Analysis Terminology

 Many of us think that theoretical part of any project, might be less than practical or applied one. Actually any successful application of project you had been dealing with, was standing behind great work and individuals effort. We can’t deny that, even good project with unfit execution does not work properly or gives awaited results for public. Undoubtedly; with who draw the parallel work line between theoretical and applied applications going more effectively to achieve intended objects than without. Though, the work sustainability of work highly impact on final end rewards but also hurrying maintenance integration among variable kind of ideas and implementation procedures leading to proper accepted yield. Analysis terminology is first set of knowledge regards medical system analysis process, whether you are medical expert or just enterprising reader cares about more academic and scientific data, terms of any domain give the skeleton for that science and form angel stone to understand current analytical perspectives enclosed. System analysis depending on human factor engineering and equipment/instrumental analysis with new applied technologies techniques such as; networks, database architecture, database articulations, information management pattern and reviewing platforms. All of them carry different sort of terminology in order to provide sound understanding and knowledge. Regarding the terminology of health system analysis enumerated as follow;

System element: A system element is anything that is part of a particular system. Elements can include people, technologies, policies, lighting, furniture, and jobs. In the case of the medication administration system, elements include the nurses, patients, medications, medication administration record (MAR), medication stock room, patient rooms, and identification bands.

System attribute: System attributes are the perceived characteristics of the system. The medication administration system attributes could include “error-free,” “time consuming,” “chaotic,” and “high quality.”

System boundary: System boundaries are zones between one system and another. These zones can be in time, space, process, or hierarchy.

Temporal boundary: A temporal boundary separates systems in time. For the medication administration system, a temporal boundary could be drawn between the first and second shift.

Spatial boundary: A spatial boundary separates systems in space. An example could be the medication administration system for one particular unit versus that of another unit.

 Process boundary: A process boundary separates systems intra-adjacent components, also known as sub-processes. The medication use system contains component processes of ordering, transcribing, verifying, dispensing, administering, and documenting. An example might then be the boundary between the process of dispensing and delivering medications to the unit and the process of administering the medication.

Hierarchical boundary: A hierarchical boundary separates system partitions by their location. For example, the medication administration system exists within a larger system known as a unit. The unit exists within a larger system of a hospital.

System input: A system input is anything necessary to exaggerate the system activities. For administration, inputs include nurses who administer drugs, drugs, MARs, physician orders, and pharmacy dispensing. These elements are inputs because they are necessary for process complementation.

Transformation: Transformation is the processes that turn inputs into outputs; The action of administration in order to medicate certain patient would transform an input (i.e., a medication) into an output (i.e., a medicated patient). However, many other transformations carried out in the medication administration system network procedures. These include patient manipulations, patient monitoring, retrieving drugs from medication carts or cabinets, and reading MARs, ..etc.

Outputs: Outputs are the results of transformations. For example, the output of administering a medication is a medicated patient.

Unit operation: A unit operation is a simple input-transformation output processed solitary that by its role;  does not contain any other convertible transformations It is the most basic component process of interest. For example, within the larger process of administering medications, which might have a process boundary that starts with a nurse examining a MAR and ends when the administration is documented, there are a number of unit operations.

By reviewing terms of system analysis, hope you right now more aware with health system analytical life style, for sure it needs more details and explanation but for whose who interested to know more about working steps, feel free to ask more about explaining documents and associated materials, most of them available free and on demand. Seriously, I always believe that any work or life correction start with understanding and evaluation then the rest which coming easier to implement and get desirable results, try to believe me most of our work and life mistakes had been come basically resultant from inappropriate understanding and evaluation. If you applying the same concept with health systems understanding and evaluation, eventually you will find the whole process actually dependable on both concepts then the matter of implementation going to be normal routine work steps with expected accuracy and much affordable. :) 

Reference:

Stamatis D. Failure mode and effect analysis: FMEA

from theory to execution. Milwaukee, WI: American

Society for Quality; 1995.

40. Sheff R, Marder R. The step-by-step guide to failure

modes and effects analysis. Marblehead, MA: HCPro,

Inc.; 2002.

41. VA National Center for Patient Safety. Healthcare

failure mode and effect analysis course materials

(HFMEA™). Available at:

http://www.patientsafety.gov/HFMEA.html. Accessed

March 3, 2004.

Healthcare Analytics for Everyone

Short movie show, how far data and information analysis carries direct and indirect impact on the whole process of health delivery channels and different sort of analytic pattern should be implemented:) 

Why Do You Need Big Data in Healthcare?

