Location of Emergency Treatment Sites after Earthquake using Hybrid Simulation

A mass-casualty natural disaster such as an earthquake is a rare, surprising event that is usually characterized by chaos and a lack of information, resulting in an overload of casualties in hospitals. Thus, it is very important to refer minor and moderately-injured casualties, that are the majority of casualties and whose injuries are usually not life threatening, to ad hoc care facilities such as Emergency Treatment Sites (ETSs). These facilities support the efficient use of health resources and reduce the burden on permanent healthcare facilities. In our study, a hybrid simulation model, based on a combination of discrete events and an agent-based simulation, provides a solution to the uncertainty of positioning temporary treatment sites. The simulation methodology used compares between "rigid" and "flexible" operating concepts of ETSs (main vs. main+minor ETSs) and found the "flexible" concept to be more efficient in terms of the average walking distance and number of casualties treated in the disaster area

Investigative approaches: Lessons learned from the RaDonda Vaught case

Accidental patient harms occur frequently in healthcare, but their exact prevalence and interventions that will best prevent them are still poorly understood. In rare cases, healthcare providers who have contributed to accidental patient harm may be criminally prosecuted to obtain justice for the patient and family or to set an example, which theoretically prevents other providers from making similar mistakes due to fear of punishment. A recent case where this strategy was chosen is the RaDonda L. Vaught vs. Tennessee (2022) criminal case. The present article discusses this case and its ramifications, as well as provides concrete recommendations for actions that healthcare organizations should take to foster a safer and more resilient healthcare system. Recommendations include placing an emphasis on just culture; ensuring timely, systems-level investigations of all incidents; creating and facilitating participation in a national reporting system; incorporating Human Factors professionals at multiple levels of organizations; and establishing a national safety board for medicine

FULE—Functionality, Usability, Look-and-Feel and Evaluation Novel User-Centered Product Design Methodology—Illustrated in the Case of an Autonomous Medical Device

The overall goal of the novel Functionality, Usability, Look-and-Feel, and Evaluation (FULE) user-centered methodology for product design proposed in this paper is to develop usable and aesthetic products. Comprising several product design methods, this novel methodology we devised focuses on the product designer’s role and responsibility. Following the first three formative assessment phases that define the product’s functionality, usability, and look-and-feel, the summative evaluation phase not only assesses the product, but also provide guidelines to its implementation, marketing, and support. A case study devoted to the design of an autonomous medical device illustrates how the FULE methodology can provide the designer with tools to better select among design alternatives and contribute to reducing bias and subjective decisions

FULE—Functionality, Usability, Look-and-Feel and Evaluation Novel User-Centered Product Design Methodology—Illustrated in the Case of an Autonomous Medical Device

The overall goal of the novel Functionality, Usability, Look-and-Feel, and Evaluation (FULE) user-centered methodology for product design proposed in this paper is to develop usable and aesthetic products. Comprising several product design methods, this novel methodology we devised focuses on the product designer’s role and responsibility. Following the first three formative assessment phases that define the product’s functionality, usability, and look-and-feel, the summative evaluation phase not only assesses the product, but also provide guidelines to its implementation, marketing, and support. A case study devoted to the design of an autonomous medical device illustrates how the FULE methodology can provide the designer with tools to better select among design alternatives and contribute to reducing bias and subjective decisions

Location of Emergency Treatment Sites after Earthquake using Hybrid Simulation

A mass-casualty natural disaster such as an earthquake is a rare, surprising event that is usually characterized by chaos and a lack of information, resulting in an overload of casualties in hospitals. Thus, it is very important to refer minor and moderately-injured casualties, that are the majority of casualties and whose injuries are usually not life threatening, to ad hoc care facilities such as Emergency Treatment Sites (ETSs). These facilities support the efficient use of health resources and reduce the burden on permanent healthcare facilities. In our study, a hybrid simulation model, based on a combination of discrete events and an agent-based simulation, provides a solution to the uncertainty of positioning temporary treatment sites. The simulation methodology used compares between "rigid" and "flexible" operating concepts of ETSs (main vs. main+minor ETSs) and found the "flexible" concept to be more efficient in terms of the average walking distance and number of casualties treated in the disaster area

Attitudes of mental health clinicians toward perceived inaccuracy of a schizophrenia diagnosis in routine clinical practice

Abstract Background Mental health clinicians have previously been reported to express reservations regarding the utility and accuracy of the psychiatric classification systems. In this study we aimed to examine clinicians’ experiences with instances of perceived inaccuracy of a schizophrenia diagnosis. Methods Mental health clinicians (N = 175) participated in an online survey assessing prevalence and perceived reasons for inaccuracies of a schizophrenia diagnosis. Respondents included psychiatric ward directors (13.1%), senior psychiatrists and psychologists (40.5%), and psychiatry and clinical psychology residents (36%). Results Fifty-three percent of respondents reported encountering instances where a schizophrenia diagnosis was assigned even though clinical presentation did not match diagnostic criteria. Seventy-three percent of senior psychiatrists in a position to determine a diagnosis declared assigning schizophrenia even when controversial among clinical staff, and 15% of them declared doing so frequently. The likelihood of frequently assigning a schizophrenia diagnosis even when clearly controversial was predicted by the perception that an inaccurate diagnosis is assigned due to the presence of negative symptoms (OR 2.20, 95% CI 1.04–4.66, p = 0.039) and due to patient-related factors, such as the need to facilitate rehabilitation (OR 1.77, 95% CI 1.07–2.90, p = 0.024). Conclusions Although a schizophrenia diagnosis is considered relatively stable and clear, our study indicates that, in clinical practice, the assignment of this diagnosis is frequently controversial. These controversies are associated with the perception that an inaccurate diagnosis is assigned due to diagnostic considerations, or due to the possibility that patients might benefit from such a diagnosis. Implications and limitations for psychiatric practice and discourse are discussed