Medicine and Health Sciences Commons^™

Critical Event Review Team (Cert), Jeffrey Kuhlman, Thomas Looke, Louis Barr, Jeanette Bartos, Gengie Nail, Brittany Almon, Joseph Keebler, Elizabeth Lazzara, Elizabeth Blickensderfer

Publications

The culture of medicine is shifting from placing blame on providers to a systems-minded culture of trying to understand human error as a symptom of deeper rooted systemic issues. The goal is to reduce harm by redesigning the systems in which humans work.

A Pilot Study Of Computerized, Tailored Intervention To Promote Hpv Vaccination In Mexican-Heritage Adolescents, Angela Chia-Chen Chen, Michael Todd, Ashish Amresh, Usha Menon, Laura Szalacha

Publications

This study examined feasibility, acceptability, and preliminary effects of a computer-tailored intervention aimed at promoting HPV vaccination in Mexican-heritage adolescents aged 11-17. Among 46 Mexican-heritage parents who had one or more eligible children who had not received HPV vaccines, 91% (n = 42) completed the intervention and assessments via touchscreen tablet computers in a vaccine clinic. Mean knowledge scores increased significantly from pre- to post-intervention. After the intervention, 95% (n = 40) of parents intended to get their children vaccinated; 50% (n=21) of them consented to vaccination immediately, resulting in 24 adolescents being vaccinated at that time. All parents reported …

Usability Of A Smartphone Application To Support The Prevention And Early Intervention Of Anxiety In Youth, Ryan D. Stoll, Armando A. Pina, Kevin Gary, Ashish Amresh

Publications

Anxiety disorders are among the most common psychiatric problems in youth, fail to spontaneously remit, and place some youth at risk for additional behavioral and emotional difficulties. Efforts to target anxiety have resulted in evidence-based interventions but the resulting prevention effects are relatively small, often weakening over time. Mobile health (mHealth) tools could be of use to strengthen the effects of anxiety prevention efforts. Although a large number of mHealth apps have been developed, few have been evaluated in terms of usability prior to clinical effectiveness testing. Because usability is one of the main barriers to mHealth usage and adoption, …

Multicenter Handoff Collaborative, Philip E. Greilich, Joseph R. Keebler

Publications

Communication and team-based care are at the heart of patient safety. As anesthesia professionals, we witness this at its very best and worst when transferring patients to and from the operating room (see article by Dr. Lorinc on types of transfers in this issue). In response, we have an opportunity to take a leading role in redesigning the most ubiquitous teaming event in hospitals in a manner that promotes team-based behaviors. The impact of unreliable handoffs on communication failures and medical errors is well known. To combat this issue, mandates by The Joint Commission (TJC) in 2006 and the American …

Evaluation Of A Scientifically Developed Anesthesiology Handoff Protocol, Kristen Lise Welsh Webster

Doctoral Dissertations and Master's Theses

Communication failures have been cited as the leading cause of avoidable adverse events in healthcare. Specifically, within handoffs, these communication failures can cause error in the transfer of patient information. A multitude of factors can affect the transmission of patient information between providers including transactive memory, power distance, and conversational noise; however, literature suggests that the use of handoff protocols assist in improving communication and efficiency during handoffs. Studies regarding handoffs have typically centered on the content or delivery of the information during the handoff. To date, none have targeted the underlying mechanisms of the communication and their effects on …

Osteopontin Facilitates West Nile Virus Neuroinvasion Via Neutrophil “Trojan Horse” Transport, Amber M. Paul, Dhiraj Acharya, Laurel Duty, E. Ashley Thompson, Linda Le, Dobrivoje S. Stokic, A. Arturo Leis, Fengwei Bai

Publications

West Nile virus (WNV) can cause severe human neurological diseases including encephalitis and meningitis. The mechanisms by which WNV enters the central nervous system (CNS) and host factors that are involved in WNV neuroinvasion are not completely understood. The proinflammatory chemokine osteopontin (OPN) is induced in multiple neuroinflammatory diseases and is responsible for leukocyte recruitment to sites of its expression. In this study, we found that WNV infection induced OPN expression in both human and mouse cells. Interestingly, WNV-infected OPN deficient (Opn−/−) mice exhibited a higher survival rate (70%) than wild type (WT) control mice (30%), suggesting OPN plays a …

A Prospective Investigation To Develop Data-Driven Interventions And Improve Process Efficiency At A Level Ii Trauma Center, Tracy L. Litzinger

Doctoral Dissertations and Master's Theses

INTRODUCTION: The purpose of this investigation was to better understand process inefficiencies in a Level II trauma center through the identification and classification of flow disruptions. Data-driven interventions were systematically developed and introduced in an effort to reduce disruptions threatening the optimal delivery of trauma care.