Short movie, explain the importance of data gathering and appraisal valuation process and also review the difference between traditional and data current in modern healthcare systems:)

Analysis Healthcare Tools

In our previous post, we were reviewing the main guidelines and steps might be used to implement analysis work toward healthcare system. Today we focusing on review in details some tools involved the process of analysis itself. We deal that there are a lot of work in order to reach the proper cause of system setbacks, although it seems that easy but practically time consuming than imagined. However with certain determined work steps could be taken in account try to do the whole process steps more convenient to processing team. The main features of analytical procedures actually undertake to catch the cause and categorize it and if that cause solitary or branched, means associated by other results or networks. Therefore; the sustainability and accountability necessary to reach appropriate real results.

There are many questions and data must be gathered to form Decision documents to prepare overview about which sides should get more investigations and precisely examined carefully, some of these questions as follow:

What kind of technology is used?

What kind of supervision and maintenance policies?

What are main rules of performance?

What kind of work objectives and aimed targets?

What are associated boosting tasks and networks?

What is work environment and if that matching with standards?

Building decision document gives significant impact on the success of analysis also, to prepare guidelines for future fast correction pattern serves the end results. The number of decision building documents varies according systems sort and tasks related, it might be few pages or hundreds of pages. Actually the pages itself play a role to get good reliable effect correction to appeared setbacks through providing real reliable data with further future decisions about working steps and possibilities of weakness later. 

What more interesting in this point, that even with some sound network sites, should not be far from examination to be proved or neglected in the fixation operation. In many cases, network seems sound but that soundness leading somehow to aside errors in next steps, depending degree of professionalism of analysis and method been used, so the kind used in healthcare system analysis and what better than others and what is the best for all?

To Err Is Human8 & Crossing the Quality Chasm, they are medicine institutes reported that human factor methods could addressed to serve patient safety and quality of care issues. Since these reports issued, many of human related methods modified in their work prospect to adapt mainly patient needs and demands. To conduct analysis in healthcare domain, there are many of usable methods available; but few widely used and experienced more,

1. Macro-ergonomics analysis & design (MEAD)

2. Fault Tree analysis. (FTA)

3. Failure mode and effects analysis (FMEA)

4. Probabilistic risk assessment (PRA)

Each of them used effectively to determine the system weakness and deteriorations and retardations. What really want to mention here; that sort of system used in the process of analysis is not core for end results but how to implement is the backbone of analysis success. These methods are considered just beginning of improvement requirement threshold, that might lead us to more deeply high productive ways of analysis and system data management. However; as well known optimism always; start with minimum and all of us hope more and more in future to serve our patient with great kind professional way. Wish all you health & happiness:) 

 References:

Kohn LT, Corrigan JM, Donaldson MS, editors. To err

is human: building a safer health system. A report of

the Committee on Quality of Health Care in America,

Institute of Medicine. Washington, DC: National

Academy Press; 2000.

Hurtado MP, Swift EK, Corrigan JM, editors.

Crossing the quality chasm: a new health system for

the 21st century. Washington, DC: National Academy

Press; 2001.

Hendrik HW, Kleiner BM. Macroergonomics: and

introduction to work system design. Santa Monica,

CA: Human Factors and Ergonomics Society; 2000.

Pasmore W. Designing effective organizations: the

sociotechnical systems perspective. New York, NY:

John Wiley and Sons; 1988.

Healthcare system analysis

As health systems errors have grown; we got more in need to find appropriated solutions. Moreover; depending on how far these errors been understandable that it determines efficient nature of them later. And that undoubtedly move our thoughts to find remarkable unique ones. If we are gathering briefly former mentioned steps we call them ‘’Analysis’. There are many articles talking about systems analysis and how it might be work with different kind of problems and errors. Most of them focusing on the system solutions for errors give complicated work problems, but here would like to focus on nature of errors that give us strong backbone about solutions finding journey. The process of working system analysis is not simple ever as some imagine, months ongoing effort daily with certain system segment only in order to reach proper error identification but the good news that this job has not ever done individually, is a team job.  

But the real question is the process of analysis really necessary, in other meaning; that carries valuable significance to the future system performance and its quality. We could say system without analysis means; no further development and work error corrections. In general; System analysis yields an understanding how system works and how different system elements interact. Also used to modify, adapt, redesign and comfort the working elements with additional needs and demands. The process of the analysis for work system determines the human factors and human engineering tools usable, which if followed; we would produce working system devoid of numerous errors and human mistakes. In conventional approach of system was focusing more on the working elements and operation unites related to that elements neglected the behavior of humankind with the system and human associated factors. 

Recently; found most of IT produced errors owned far or soon, roots to human factor engineering. That embarrasses human much and open a lot of questions, how humankind do well with machines, would be discuss in coming posts. The role of analysis process is much significant to find new solutions, reduce risk, identify new system objects, leading to good design and exaggerate; safety, quality, performance of the system. There are steps followed in process of system analysis briefly reviewed:

Step 1: it is the process of identify system segment and declare the involved portion which serve an analysis team to determine the proper elements as physician order , document administration, prescription platform.

