, we adopted the RE process into a system adaptation software project for a Hospital Information System (HIS). Instead of developing from scratch, the adaptation of an existing system enables a working system to be configured into use in a similar situation in another organization, or use it in a different organization in a different geographical area. Nonetheless. the approach of systems adaptation has its own issues and challenges. This research considers investigating culture-specific behaviour when adapting a system to another environment. The research is motivated by the challenges faced by real-life cases of implementation of a HIS developed in South Korea at one of Saudi Arabian hospital. The outcome of the research is validated through evaluation of academic experts and feedback from a request tracking system. The contribution of the research outcome provides an insight to facilitate the HIS adaptation into Saudi Arabia HIS, and could also be used as a reference for any adaptation process to suit the needs of the stakeholders in similar application domains

Assessing safety climate in acute hospital settings: a systematic review of the adequacy of the psychometric properties of survey measurement tools

Background: The perceived importance of safety culture in improving patient safety and its impact on patient outcomes has led to a growing interest in the assessment of safety climate in healthcare organizations; however, the rigour with which safety climate tools were developed and psychometrically tested was shown to be variable. This paper aims to identify and review questionnaire studies designed to measure safety climate in acute hospital settings, in order to assess the adequacy of reported psychometric properties of identified tools. Methods: A systematic review of published empirical literature was undertaken to examine sample characteristics and instrument details including safety climate dimensions, origin and theoretical basis, and extent of psychometric evaluation (content validity, criterion validity, construct validity and internal reliability). Results: Five questionnaire tools, designed for general evaluation of safety climate in acute hospital settings, were included. Detailed inspection revealed ambiguity around concepts of safety culture and climate, safety climate dimensions and the methodological rigour associated with the design of these measures. Standard reporting of the psychometric properties of developed questionnaires was variable, although evidence of an improving trend in the quality of the reported psychometric properties of studies was noted. Evidence of the theoretical underpinnings of climate tools was limited, while a lack of clarity in the relationship between safety culture and patient outcome measures still exists. Conclusions: Evidence of the adequacy of the psychometric development of safety climate questionnaire tools is still limited. Research is necessary to resolve the controversies in the definitions and dimensions of safety culture and climate in healthcare and identify related inconsistencies. More importance should be given to the appropriate validation of safety climate questionnaires before extending their usage in healthcare contexts different from those in which they were originally developed. Mixed methods research to understand why psychometric assessment and measurement reporting practices can be inadequate and lacking in a theoretical basis is also necessary

The chaotic nature of healthcare information systems: The need for transdisciplinary collaboration

Copyright @ 2013 EMCIS.This paper demonstrates one of the challenges of the healthcare information systems development, namely the chaotic nature of healthcare systems. Although the reliable evidence demonstrating the positive effects of health information systems on safety and quality remains inconclusive (a growing body of research revealing the unintended consequences and potentially error producing effects of health information systems’ implementation. Different arguments from the literature concerning the chaotic nature of healthcare, including but not limited to the nature of patients and disease have been presented. The requirements of new ways of systems design and the need for transdisciplinary dynamic teams within the requirements engineering phase as a start has been discussed. These arguments have been investigated in the context of an exploratory case addressing one of the advanced oncology centres in the US. This paper concludes that there is an important need to rethink healthcare information systems development method, which has to be in a dynamic ongoing manner for some major issues

Adaptive Process Management in Cyber-Physical Domains

The increasing application of process-oriented approaches in new challenging cyber-physical domains beyond business computing (e.g., personalized healthcare, emergency management, factories of the future, home automation, etc.) has led to reconsider the level of flexibility and support required to manage complex processes in such domains. A cyber-physical domain is characterized by the presence of a cyber-physical system coordinating heterogeneous ICT components (PCs, smartphones, sensors, actuators) and involving real world entities (humans, machines, agents, robots, etc.) that perform complex tasks in the “physical” real world to achieve a common goal. The physical world, however, is not entirely predictable, and processes enacted in cyber-physical domains must be robust to unexpected conditions and adaptable to unanticipated exceptions. This demands a more flexible approach in process design and enactment, recognizing that in real-world environments it is not adequate to assume that all possible recovery activities can be predefined for dealing with the exceptions that can ensue. In this chapter, we tackle the above issue and we propose a general approach, a concrete framework and a process management system implementation, called SmartPM, for automatically adapting processes enacted in cyber-physical domains in case of unanticipated exceptions and exogenous events. The adaptation mechanism provided by SmartPM is based on declarative task specifications, execution monitoring for detecting failures and context changes at run-time, and automated planning techniques to self-repair the running process, without requiring to predefine any specific adaptation policy or exception handler at design-time

Innovation dialogue - Being strategic in the face of complexity - Conference report

The Innovation Dialogue on Being Strategic in the Face of Complexity was held in Wageningen on 31 November and 1 December 2009. The event is part of a growing dialogue in the international development sector about the complexities of social, economic and political change. It builds on two previous events hosted the Innovation Dialogue on Navigating Complexity (May 2009) and the Seminar on Institutions, Theories of Change and Capacity Development (December 2008). Over 120 people attended the event coming from a range of Dutch and international development organizations. The event was aimed at bridging practitioner, policy and academic interests. It brought together people working on sustainable business strategies, social entrepreneurship and international development. Leading thinkers and practitioners offered their insights on what it means to "be strategic in complex times". The Dialogue was organized and hosted by the Wageningen UR Centre for Development Innovation working with the Chair Groups of Communication & Innovation Studies, Disaster Studies, Education & Competence Studies and Public Administration & Policy as co; organisers. The theme of the Dialogue aligns closely with Wageningen UR’s interest in linking technological and institutional innovation in ways that enable ‘science for impact’

