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

A review of applications of fuzzy sets to safety and reliability engineering

Safety and reliability are rigorously assessed during the design of dependable systems. Probabilistic risk assessment (PRA) processes are comprehensive, structured and logical methods widely used for this purpose. PRA approaches include, but not limited to Fault Tree Analysis (FTA), Failure Mode and Effects Analysis (FMEA), and Event Tree Analysis (ETA). In conventional PRA, failure data about components is required for the purposes of quantitative analysis. In practice, it is not always possible to fully obtain this data due to unavailability of primary observations and consequent scarcity of statistical data about the failure of components. To handle such situations, fuzzy set theory has been successfully used in novel PRA approaches for safety and reliability evaluation under conditions of uncertainty. This paper presents a review of fuzzy set theory based methodologies applied to safety and reliability engineering, which include fuzzy FTA, fuzzy FMEA, fuzzy ETA, fuzzy Bayesian networks, fuzzy Markov chains, and fuzzy Petri nets. Firstly, we describe relevant fundamentals of fuzzy set theory and then we review applications of fuzzy set theory to system safety and reliability analysis. The review shows the context in which each technique may be more appropriate and highlights the overall potential usefulness of fuzzy set theory in addressing uncertainty in safety and reliability engineering

SAFE-FLOW : a systematic approach for safety analysis of clinical workflows

The increasing use of technology in delivering clinical services brings substantial benefits to the healthcare industry. At the same time, it introduces potential new complications to clinical workflows that generate new risks and hazards with the potential to affect patients’ safety. These workflows are safety critical and can have a damaging impact on all the involved parties if they fail.Due to the large number of processes 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. Using methodological approaches and automated tools to carry out an analysis of the workflow can help in determining the origins of potential adverse events and consequently help in avoiding preventable errors. There is a scarcity of studies addressing this problem; this was a partial motivation for this thesis.The main aim of the research is to demonstrate the potential value of computer science based dependability approaches to healthcare and in particular, the appropriateness and benefits of these dependability approaches to overall clinical workflows. A particular focus is to show that model-based safety analysis techniques can be usefully applied to such areas and then to evaluate this application.This thesis develops the SAFE-FLOW approach for safety analysis of clinical workflows in order to establish the relevance of such application. SAFE-FLOW detailed steps and guidelines for its application are explained. Then, SAFE-FLOW is applied to a case study and is systematically evaluated. The proposed evaluation design provides a generic evaluation strategy that can be used to evaluate the adoption of safety analysis methods in healthcare.It is concluded that safety of clinical workflows can be significantly improved by performing safety analysis on workflow models. The evaluation results show that SAFE-FLOW is feasible and it has the potential to provide various benefits; it provides a mechanism for a systematic identification of both adverse events and safeguards, which is helpful in terms of identifying the causes of possible adverse events before they happen and can assist in the design of workflows to avoid such occurrences. The clear definition of the workflow including its processes and tasks provides a valuable opportunity for formulation of safety improvement strategies

