DFTCalc: reliability centered maintenance via fault tree analysis (tool paper)

Reliability, availability, maintenance and safety (RAMS) analysis is essential in the evaluation of safety critical systems like nuclear power plants and the railway infrastructure. A widely used methodology within RAMS analysis are fault trees, representing failure propagations throughout a system. We present DFTCalc, a tool-set to conduct quantitative analysis on dynamic fault trees including the effect of a maintenance strategy on the system dependability

Determinants of preventable readmissions in the United States: a systematic review

<p>Abstract</p> <p>Background</p> <p>Hospital readmissions are a leading topic of healthcare policy and practice reform because they are common, costly, and potentially avoidable events. Hospitals face the prospect of reduced or eliminated reimbursement for an increasing number of preventable readmissions under nationwide cost savings and quality improvement efforts. To meet the current changes and future expectations, organizations are looking for potential strategies to reduce readmissions. We undertook a systematic review of the literature to determine what factors are associated with preventable readmissions.</p> <p>Methods</p> <p>We conducted a review of the English language medicine, health, and health services research literature (2000 to 2009) for research studies dealing with unplanned, avoidable, preventable, or early readmissions. Each of these modifying terms was included in keyword searches of readmissions or rehospitalizations in Medline, ISI, CINAHL, The Cochrane Library, ProQuest Health Management, and PAIS International. Results were limited to US adult populations.</p> <p>Results</p> <p>The review included 37 studies with significant variation in index conditions, readmitting conditions, timeframe, and terminology. Studies of cardiovascular-related readmissions were most common, followed by all cause readmissions, other surgical procedures, and other specific-conditions. Patient-level indicators of general ill health or complexity were the commonly identified risk factors. While more than one study demonstrated preventable readmissions vary by hospital, identification of many specific organizational level characteristics was lacking.</p> <p>Conclusions</p> <p>The current literature on preventable readmissions in the US contains evidence from a variety of patient populations, geographical locations, healthcare settings, study designs, clinical and theoretical perspectives, and conditions. However, definitional variations, clear gaps, and methodological challenges limit translation of this literature into guidance for the operation and management of healthcare organizations. We recommend that those organizations that propose to reward reductions in preventable readmissions invest in additional research across multiple hospitals in order to fill this serious gap in knowledge of great potential value to payers, providers, and patients.</p

An overview of the approaches for automotive safety integrity levels allocation

YesISO 26262, titled Road Vehicles–Functional Safety, is the new automotive functional safety standard for passenger vehicle industry. In order to accomplish the goal of designing and developing dependable automotive systems, ISO 26262 uses the concept of Automotive Safety Integrity Levels (ASILs), the adaptation of Safety Integrity Levels. ASILs are allocated to the components and subsystems that can cause system failure and malfunctions that lead to hazards. ASILs allocation is a hard problem consists of finding the optimal allocation of safety levels to the system architecture which must guarantee that the highest safety requirements are met while development cost of the automotive system is kept minimum. There were many successful attempts to solve this problem using different techniques. However, it is worth pointing out that there is an absence of a review that provides an in-depth study of all the existing methods and highlights their merits and demerits. This paper presents an overview of different approaches that were used to solve ASILs allocation problem. The review provides an overview of safety requirements including the related standards followed by a study of the resolution methods of the existing approaches. The study of each approach provides a detailed explanation of the used methodology and a discussion of its strength and weaknesses including the main open challenges