Proceedings ICPW'07: 2nd International Conference on the Pragmatic Web, 22-23 Oct. 2007, Tilburg: NL

Proceedings ICPW'07: 2nd International Conference on the Pragmatic Web, 22-23 Oct. 2007, Tilburg: N

Putting the patient in patient safety: qualitative exploration and co-design of a new paradigm

There has been increasing interest in involving patients in patient safety. Whilst interventions have been introduced to support this, there are still barriers to patient involvement. Currently, there is a focus upon the clinical risk paradigm, where policymakers, academics and healthcare professionals define patient safety; however, evidence suggests that patients and healthcare professionals may conceptualise patient safety differently. This means that patient safety, as it is currently defined, may not be meaningful or accessible to patients. It is therefore necessary to understand, value and incorporate the patient perspective to support genuine patient involvement. This thesis aims to explore and compare different stakeholder perspectives of patient safety using qualitative methods, and reconcile these in a new patient safety paradigm. Chapter 1 provides the background to patient safety and patient involvement, and addresses the rationale for the thesis. Chapter 2 details the qualitative methods to be used in this research. Chapter 3 presents a systematic review using meta-study methodology to synthesise the current qualitative evidence that explores patient and healthcare professional perceptions of patient safety. Chapters 4 and 5 use constructivist grounded theory to explore patient and healthcare professional perceptions of patient safety within acute medicine for the elderly, elective surgery and maternity, and develop explanatory theory for their conceptualisations of patient safety. Additionally, these chapters allow a comparison of healthcare professional and patient conceptualisations, as well as comparison to existing definitions and models for patient safety. Chapter 6 presents the results of a co-design workshop involving patients and healthcare professionals in elective surgery; this utilises the qualitative findings of the thesis to develop a practical product that, if implemented, will broaden the current patient safety paradigm by identifying, understanding and using the patient perspective. Finally, Chapter 7 discusses the implications of this research for patient safety policy and practice.Open Acces

A semantic and agent-based approach to support information retrieval, interoperability and multi-lateral viewpoints for heterogeneous environmental databases

PhDData stored in individual autonomous databases often needs to be combined and interrelated. For example, in the Inland Water (IW) environment monitoring domain, the spatial and temporal variation of measurements of different water quality indicators stored in different databases are of interest. Data from multiple data sources is more complex to combine when there is a lack of metadata in a computation forin and when the syntax and semantics of the stored data models are heterogeneous. The main types of information retrieval (IR) requirements are query transparency and data harmonisation for data interoperability and support for multiple user views. A combined Semantic Web based and Agent based distributed system framework has been developed to support the above IR requirements. It has been implemented using the Jena ontology and JADE agent toolkits. The semantic part supports the interoperability of autonomous data sources by merging their intensional data, using a Global-As-View or GAV approach, into a global semantic model, represented in DAML+OIL and in OWL. This is used to mediate between different local database views. The agent part provides the semantic services to import, align and parse semantic metadata instances, to support data mediation and to reason about data mappings during alignment. The framework has applied to support information retrieval, interoperability and multi-lateral viewpoints for four European environmental agency databases. An extended GAV approach has been developed and applied to handle queries that can be reformulated over multiple user views of the stored data. This allows users to retrieve data in a conceptualisation that is better suited to them rather than to have to understand the entire detailed global view conceptualisation. User viewpoints are derived from the global ontology or existing viewpoints of it. This has the advantage that it reduces the number of potential conceptualisations and their associated mappings to be more computationally manageable. Whereas an ad hoc framework based upon conventional distributed programming language and a rule framework could be used to support user views and adaptation to user views, a more formal framework has the benefit in that it can support reasoning about the consistency, equivalence, containment and conflict resolution when traversing data models. A preliminary formulation of the formal model has been undertaken and is based upon extending a Datalog type algebra with hierarchical, attribute and instance value operators. These operators can be applied to support compositional mapping and consistency checking of data views. The multiple viewpoint system was implemented as a Java-based application consisting of two sub-systems, one for viewpoint adaptation and management, the other for query processing and query result adjustment

User-centered visual analysis using a hybrid reasoning architecture for intensive care units