Risk-based maintenance of critical and complex systems

Tableau d’honneur de la Faculté des études supérieures et postdoctorales, 2016-2017.De nos jours, la plupart des systèmes dans divers secteurs critiques tels que l'aviation, le pétrole et les soins de santé sont devenus très complexes et dynamiques, et par conséquent peuvent à tout moment s'arrêter de fonctionner. Pour éviter que cela ne se reproduise et ne devienne incontrôlable ce qui engagera des pertes énormes en matière de coûts et d'indisponibilité; l'adoption de stratégies de contrôle et de maintenance s'avèrent plus que nécessaire et même vitale. Dans le génie des procédés, les stratégies optimales de maintenance pour ces systèmes pourraient avoir un impact significatif sur la réduction des coûts et sur les temps d'arrêt, sur la maximisation de la fiabilité et de la productivité, sur l'amélioration de la qualité et enfin pour atteindre les objectifs souhaités des compagnies. En outre, les risques et les incertitudes associés à ces systèmes sont souvent composés de plusieurs relations de cause à effet de façon extrêmement complexe. Cela pourrait mener à une augmentation du nombre de défaillances de ces systèmes. Par conséquent, un outil d'analyse de défaillance avancée est nécessaire pour considérer les interactions complexes de défaillance des composants dans les différentes phases du cycle de vie du produit pour assurer les niveaux élevés de sécurité et de fiabilité. Dans cette thèse, on aborde dans un premier temps les lacunes des méthodes d'analyse des risques/échec et celles qui permettent la sélection d'une classe de stratégie de maintenance à adopter. Nous développons ensuite des approches globales pour la maintenance et l'analyse du processus de défaillance fondée sur les risques des systèmes et machines complexes connus pour être utilisées dans toutes les industries. Les recherches menées pour la concrétisation de cette thèse ont donné lieu à douze contributions importantes qui se résument comme suit: Dans la première contribution, on aborde les insuffisances des méthodes en cours de sélection de la stratégie de maintenance et on développe un cadre fondé sur les risques en utilisant des méthodes dites du processus de hiérarchie analytique (Analytical Hierarchy Process (AHP), de cartes cognitives floues (Fuzzy Cognitive Maps (FCM)), et la théorie des ensembles flous (Fuzzy Soft Sets (FSS)) pour sélectionner la meilleure politique de maintenance tout en considérant les incertitudes. La deuxième contribution aborde les insuffisances de la méthode de l'analyse des modes de défaillance, de leurs effets et de leur criticité (AMDEC) et son amélioration en utilisant un modèle AMDEC basée sur les FCM. Les contributions 3 et 4, proposent deux outils de modélisation dynamique des risques et d'évaluation à l'aide de la FCM pour faire face aux risques de l'externalisation de la maintenance et des réseaux de collaboration. Ensuite, on étend les outils développés et nous proposons un outil d'aide à la décision avancée pour prédire l'impact de chaque risque sur les autres risques ou sur la performance du système en utilisant la FCM (contribution 5).Dans la sixième contribution, on aborde les risques associés à la maintenance dans le cadre des ERP (Enterprise Resource Planning (ERP)) et on propose une autre approche intégrée basée sur la méthode AMDEC floue pour la priorisation des risques. Dans les contributions 7, 8, 9 et 10, on effectue une revue de la littérature concernant la maintenance basée sur les risques des dispositifs médicaux, puisque ces appareils sont devenus très complexes et sophistiqués et l'application de modèles de maintenance et d'optimisation pour eux est assez nouvelle. Ensuite, on développe trois cadres intégrés pour la planification de la maintenance et le remplacement de dispositifs médicaux axée sur les risques. Outre les contributions ci-dessus, et comme étude de cas, nous avons réalisé un projet intitulé “Mise à jour de guide de pratique clinique (GPC) qui est un cadre axé sur les priorités pour la mise à jour des guides de pratique cliniques existantes” au centre interdisciplinaire de recherche en réadaptation et intégration sociale du Québec (CIRRIS). Nos travaux au sein du CIRRIS ont amené à deux importantes contributions. Dans ces deux contributions (11e et 12e) nous avons effectué un examen systématique de la littérature pour identifier les critères potentiels de mise à jour des GPCs. Nous avons validé et pondéré les critères identifiés par un sondage international. Puis, sur la base des résultats de la onzième contribution, nous avons développé un cadre global axé sur les priorités pour les GPCs. Ceci est la première fois qu'une telle méthode quantitative a été proposée dans la littérature des guides de pratiques cliniques. L'évaluation et la priorisation des GPCs existants sur la base des critères validés peuvent favoriser l'acheminement des ressources limitées dans la mise à jour de GPCs qui sont les plus sensibles au changement, améliorant ainsi la qualité et la fiabilité des décisions de santé.Today, most systems in various critical sectors such as aviation, oil and health care have become very complex and dynamic, and consequently can at any time stop working. To prevent this from reoccurring and getting out of control which incur huge losses in terms of costs and downtime; the adoption of control and maintenance strategies are more than necessary and even vital. In process engineering, optimal maintenance strategies for these systems could have a significant impact on reducing costs and downtime, maximizing reliability and productivity, improving the quality and finally achieving the desired objectives of the companies. In addition, the risks and uncertainties associated with these systems are often composed of several extremely complex cause and effect relationships. This could lead to an increase in the number of failures of such systems. Therefore, an advanced failure analysis tool is needed to consider the complex interactions of components’ failures in the different phases of the product life cycle to ensure high levels of safety and reliability. In this thesis, we address the shortcomings of current failure/risk analysis and maintenance policy selection methods in the literature. Then, we develop comprehensive approaches to maintenance and failure analysis process based on the risks of complex systems and equipment which are applicable in all industries. The research conducted for the realization of this thesis has resulted in twelve important contributions, as follows: In the first contribution, we address the shortcomings of the current methods in selecting the optimum maintenance strategy and develop an integrated risk-based framework using Analytical Hierarchy Process (AHP), fuzzy Cognitive Maps (FCM), and fuzzy Soft set (FSS) tools to select the best maintenance policy by considering the uncertainties.The second contribution aims to address the shortcomings of traditional failure mode and effect analysis (FMEA) method and enhance it using a FCM-based FMEA model. Contributions 3 and 4, present two dynamic risk modeling and assessment tools using FCM for dealing with risks of outsourcing maintenance and collaborative networks. Then, we extend the developed tools and propose an advanced decision support tool for predicting the impact of each risk on the other risks or on the performance of system using FCM (contribution 5). In the sixth contribution, we address the associated risks in Enterprise Resource Planning (ERP) maintenance and we propose another integrated approach using fuzzy FMEA method for prioritizing the risks. In the contributions 7, 8, 9, and 10, we perform a literature review regarding the risk-based maintenance of medical devices, since these devices have become very complex and sophisticated and the application of maintenance and optimization models to them is fairly new. Then, we develop three integrated frameworks for risk-based maintenance and replacement planning of medical devices. In addition to above contributions, as a case study, we performed a project titled “Updating Clinical Practice Guidelines; a priority-based framework for updating existing guidelines” in CIRRIS which led to the two important contributions. In these two contributions (11th and 12th) we first performed a systematic literature review to identify potential criteria in updating CPGs. We validated and weighted the identified criteria through an international survey. Then, based on the results of the eleventh contribution, we developed a comprehensive priority-based framework for updating CPGs based on the approaches that we had already developed and applied success fully in other industries. This is the first time that such a quantitative method has been proposed in the literature of guidelines. Evaluation and prioritization of existing CPGs based on the validated criteria can promote channelling limited resources into updating CPGs that are most sensitive to change, thus improving the quality and reliability of healthcare decisions made based on current CPGs. Keywords: Risk-based maintenance, Maintenance strategy selection, FMEA, FCM, Medical devices, Clinical practice guidelines

