Approaching the hotspot increases the impact: Process breakdowns in a safety-critical system-of-systems

被引：0
|
作者：
Taneva, Svetlena [1 ,2 ]
Higgins, Jacqueline [2 ]
Easty, Anthony [2 ]
Plattner, Bernhard [1 ]
机构：
[1] Swiss Fed Inst Technol, Swiss Fed Inst Technol, Zurich, Switzerland
[2] Univ Hlth Network, Toronto, ON, Canada
来源：
2009 IEEE INTERNATIONAL SYSTEMS CONFERENCE, PROCEEDINGS | 2009年
关键词：
healthcare; breakdowns; error; safety; OR;
D O I：
10.1109/SYSTEMS.2009.4815767
中图分类号：
TP [自动化技术、计算机技术];
学科分类号：
0812 ;
摘要：
This paper reports a study that examines process breakdowns in the operations of a hospital's surgical unit. We rind a correlation between the stage in the surgical process in which a breakdown is detected and the breakdown impact. We derive a model of the relationship between breakdown detection, impact, and safety within the surgical domain. We discuss the practical implications for targeted breakdown prevention and detection within the process, and the latent effects on safety.
引用
收藏
页码：31 / +
页数：2
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