METHOD: Medical human factors researchers observed disruptions during resuscitation and imaging in 117 trauma cases. Data was classified using the human factors taxonomy Realizing Improved Patient Care through Human-centered Operating Room Design for Threat Window Analysis (RIPCHORD-TWA). Interdisciplinary subject matter experts (SMEs) utilized a human factors intervention matrix (HFIX) to generate targeted interventions designed …

E-Cigarettes: A Hazy Hazard, Cheryl (Cheri) L. Marcham, John (Jack) P. Springston

Publications

• Electronic cigarettes (e-cigarettes or e-cigs) are battery-powered devices that deliver vaporized nicotine and other substances, such as flavorings, to users without smoke or combustion. They are commonly marketed as smoking cessation tools and, as such, are promoted as being a healthier alternative to smoking.

• A common misperception is that that e-cigarettes only release water vapor. In reality, though, these devices release nicotine and other chemicals in a vapor form that can expose both the user (a.k.a., the vaper), as well as those in the immediate vicinity, to those contaminants. While the health risks of e-cigarettes compared to regular …

Hazcom 2012 Implementation, Cheri Marcham

Publications

This presentation reviews changes to the OSHA Standard called HazCom 2012. Old and new definitions for "health hazards" are discussed as well as labeling requirements.

General Aviation Hypoxia And Reporting Statistics, Timothy B. Holt, Jacqueline Luedtke, Claire Schindler

Publications

“All too often, pilots tell me they don't need physiological training because they don't fly that high. The statement points out the general feelings of a large majority of the aviation population. I suppose then the burning question is ‘why do we still have aircraft accidents?’” (Boshers, 2015). To this day there are no statistics on how often general aviation pilots experience hypoxia during everyday operations. General aviation pilots (i.e. non-commercial operations) were chosen for this study because:

• Little regulation regarding flight physiology training
• General attitude of invulnerability towards hypoxia
• No requirement to report hypoxia or similar events

A Human Factors Approach For Identifying Latent Failures In Healthcare Settings, Tara N. Cohen

Doctoral Dissertations and Master's Theses

INTRODUCTION: The purpose of the current research was to assess the utility of the Human Factors Analysis and Classification System (HFACS), a tool that has historically been used reactively to look at accidents and incidents, for classifying observational data from various healthcare venues.

METHOD: Three studies are presented to investigate the reliability of HFACS for classifying observational data. In Study I, HFACS was applied to observational human factors data collected from the cardiovascular operating room (CVOR) at an academic medical university. Three trained analysts categorized the data using HFACS and several approaches were used to evaluate its reliability during the …

Undergraduate Research On General Aviation Hypoxia: A Student’S Perspective, Claire Schindler

Discovery Day - Prescott

During the fall academic term of 2016, an opportunity arose through the College of Aviation to serve as an undergraduate research assistant. Through discussion with faculty mentors, it was decided that a severely overlooked aspect of the aviation industry was survivors of hypoxia, especially in the less regulated general aviation community. The problem this study addresses is the uncertainty of the common circumstances that general aviation pilots find themselves in that create a hypoxic state, as well as whether or not that pilot reported the occurrence to the proper establishments. The results of this study showed not only those that …

Modelling Fatigue For Management Decision Making: A Case Study, Rajee Olaganathan, Timothy B. Holt, Jacqueline Luedtke

Publications

Fatigue is one major contributing factor that reduces the human ability and leads to accidents, and threatens the safety of aircraft and human lives.

Though fatigue is seen in all the disciplines associated with the aviation industry, this paper will discuss only pilot fatigue. Based on the literature examined, this study first examines the significance of the problem.

Investigation of the inflight, pre/post flight countermeasures (both pharmacological and non - pharmacological methods) practiced at present, discusses the Fatigue Risk Management System (FRMS) – in this first, it defines the FRMS, briefly discusses its history, describes the organizational structure of FRMS …

Multi-Scale Cardiovascular Flow Analysis By An Integrated Meshless-Lumped Parameter Model, Leonardo A. Bueno, Eduardo A. Divo, Alain J. Kassab

Publications

A computational tool that integrates a Radial basis function (RBF)-based Meshless solver with a Lumped Parameter model (LPM) is developed to analyze the multi-scale and multi-physics interaction between the cardiovascular flow hemodynamics, the cardiac function, and the peripheral circulation. The Meshless solver is based on localized RBF collocations at scattered data points which allows for automation of the model generation via CAD integration. The time-accurate incompressible flow hemodynamics are addressed via a pressure-velocity correction scheme where the ensuing Poisson equations are accurately and efficiently solved at each time step by a Dual-Reciprocity Boundary Element method (DRBEM) formulation that takes advantage …