Predicting Corrosion Damage in the Human Body Using Artificial Intelligence: In Vitro Progress and Future Applications Applications

Artificial intelligence (AI) is used in the clinic to improve patient care. While the successes illustrate the impact AI can have, few studies have led to improved clinical outcomes. A gap in translational studies, beginning at the basic science level, exists. In this review, we focus on how AI models implemented in non-orthopedic fields of corrosion science may apply to the study of orthopedic alloys. We first define and introduce fundamental AI concepts and models, as well as physiologically relevant corrosion damage modes. We then systematically review the corrosion/AI literature. Finally, we identify several AI models that may be Preprint implemented to study fretting, crevice, and pitting corrosion of titanium and cobalt chrome alloys

Proceedings of the 1st Doctoral Consortium at the European Conference on Artificial Intelligence (DC-ECAI 2020)

1st Doctoral Consortium at the European Conference on Artificial Intelligence (DC-ECAI 2020), 29-30 August, 2020 Santiago de Compostela, SpainThe DC-ECAI 2020 provides a unique opportunity for PhD students, who are close to finishing their doctorate research, to interact with experienced researchers in the field. Senior members of the community are assigned as mentors for each group of students based on the student’s research or similarity of research interests. The DC-ECAI 2020, which is held virtually this year, allows students from all over the world to present their research and discuss their ongoing research and career plans with their mentor, to do networking with other participants, and to receive training and mentoring about career planning and career option

Big data analytics:Computational intelligence techniques and application areas

Big Data has significant impact in developing functional smart cities and supporting modern societies. In this paper, we investigate the importance of Big Data in modern life and economy, and discuss challenges arising from Big Data utilization. Different computational intelligence techniques have been considered as tools for Big Data analytics. We also explore the powerful combination of Big Data and Computational Intelligence (CI) and identify a number of areas, where novel applications in real world smart city problems can be developed by utilizing these powerful tools and techniques. We present a case study for intelligent transportation in the context of a smart city, and a novel data modelling methodology based on a biologically inspired universal generative modelling approach called Hierarchical Spatial-Temporal State Machine (HSTSM). We further discuss various implications of policy, protection, valuation and commercialization related to Big Data, its applications and deployment

Risk Management for the Future

A large part of academic literature, business literature as well as practices in real life are resting on the assumption that uncertainty and risk does not exist. We all know that this is not true, yet, a whole variety of methods, tools and practices are not attuned to the fact that the future is uncertain and that risks are all around us. However, despite risk management entering the agenda some decades ago, it has introduced risks on its own as illustrated by the financial crisis. Here is a book that goes beyond risk management as it is today and tries to discuss what needs to be improved further. The book also offers some cases

Formal Safety Assessment of a Marine Seismic Survey Vessel Operation, Incorporating Risk Matrix and Fault Tree Analysis

In maritime safety research, risk is assessed usually within the framework of formal safety assessment (FSA), which provides a formal and systematic methodology to improve the safety of lives, assets, and the environment. A bespoke application of FSA to mitigate accidents in marine seismic surveying is put forward in this paper, with the aim of improving the safety of seismic vessel operations, within the context of developing an economically viable strategy. The work herein takes a close look at the hazards in North Sea offshore seismic surveying, in order to identify critical risk factors, leading to marine seismic survey accidents. The risk factors leading to undesirable events are analysed both qualitatively and quantitatively. A risk matrix is introduced to screen the identified undesirable events. Further to the screening, Fault Tree Analysis (FTA) is presented to investigate and analyse the most critical risks of seismic survey operation, taking into account the lack of historical data. The obtained results show that man overboard (MOB) event is a major risk factor in marine seismic survey operation; lack of training on safe work practice, slippery deck as a result of rain, snow or water splash, sea state affecting human judgement, and poor communication are identified as the critical risk contributors to the MOB event. Consequently, the risk control options are focused on the critical risk contributors for decision-making. Lastly, suggestions for the introduction and development of the FSA methodology are highlighted for safer marine and offshore operations in general