Human Factors Applied to Perioperative Process Improvement

Human factors/ergonomics (HF/E) is its own scientific discipline that can be applied to understanding performance in perioperative medicine. Humans are not perfect decision makers and are affected by a variety of factors that can greatly harm their ability to perform, including attention, bias, stress, and fatigue. HF/E has a unique perspective on human error, and HF/E can illustrate how moving away from blame can enhance safety. HF/E offers strategies for undertaking a systematic approach to assessment of work processes in perioperative medicine that can be used to increase safety and wellbeing of patients and providers

Utilizing Human Factors to Improve Perioperative Adverse Event Investigations: An Integrated Approach

Objective: Apply Human Factors (HF), systems engineering, and high reliability organizational principles to improve adverse event investigations in a regional hospital system. Background: Given the complexity of medicine and healthcare systems, innovative thinking is required to ensure these systems are resilient to error. Understanding the work system and its constituent parts is fundamental to understanding how errors begin and propagate. Method: This paper provides a discussion on employing a systems-based approach to improve perioperative adverse event investigations within a hospital system. Results: Data was collected across 13 investigations. The findings are summarized into 16 contributing factors, with 10 specific examples of critical/serious risks that were addressed by the hospital system. Conclusion: Modern medicine needs to look to HF to improve safety and reduce errors. This manuscript provides a systems-based approach grounded in HF and organizational theories to improve how investigations are conducted and the approach to human error within a large hospital system. Application: This work provides practical guidance for those who want to improve postoperative investigations within their own units or hospitals. Precis: This article describes research that evolves the approach to accident investigation to improve perioperative adverse event investigations in hospital settings

Team Dynamics Theory: Nomological network among cohesion, team mental models, coordination, and collective efficacy

I put forth a theoretical framework, namely Team Dynamics Theory (TDT), to address the need for a parsimonious yet integrated, explanatory and systemic view of team dynamics. In TDT, I integrate team processes and outputs and explain their relationships within a systemic view of team dynamics. Specifically, I propose a generative nomological network linking cohesion, team mental models, coordination, collective efficacy, and team outcomes. From this nomological conceptualization, I illustrate how myriad alternative models can be derived to account for variance in different working teams, each comprised of unique members, and embedded in singular contexts. I outline TDT’s applied implications for team development, the enhancement of team functioning, and the profiling of team resilience. I conclude by discussing how TDT’s ontological and nomological propositions can be tested through various theoretical inquiries, methodological approaches, and intervention-based studies

SPECTROSCOPIC EVIDENCE FOR BINARY OXYGEN CLUSTERS IN THE GAS PHASE.

Author Institution: Department of Chemistry, Indiana UniversityThe 0-0 band of the $^{1}\Delta_{6}-^{3}\Sigma^{-}_{3}$ system of molecular oxygen has been examined at low temperatures using a White cell with an effective path of 30 meters. The integrated absorption coefficient at $87^{\circ}K$ is nearly twice as large as at room temperature. This intensity anomaly may be interpreted in terms of a ``clustering'' process, which includes both bound -pairs and collision pairs, both of which are expected to increase in importance at low temperatures. From the temperature dependence of the integrated absorption coefficient, a clustering energy $\Delta E=-360$ cal./mole is found. At present it is not possible to separate the effects of bound-pairs and collision pairs, since both of these contribute to the maximum of the pair-distribution function which governs the spectroscopic intensity. A direct confirmation of bound oxygen dimers will depend on observation of fine structure corresponding to the bound-states of the intermolecular potential

COLLISION INDUCED SPECTRA OF OXYGEN

$^{1}$ R.P. Blickensderfer, R. Leonard and G.E. Ewing, Applied Optics 1968, in press.Author Institution: Department of Chemistry, Indiana UniversityA 3.8 meter cell which operates routinely at variable path lengths up to 230 meters and which may be cooled to $77^{\circ}K$ will be $described.^{1}$ The collision induced spectra are examined in several regions at a pressure of about 1 atmosphere and temperatures from $77-300^{\circ}K$. The $^{1}\Delta_{g}\leftarrow ^{3}\Sigma^{-}_{g}$ system $(1.2 \mu)$ consists of sharp features due to rotational fine structure of monomer $O_{2}$ and a broad underlying continuum attributed to the collision induced spectra of oxygen dimers. Simultaneous transitions are observed at $0.6 \mu$ in which a collision complex of two oxygens simultaneously undergo a $^{1}\Delta_{g}\leftarrow ^{3}\Sigma^{-}_{g}$ transition. The absorptions of collision induced transitions increase dramatically at temperatures near $\epsilon/k \sim 100^{\circ}K$ for oxygen. This occurs when the kinetic energy approaches the intermolecular potential energy and oxygen begins to cluster in the gas phase

Faster Than Light: Preliminary Review of a Complex GameBased Testbed

Commercial off-the-shelf (COTS) products allow researchers to conduct studies using readily accessible systems in order to save time, effort, and/or money that would otherwise be spent designing a custom product. In this article, we discuss the potential of a low-cost and commercially available video game, FTL: Faster Than Light, to be used as a testbed for research into complex or high-workload situations. In this preliminary review, we prototype a performance assessment tool for FTL, which we call FTL Score, and evaluate its ability to distinguish performances between a pilot sample of three participants. The results of this exploratory study showed that our measurement methods were able to distinguish between the performance of two novices and an expert. This suggests that a larger follow-up study is warranted, and lends some support to the hypothesis that FTL can be used as an easy-to-deploy and low-cost testbed for research into high-workload performance

Human Factors Applied to Perioperative Process Improvement

Human factors/ergonomics (HF/E) is its own scientific discipline that can be applied to understanding performance in perioperative medicine. Humans are not perfect decision makers and are affected by a variety of factors that can greatly harm their ability to perform, including attention, bias, stress, and fatigue. HF/E has a unique perspective on human error, and HF/E can illustrate how moving away from blame can enhance safety. HF/E offers strategies for undertaking a systematic approach to assessment of work processes in perioperative medicine that can be used to increase safety and wellbeing of patients and providers