An approach to safety analysis of clinical workflows

A clinical workflow considers the information and processes that are involved in providing a clinical service. They are safety critical since even minor faults have the potential to propagate and consequently cause harm to a patient, or even for a patient's life to be lost. Experiencing these kinds of failures has a destructive impact on all the involved parties. Due to the large number of processes and tasks included in the delivery of a clinical service, it can be difficult to determine the individuals or the processes that are responsible for adverse events, since such an analysis is typically complex and slow to do manually. Using automated tools to carry out an analysis can help in determining the root causes of potential adverse events and consequently help in avoiding preventable errors through either the alteration of existing workflows, or the design of a new workflow. This paper describes a technical approach to safety analysis of clinical workflows, utilising a safety analysis tool (Hierarchically-Performed Hazard Origin and Propagation Studies (HiP-HOPS)) that is already in use in the field of mechanical systems. The paper then demonstrates the applicability of the approach to clinical workflows by applying it to analyse the workflow in a radiology department. We conclude that the approach is applicable to this area of healthcare and provides a mechanism both for the systematic identification of adverse events and for the introduction of possible safeguards in clinical workflows

Focal Spot, Spring 2003

https://digitalcommons.wustl.edu/focal_spot_archives/1093/thumbnail.jp

Application of Asynchronous Transfer Mode (Atm) technology to Picture Archiving and Communication Systems (Pacs): A survey

Broadband Integrated Services Digital Network (R-ISDN) provides a range of narrowband and broad-band services for voice, video, and multimedia. Asynchronous Transfer Mode (ATM) has been selected by the standards bodies as the transfer mode for implementing B-ISDN; The ability to digitize images has lead to the prospect of reducing the physical space requirements, material costs, and manual labor of traditional film handling tasks in hospitals. The system which handles the acquisition, storage, and transmission of medical images is called a Picture Archiving and Communication System (PACS). The transmission system will directly impact the speed of image transfer. Today the most common transmission means used by acquisition and display station products is Ethernet. However, when considering network media, it is important to consider what the long term needs will be. Although ATM is a new standard, it is showing signs of becoming the next logical step to meet the needs of high speed networks; This thesis is a survey on ATM, and PACS. All the concepts involved in developing a PACS are presented in an orderly manner. It presents the recent developments in ATM, its applicability to PACS and the issues to be resolved for realising an ATM-based complete PACS. This work will be useful in providing the latest information, for any future research on ATM-based networks, and PACS

Password compliance for PACS work stations: Implications for emergency-driven medical environments

Background. The effectiveness of password usage in data security remains an area of high scrutiny. Literature findings do not inspire confidence in the use of passwords. Human factors such as the acceptance of and compliance with minimum standards of data security are considered significant determinants of effective data-security practices. However, human and technical factors alone do not provide solutions if they exclude the context in which the technology is applied.Objectives. To reflect on the outcome of a dissertation which argues that the minimum standards of effective password use prescribed by the information security sector are not suitable to the emergency-driven medical environment, and that their application as required by law raises new and unforeseen ethical dilemmas.Method. A close-ended questionnaire, the Picture Archiving and Communication System Confidentiality Scale (PAC-CS) was used to collect quantitative data from 115 health professionals employed in both a private radiology and a hospital setting. The PACS-CS sought to explore the extent of compliance with accepted minimum standards of effective password usage.Results. The percentage compliance with minimum standards was calculated. A significant statistical difference (p<0.05) between the expected and observed data-security practices was recorded.Conclusion. The study interrogates the suitability of adherence to minimum standards of effective password usage in an emergency-driven medical environment and calls for much-needed debate in this area