One problem pertaining to Intensive Care Unit information systems is that, in some cases, a very dense display of data can result. To ensure the overview and readability of the increasing volumes of data, some special features are required (e.g., data prioritization, clustering, and selection mechanisms) with the application of analytical methods (e.g., temporal data abstraction, principal component analysis, and detection of events). This paper addresses the problem of improving the integration of the visual and analytical methods applied to medical monitoring systems. We present a knowledge- and machine learning-based approach to support the knowledge discovery process with appropriate analytical and visual methods. Its potential benefit to the development of user interfaces for intelligent monitors that can assist with the detection and explanation of new, potentially threatening medical events. The proposed hybrid reasoning architecture provides an interactive graphical user interface to adjust the parameters of the analytical methods based on the users' task at hand. The action sequences performed on the graphical user interface by the user are consolidated in a dynamic knowledge base with specific hybrid reasoning that integrates symbolic and connectionist approaches. These sequences of expert knowledge acquisition can be very efficient for making easier knowledge emergence during a similar experience and positively impact the monitoring of critical situations. The provided graphical user interface incorporating a user-centered visual analysis is exploited to facilitate the natural and effective representation of clinical information for patient care

A qualitative study and thematic analysis concerning the applicability and efficacy of service design processes applied to healthcare service innovation

The emergence of design and systems development have arisen as legitimate tools for facilitating innovative practices in the delivery of care within public services. Development mechanisms deriving from design led thinking and their associated methodologies have evidently been adopted to construct services that fulfill the interest of public health outcomes. Moreover, the innovations are being generated in response to multi-faceted factors necessitating the need to generate new solutions to improve health outcomes. These factors range from changing, and increasingly complex health needs of the current local population; to advances in medical science; and of the development trends emerging in medical technologies further enhancing potential in health outcomes. The research is conducted to answer key questions regarding both relevance and effective impact, surrounding the adoption of design-led thinking and processes in developing health services within the National Healthcare Service in Wales. The research focus and scope of this investigation encompasses the development processes that are integral to creating innovative services. These processes consist of a combination of tools and principles used by stakeholders with the aim of improving the delivery of health related outcomes. The research has sought to address its core questions by implementing a thematic interpretive analysis, to qualitatively extrapolate how live engagement with design processes among relevant stakeholders facilitate innovative interventions. The relevance and effectiveness by which design processes seek to generate ideas against a set criterion is therefore sought through the interpreted narrative of transcribed data from participant stakeholders. From the analytical narrative, the research aims to establish an original framework that would help stakeholders make sense of the developmental means by which innovative services emerge and can concurrently be evaluated for their appositeness to a design exercise

An Ontology for Product-Service Systems

Industries are transforming their business strategy from a product-centric to a more service-centric nature by bundling products and services into integrated solutions to enhance the relationship between their customers. Since Product- Service Systems design research is currently at a rudimentary stage, the development of a robust ontology for this area would be helpful. The advantages of a standardized ontology are that it could help researchers and practitioners to communicate their views without ambiguity and thus encourage the conception and implementation of useful methods and tools. In this paper, an initial structure of a PSS ontology from the design perspective is proposed and evaluated

The influence of informal power structures on corporate strategy of a selected mining organisation in Northern Cape Province, South Africa

Corporate strategy has gained a lot of traction in academic discourse as a critical field that ensures organisational success and the role of informal structures in achieving this success has also gained a lot of focus. However, several scholars have pointed out that most of the studies on informal structures have used western and Asian socioecological narratives to contextualise informal structures. The contextual gap identified by the study and the assumptions by scholars that African, Asian and Western contexts have huge variances prompted the study to explore the contextual gap in South Africa. After defining the contextual gap, the critical question that the study sought to answer was; How are informal structures responding to corporate strategy within a South African context? To answer this question the study used an interpretive approach and a single case study to draw from the subjective experiences of 30 employees using in depth interviews. To ensure the abstraction of high-quality data the study utilised heterogeneous purposive sampling to draw insights from informed participants which in turn enabled the study to explore diversified perspectives. The study established that the socio ecological context of the organisation had both positive and negative influence on the employee's desire to accept or reject corporate strategy. The study established that the positive influence enabled smooth flow of information, flexibility, fulfilment of social needs and sharing of ideas. However, the study also established that the negative influence which manifested in resistance to corporate strategy, social fragmentation, conflict and political bickering outweighed the positive influence. The study concluded by adopting a strategic management model and extending it to contain the negative attributes of the socio-cultural environment with the hope that the model may enable the organisation to positively influence informal structures