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首页> 外文会议>Safety-Critical Systems Symposium; 20050208-10; Southampton(GB) >The Effects of Timing and Collaboration on Dependability in the Neonatal Intensive Care Unit
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The Effects of Timing and Collaboration on Dependability in the Neonatal Intensive Care Unit

机译：时间和协作对新生儿重症监护室可靠性的影响

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Dependability is inherent in the NICU system. Contributions to the dependability of the socio-technical system are made by the humans (the NICU staff), the technology (ventilator, Neotrend and so on) and the context (social and physical). This study has focused more on those aspects associated with the humans, particularly the timing aspects of the human-machine interaction, and collaboration between the staff. The study identified several examples of timing issues and collaboration issues that contribute to the dependability of the system before the introduction of FLORENCE. It is important that the system after the introduction of FLORENCE should be at least as dependable as it was before. Although there are often problems when new technology is introduced into clinical settings by outsiders (Coiera, 1999), this should not be the case in the NICU because it was the consultants in the unit who identified the need for FLORENCE, and they have been closely involved in its development. Furthermore they have the experiences of a previous expert system, ESNIC (Snowden, Brownlee, & Dear, 1997) to build on, where the issue of having to manually transfer the data readings from the equipment into ESNIC made it unacceptable to staff. The consultants took this into account in their requirement that FLORENCE had to be both clinically useful and acceptable to the staff for it to be successful. Whether FLORENCE will improve the dependability of the system is an empirical question, albeit a difficult one due to the particular constraints of the NICU. SHOs are on rotation in the neonatal unit for only six months . This, coupled with the fact that the set of cases of RDS in the NICU changes considerably over time, makes it hard to directly compare the pre- and post-FLORENCE systems. The different rates of development of the babies also makes it hard to make direct comparisons across cases that are matched for gestation and birth weight at the start of their stay in the NICU for the pre- and post-FLORENCE systems. Some of the ways in which FLORENCE could affect the dependability of the system have been identified here. In particular, the possible ways in which timing issues and collaboration could be affected have been highlighted. The next step is to return to the NICU after FLORENCE has been in place for some time to evaluate how the identified issues have really been affected.
机译：可靠性是NICU系统中固有的。人类（NICU工作人员），技术（通风机，Neotrend等）和环境（社会和自然环境）对社会技术系统的可靠性做出了贡献。这项研究更多地侧重于与人相关的方面，特别是人机交互和员工之间协作的时间安排方面。该研究在引入FLORENCE之前确定了一些时序问题和协作问题的示例，这些问题会导致系统的可靠性。引入FLORENCE之后的系统至少应像以前一样可靠，这一点很重要。尽管外界将新技术引入临床环境时经常会遇到问题（Coiera，1999年），但在NICU中情况并非如此，因为正是该部门的顾问确定了FLORENCE的必要性，并且他们一直密切合作。参与其发展。此外，他们还具有以前的专家系统ESNIC的经验（Snowden，Brownlee和Dear，1997年），在该系统上，必须将设备中的数据读数手动传输到ESNIC的问题使工作人员无法接受。顾问考虑到了这一点，他们要求FLORENCE必须在临床上有用并且必须为员工所接受，以使其成功。尽管由于NICU的特殊限制，这是一个难题，但FLORENCE是否会改善系统的可靠性是一个经验性的问题。 SHO在新生儿病房中旋转的时间仅为6个月。再加上NICU中RDS的情况会随着时间的推移而发生很大变化，因此很难直接比较FLORENCE之前和之后的系统。婴儿不同的发育速度也使得难以对出生前后在佛罗伦萨新生儿重症监护系统之前在新生儿重症监护病房住院期间匹配妊娠和出生体重的病例进行直接比较。此处已经确定了FLORENCE可能影响系统可靠性的一些方式。特别是，已经突出了影响时序问题和协作的可能方式。下一步是在佛罗伦萨成立了一段时间后回到新生儿重症监护病房，以评估已确定的问题如何真正受到影响。

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