Redesigning the 'choice architecture' of hospital prescription charts: a mixed methods study incorporating in situ simulation testing.

Objectives: To incorporate behavioural insights into the user-centred design of an inpatient prescription chart (Imperial Drug Chart Evaluation and Adoption Study, IDEAS chart) and to determine whether changes in the content and design of prescription charts could influence prescribing behaviour and reduce prescribing errors. Design: A mixed-methods approach was taken in the development phase of the project; in situ simulation was used to evaluate the effectiveness of the newly developed IDEAS prescription chart. Setting: A London teaching hospital. Interventions/methods: A multimodal approach comprising (1) an exploratory phase consisting of chart reviews, focus groups and user insight gathering (2) the iterative design of the IDEAS prescription chart and finally (3) testing of final chart with prescribers using in situ simulation. Results: Substantial variation was seen between existing inpatient prescription charts used across 15 different UK hospitals. Review of 40 completed prescription charts from one hospital demonstrated a number of frequent prescribing errors including illegibility, and difficulty in identifying prescribers. Insights from focus groups and direct observations were translated into the design of IDEAS chart. In situ simulation testing revealed significant improvements in prescribing on the IDEAS chart compared with the prescription chart currently in use in the study hospital. Medication orders on the IDEAS chart were significantly more likely to include correct dose entries (164/164 vs 166/174; p=0.0046) as well as prescriber's printed name (163/164 vs 0/174; p<0.0001) and contact number (137/164 vs 55/174; p<0.0001). Antiinfective indication (28/28 vs 17/29; p<0.0001) and duration (26/28 vs 15/29; p<0.0001) were more likely to be completed using the IDEAS chart. Conclusions: In a simulated context, the IDEAS prescription chart significantly reduced a number of common prescribing errors including dosing errors and illegibility. Positive behavioural change was seen without prior education or support, suggesting that some common prescription writing errors are potentially rectifiable simply through changes in the content and design of prescription charts

A simple approach for monitoring business service time variation.

Control charts are effective tools for signal detection in both manufacturing processes and service processes. Much of the data in service industries comes from processes having nonnormal or unknown distributions. The commonly used Shewhart variable control charts, which depend heavily on the normality assumption, are not appropriately used here. In this paper, we propose a new asymmetric EWMA variance chart (EWMA-AV chart) and an asymmetric EWMA mean chart (EWMA-AM chart) based on two simple statistics to monitor process variance and mean shifts simultaneously. Further, we explore the sampling properties of the new monitoring statistics and calculate the average run lengths when using both the EWMA-AV chart and the EWMA-AM chart. The performance of the EWMA-AV and EWMA-AM charts and that of some existing variance and mean charts are compared. A numerical example involving nonnormal service times from the service system of a bank branch in Taiwan is used to illustrate the applications of the EWMA-AV and EWMA-AM charts and to compare them with the existing variance (or standard deviation) and mean charts. The proposed EWMA-AV chart and EWMA-AM charts show superior detection performance compared to the existing variance and mean charts. The EWMA-AV chart and EWMA-AM chart are thus recommended

Comparing Statistical Feature and Artificial Neural Networks for Control Chart Pattern Recognition: A Case Study