Step 2: drawing preliminary system map that firstly; facilitate the work with different system elements and create represented itinerary with proper identified objects. This map has say more details such as system working segment, sort of technologies used, environmental factors and human influences on execution.

Step 3: representation of the team members who carry out the analysis process. Work team representation is essence of the analysis examination, monitoring and assessment.

Step 4: Initial scan of the systems, after determining involved segments of work should be analyzed. Then each of them scanned carefully for further error identification and some other technical assessments.

Step 5:  involved segment should be enclosed by boundaries, whether hierarchical, temporary and spatial boundaries would isolate the site of work away from rest of system components to avoid more errors.

Step 6: performance determination of each system elements to make proper scan of all components. the determination carries out in qualitative and quantitative methodologies make sense to distinguish error categories of problematic mistake.

Step 7: The team should implements formal data collection to revise and update the work system map according to current involved errors through defining the work performance baseline regularly.

Step 8: the team can begin to analyze the collected data and find out the weakness, variances and previous of events could cause system fail. The analysis period can extend for months or years in certain cases and the team should be more patient in this step; it considered crucial point of analysis process.

Step 9: one the failure causes become clear and declared including IT errors or/and human produced, the 2^nd step is planning for solutions what is called Hazard control plan that will serve team to be more focused on certain points of weakness and prevent confusion.

Step 10: the innovative solutions should be designed and tested separately to each work segment, performance sustainability is most important here and after testing good effective solutions that would implemented and conjugated with other system elements.

The process of system analysis is not light topic of discussions and easily can find full books talking in details but I hope this hint about healthcare system analysis process give you even the main concepts about analysis and procedures.

Reference:

Kaushal R, Bates DW, Landrigan C, et al. Medication

errors and pediatric inpatients. JAMA 2001

Apr;285(16):2114–20.

27. Cook R, Woods DD. Adapting to new technology in

the operating room. Hum Factors 1996

Dec;38(4):593–613.

28. Berg M, Langenberg C, vd Berg I, et al.

Considerations for sociotechnical design: experiences

with an electronic patient record in a clinical context.

Int J Med Inform 1998 Oct–Dec;52(1–3):243–51.

Chronic care

On August 26, the united states preventive services tasks force (USPSTF) issued a final recommendation that any community individual currently living with predisposed factors lead to appearance of future chronic health problems should be offered counselling interventions, that kind of interventions do preparing of human individual and their behaviour to take healthy pattern lifestyle.

Chronic care management recently form a healthcare implied indicator of whole process of care provision. Meanwhile; there different satisfaction concepts produced with appropriate decisions about how the process runs, in other meaning what the chronic patient needs from providers; care or assessment or diagnosis or follow up or eventually psychological support even. There are many defaulted mistakes with improper chronicity management.

Moreover the way of determination of each case hides numerous of further complications may affect  a patient life and interrupt daily living performance. We can say that the process of identification and handling of each chronic case determines the tunnel of soundness in future. Most of patients, their expectation about received services is modest and in many times lower than humble because they want to feel more secure about their medicines monthly especially with private providers and greedy pharmaceutical entities. Persistent continuation of service carries strong impact toward their lives and health.

Dr. Jacob Teitelbaum is medical director of the Fibromyalgia and Fatigue Centers and author of Pain Free. A Proven Program for Eliminating Chronic Pain Now. He says it helps to “recognize that after hearing about it a few times, most healthy people will not want to be immersed in a day-to-day pain report. As the saying goes ‘you can’t pull somebody out of quicksand by jumping in with them.’

Dr. Jacob wanted to refers to the role of associated tools of disease management, whatever program used within are many other companioned roles emitted from people around the patients. Also, role of family should pushing the patient to going normally in daily life work without additional overload gained if they stay solitary without normal concerns and that forms extra psychological burden.

So, the service continuation, how far easy to get, fewer healthcare access steps, medical psychological support; all support their normal productive life and proved level of soundness of healing system model. But we are taking about health system performance with end received patients, it also supposed to talk about role of country toward chronic diseases and if that give the patients hope for life and have suppressed effect on thiers.

In last 20 years, chronic diseases are not restricted to elderly members of our communities only, there are thousands of infant and children they live with diabetes, obese, hypertension and even hormones disturbances, therefore; medical planning and forecast performance for diseased younger and elders have become more integrated to over one society segment. Country attitudes always in good support first to medical providers, non profit organizations & health promotional institutions throughout healing steps medically or socially. We wish all health and happiness to grandmothers and grandfathers.J

Happy weekend and all health :)

Carelessness with primary care

Matter of carelessness in medical domain rises from time to time, resultant of daily errors and human mistakes could not be happened if the authorized worker was more awaken. The direct and indirect significant impact toward the patients would be discussed below but here we like to highlight on causes and related reasons. Some theories explained that as way of poor management followed by inappropriate editing procedures to correct all in situ, meanwhile dynamic style of intervention and its nature minimize the time necessary to avoid complications may be appeared as a realistic pathway moreover, helping in blocking the future possibilities of setbacks afterward.