Forging partnerships in health care: Process and measuring benefits

Universally, there is concern that much academic learning has dealt mainly in theory, removing knowledge from context with a resultant lack of practical experience. Here, the catalyst for strengthening university-community engagement, emanated from a desire to foster greater propensity within students to make connections between their academic courses and responsibility toward the community and people in need, and thus develop enhanced skills in social interaction, teamwork and effectiveness. This paper explores a variety of models of university-community engagement that aim to achieve and model good practice in policy making and planning around healthcare education and service development. Ways of integrating teaching and learning with community engagement, so there is reciprocal learning with significant benefits to the community, students, the university and industry are described. The communities of engagement for a transdisciplinary approach in healthcare are defined and the types of collaborative partnerships are outlined, including public/private partnerships, service learning approaches and regional campus engagement. The processes for initiating innovation in this field, forging sustainable partnerships, providing cooperative leadership and building shared vision are detailed. Measuring shared and sustained benefits for all participants is examined in the context of effecting changes in working relationships as well as the impact on students in terms of increased personal and social responsibility, confidence and competence. For the health professions, it is considered vital to adopt this approach in order to deliver graduates who feel aware of community needs, believe they can make a difference, and have a greater sense of community responsibility, ethic of service and more sophisticated understandings of social contexts. In the longer term, it is proposed the strategy will deliver a future healthcare workforce that is more likely to have a strengthened sense of community, social and personal responsibility and thus effect positive social change

A Review of Best Practices for Monitoring and Improving Inpatient Pediatric Patient Experiences.

ContextAchieving high-quality patient-centered care requires assessing patient and family experiences to identify opportunities for improvement. With the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey, hospitals can assess performance and make national comparisons of inpatient pediatric experiences. However, using patient and family experience data to improve care remains a challenge.ObjectiveWe reviewed the literature on best practices for monitoring performance and undertaking activities aimed at improving pediatric patient and family experiences of inpatient care.Data sourcesWe searched PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsychINFO.Study selectionWe included (1) English-language peer-reviewed articles published from January 2000 to April 2019; (2) articles based in the United States, United Kingdom, or Canada; (3) articles focused on pediatric inpatient care; (4) articles describing pediatric patient and family experiences; and (5) articles including content on activities aimed at improving patient and family experiences. Our review included 25 articles.Data extractionTwo researchers reviewed the full article and abstracted specific information: country, study aims, setting, design, methods, results, Quality Improvement (QI) initiatives performed, internal reporting description, best practices, lessons learned, barriers, facilitators and study implications for clinical practice, patient-experience data collection, and QI activities. We noted themes across samples and care settings.ResultsWe identified 10 themes of best practice. The 4 most common were (1) use evidence-based approaches, (2) maintain an internal system that communicates information and performance on patient and family experiences to staff and hospital leadership, (3) use experience survey data to initiate and/or evaluate QI interventions, and (4) identify optimal times (eg, discharge) and modes (eg, print) for obtaining patient and family feedback. These correspond to adult inpatient best practices.ConclusionsBoth pediatric and adult inpatient best practices rely on common principles of culture change (such as evidence-based clinical practice), collaborative learning, multidisciplinary teamwork, and building and/or supporting a QI infrastructure that requires time, money, collaboration, data tracking, and monitoring. QI best practices in both pediatric and adult inpatient settings commonly rely on identifying drivers of overall ratings of care, rewarding staff for successful implementation, and creating easy-to-use and easy-to-access planning and QI tools for staff

Contextual Sensitivity in Grounded Theory: The Role of Pilot Studies

Grounded Theory is an established methodological approach for context specific inductive theory building. The grounded nature of the methodology refers to these specific contexts from which emergent propositions are drawn. Thus, any grounded theory study requires not only theoretical sensitivity, but also a good insight on how to design the research in the human activity systems to be studied. The lack of this insight may result in inefficient theoretical sampling or even erroneous purposeful sampling. These problems would not necessarily be critical, as it could be argued that through the elliptical process that characterizes grounded theory, remedial loops would always bring the researcher to the core of the theory. However, these elliptical remedial processes can take very long periods of time and result in catastrophic delays in research projects. As a strategy, this paper discusses, contrasts and compares the use of pilot studies in four different grounded theory projects. Each pilot brought different insights about the context, resulting in changes of focus, guidance to improve data collection instruments and informing theoretical sampling. Additionally, as all four projects were undertaken by researchers with little experience of inductive approaches in general and grounded theory in particular, the pilot studies also served the purpose of training in interviewing, relating to interviewees, memoing, constant comparison and coding. This last outcome of the pilot study was actually not planned initially, but revealed itself to be a crucial success factor in the running of the projects. The paper concludes with a theoretical proposition for the concept of contextual sensitivity and for the inclusion of the pilot study in grounded theory research designs