Control chart has been widely used for monitoring production process, especially in evaluating the quality performance of a product. An uncontrolled process is usually known by recognizing its chart pattern, and then performing some actions to overcome the problems. In high speed production process, real-time data is recorded and plotted almost automatically, and the control chart pattern needs to be recognized immediately for detecting any unusual process behavior. Neural networks for automatic control chart recognition have been studied in detecting its pattern. In the field of computer science, the performance of its automatic and fast recognition ability can be a substitution for a conventional method by human. Some researchers even have developed newer algorithm to increase the recognition process of this neural networks control chart. However, artificial approaches have some difficulties in implementation, especially due to its sophisticated programming algorithm. Another competing method, based on statistical feature also has been considered in recognition process. Control chart is related to applied statistical method, so it is not unreasonable if statistical properties are developed for its pattern recognition. Correlation coefficient, one of classic statistical features, can be applied in control chart recognition. It is a simpler approach than the artificial one. In this paper, the comparison between these two methods starts by evaluating the behavior of control chart time series point, and measured for its closeness to some training data that are generated by simulation and followed some unusual control chart pattern. For both methods, the performance is evaluated by comparing their ability in detecting the pattern of generated control chart points. As a sophisticated method, neural networks give better recognition ability. The statistical features method simply calculate the correlation coefficient, even with small differences in recognizing the generated pattern compared to neural networks, but provides easy interpretation to justify the unusual control chart pattern. Both methods are then applied in a case study and performances are then measured

Organizational Chart Inference

Nowadays, to facilitate the communication and cooperation among employees, a new family of online social networks has been adopted in many companies, which are called the "enterprise social networks" (ESNs). ESNs can provide employees with various professional services to help them deal with daily work issues. Meanwhile, employees in companies are usually organized into different hierarchies according to the relative ranks of their positions. The company internal management structure can be outlined with the organizational chart visually, which is normally confidential to the public out of the privacy and security concerns. In this paper, we want to study the IOC (Inference of Organizational Chart) problem to identify company internal organizational chart based on the heterogeneous online ESN launched in it. IOC is very challenging to address as, to guarantee smooth operations, the internal organizational charts of companies need to meet certain structural requirements (about its depth and width). To solve the IOC problem, a novel unsupervised method Create (ChArT REcovEr) is proposed in this paper, which consists of 3 steps: (1) social stratification of ESN users into different social classes, (2) supervision link inference from managers to subordinates, and (3) consecutive social classes matching to prune the redundant supervision links. Extensive experiments conducted on real-world online ESN dataset demonstrate that Create can perform very well in addressing the IOC problem.Comment: 10 pages, 9 figures, 1 table. The paper is accepted by KDD 201

A control chart procedure for student grade monitoring

This article reports an application of the control chart procedure for monitoring award of grades to students by the teaching staff in a large university. The chart procedure signals the presence of special cause variations if any in the award of grades. Implementation of the grade monitoring procedure saved considerable time and effort while ensuring that the reported special cause situations are justified. The mathematical derivations for the new control chart scheme are also presented

Simplifying branched covering surface-knots by an addition of 1-handles with chart loops

A branched covering surface-knot over an oriented surface-knot $F$ is a surface-knot in the form of a branched covering over $F$. A branched covering surface-knot over $F$ is presented by a graph called a chart on a surface diagram of $F$. For a branched covering surface-knot, an addition of 1-handles equipped with chart loops is a simplifying operation which deforms the chart to the form of the union of free edges and 1-handles with chart loops. We investigate properties of such simplifications.Comment: 26 pages, 15 figures, title changed, minor modifications, to appear in J. Knot Theory Ramification

The alternating least squares technique for nonuniform intensity color correction

Color correction involves mapping device RGBs to display counterparts or to corresponding XYZs. A popular methodology is to take an image of a color chart and then solve for the best 3 × 3 matrix that maps the RGBs to the corresponding known XYZs. However, this approach fails at times when the intensity of the light varies across the chart. This variation needs to be removed before estimating the correction matrix. This is typically achieved by acquiring an image of a uniform gray chart in the same location, and then dividing the color checker image by the gray-chart image. Of course, taking images of two charts doubles the complexity of color correction. In this article, we present an alternative color correction algorithm that simultaneously estimates the intensity variation and the 3 × 3 transformation matrix from a single image of a color chart. We show that the color correction problem, that is, finding the 3 × 3 correction matrix, can be solved using a simple alternating least-squares procedure. Experiments validate our approach. © 2014 Wiley Periodicals, Inc. Col Res Appl, 40, 232–242, 201