The cause of complications: understanding the relation between post-operative complications and the systems and processes of a hospital by means of an influence diagram

Care for the patient is the core process of hospital care. Hospitals are becoming ever more complex and it is increasingly difficult to have a good overview of the hospital to ensure the quality of care. Among others, additional quality assurance and validation is required to remain in control of the situation. To acquire insight into the most important parameters in patient care, an influence diagram is made of the patient treatment process in the operating room. The outcome of this approach is an extensive diagram, giving an overview of the influences on post-operative complications in a hospital. Based on this, a concise abstraction is made, in which the occurrence of post-operative complications is summarized using a simple system diagram. The main challenges within the current system are identified, and will be used for further research. Preliminary solutions follow from the influence diagram: the essential parameters and the complex interrelations between these parameters are described

A3 architecture overviews for systems-of-systems

This work describes how the A3 architecture overviews (A3AO) tool, developed by Borches (Borches Juzgado, 2010) for reverse architecting of complex systems, can be used for the description of Systems of Systems (SoS). Where the tool originally focuses on the description of the architecture of a system aspect on an A3, this paper treats how an SoS architecture is described on a single A3AO. This difference emphasizes some of the key features of A3AO’s: condensation of architecture knowledge until only the essentials remain and the ability of communicating the descriptions among different disciplines. A case study into the subject is done, describing a complex SoS developed by the Naval Systems department of Thales Nederland B.V. in Hengelo, The Netherlands. In order to initiate the creation of this A3AO, a research methodology consisting of interviews, a questionnaire and testing phases is defined and executed. This research methodology applies a reverse architecting approach as defined in Muller (Muller, 1996) and Borches (Borches Juzgado, 2010). Results from the research are given, and the applicability of the tool for the described purpose is evaluated. Using these results, an approach to the creation of high level A3AO’s is defined. Ultimately it is concluded that, with small adaptations, the A3AO tool can be used for the description of SoS