The level of carelessness mistakes and less standards treatment came basically not from inferior existed technology. It came already from the way we used to deal with medical technology, how we feel patient needs and what we want exactly from Technology. All apps, networks, digital products created to lighten our work and save effort, time and for sure money, but actually as much technology more integrated in our life, as we are produce more sophisticated problems for innocents people, all they looking for how to get good quality medical services.

 Seriously, it is not dark vision than drawing the real picture of how working medical systems are doing within states management architectures and how far achieve patient, medical professional and community objects.

‘’Negligence defined as a group of broad terms, covering a number of errors, accidents or below standards treatment provided by medical professionals.’’

Clinical Negligence is form of carelessness appeared with clinicians work; data administration, handling, info management, low standards service, improper diagnosis, misleading decision, unnecessary expenses and unneeded prescription items are considered main tunnel of mistakes, most of them actually patients used to face in clinics. In order briefly to correct some, depending on the provider mission and working objects that determine dealing strategic behavior with patients.

Really, so interesting to talk about Surgery Negligence, why? Because that one of most repeated popular mistakes occurred globally every day, to avoid emotional impact on the reader prefer not to give examples but enough to know there are many lost their normal life style because of less standards surgery and poor skilled surgeons. Privately, I have a concept always regarding the process of education and learning, they are not applicable if you do not show strict eager to serve people efficiently. Thus forming of belief is highly significant to workers and reflects directly on whom receives the medical end value.

Virtually, it is difficult to enumerate all kind of negligence in one post but in recent time noticeably that all medical branches, over there probable to find form of Negligence. Nevertheless many of new medical providers reach in some sides of services in level of optimism. Healthcare system is package composed of working unites, must working in harmony way to produce good value and achieve medical welfare. J

Health Responsibility

We have constant idea that any community must have medical health program in order to getting its members their needs and demands. Therefore; healthcare system, primary care provider, medical professionals, work attitude habits , and non profitable institutions also greatly involved in what is called health responsibility. This term is not new but almost used widely with health promotion and wellbeing medical policy makers. Thus comprehensive independent evaluation lies on integrated sound delivery channel attributed to be main source of trustworthy gate of health society determinants and by which, aimed overview strategies drawn and work objects according to awaited services and societal demands. Whatever of numerous associated terms and dialects, still the main frame of responsibility determinants carries the same contours and components.

As a fact, there are many health responsibilities with different axial frames, some definitions talking about medical workers, society toward, state determinant responsibilities and even patients responsibilities close to themselves and protected regulations. We prefer to mention some of them separately as follow;

Medical workers responsibilities encompasses; employees attitude toward their daily tasks and how they deal, correct and manage most of faced problems with patients, whether acute, chronic or follow up for certain medical checking visits. The services responsibility not to impress the patient with new innovative technologies may be they are not ever interest to know about whenever that directly related to their medication.

They are showing more attention to their delivery value quality and that later give them more self-esteem, confidence and satisfaction with their nurses, physicians. Indeed, this deemed the logic believable core of health quality coefficient measurement that have been undertaken to push high mutual demand responsibility between the provider and patient. Patients are getting their values and provider attains their business model, termed as mutual responsibility model.

Regarding state (country) responsibility is to exaggerate health status which could be described in two main guidelines; the state give main health strategies reflect better for society needs and regular demands and provide the primary care with necessary infrastructures facilitate delivery work till end beneficial. Whose who working with IT networks be able to find paved land for their work without future routine and bureaucracy.

Ultimately, the patient carries heavier role and/with healthcare stakeholders; first with themselves must be keen to keep the soul, body and mind safe as possible far way from any harm. Honestly this part in the hard one why? Because you as a provider cannot be with patients all the day at the same time particularly with some inconvenient personal habits or problem leading decisions. This practically impossible but at least role of promotional health programs and ‘’know your disease’’ sessions make the patient share their actions with medical providers clearly. Recently; being presence of different sorts of health apps more usable than before and provider capable of build a bridge with patients most of time, make mission of provider enjoyable to reach patient health data everywhere. The health for you all. J

How Health Inequality Happens

there are different sort of reason can make inequality appear in healthcare system, some of these reason in this movie. 

Healthcare Access Inequality

This movie is highlighting on right of health access and some difficulties may meet people in process of reaching gate of access to the medical delivery systems, please let me know your feedback.