No abstract

Healthcare Failure Mode and Effect Analysis (HFMEA®) has been developed to support the proactive analysis of health care treatment processes. Its use has been reported in several studies with both positive and negative comments regarding the quality of the results and the efficacy of the method. This paper examines the HFMEA® methodology and discusses the challenges that were encountered during its application to a proactive analysis of radiotherapy patient record systems in a large public hospital. Several weaknesses in the HFMEA® method and particularly in the HFMEA Decision TreeTM are also discussed. Recommendations to support future HFMEA® studies and also for the re‐design of the HFMEA Decision TreeTM to overcome the identified weaknesses are included. Based on these recommendations, a new decision tree is presented to guide future analyses. © 2012 Wiley Periodicals, Inc.

Purpose The purpose of this paper is to explore the extent of Lean Six Sigma (LSS) implementation within manufacturing companies in the West of Ireland. It examines the key success and failure factors, benefits and quality tools influencing LSS projects deployment. Design/methodology/approach The study adopted a mixed research method (quantitative and qualitative approach). Research data were collected through a structured survey questionnaire to the target population followed by interview case studies with four manufacturing companies to gather additional insight. The targeted respondents were manufacturing engineers, quality engineers, process improvement managers, operations managers, R&D engineers, LSS experts and validation engineers. Findings LSS initiatives are still relatively unknown to many SMEs organisations, whereas large companies have adopted LSS for some time. Top management commitment, understanding the LSS methodology, tools and techniques, integrating LSS to business strategy, organisational cultural change and training and education were the topmost key success factors. Organisational strategy, lack of top management support, expensive cost for LSS projects, unclear prioritisation of LSS projects and cost effectiveness were the most important failure factors influencing LSS implementation. Originality/value This research is the original work provided by the author and is expected to address the shortcomings of both SMEs and large organisations in the West of Ireland. The recommendations and frameworks reported in this paper can be used by manufacturing and service companies in Ireland for efficiency, competitiveness and continuous improvement.

Background The patient monitor (PM) is one of the most commonly used medical devices in hospitals worldwide. PMs are used to monitor patients’ vital signs in a wide variety of patient care settings, especially in critical care settings, such as intensive care units. An interesting observation is that the design of PMs has not significantly changed over the past 2 decades, with the layout and structure of PMs more or less unchanged, with incremental changes in design being made rather than transformational changes. Thus, we believe it well-timed to review the design of novel PM interfaces, with particular reference to usability and human factors. Objective This paper aims to review innovations in PM design proposed by researchers and explore how clinicians responded to these design changes. Methods A literature search of relevant databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, identified 16 related studies. A detailed description of the interface design and an analysis of each novel PM were carried out, including a detailed analysis of the structure of the different user interfaces, to inform future PM design. The test methodologies used to evaluate the different designs are also presented. Results Most of the studies included in this review identified some level of improvement in the clinician’s performance when using a novel display in comparison with the traditional PM. For instance, from the 16 reviewed studies, 12 studies identified an improvement in the detection and response times, and 10 studies identified an improvement in the accuracy or treatment efficiency. This indicates that novel displays have the potential to improve the clinical performance of nurses and doctors. However, the outcomes of some of these studies are weakened because of methodological deficiencies. These deficiencies are discussed in detail in this study. Conclusions More careful study design is warranted to investigate the user experience and usability of future novel PMs for real time vital sign monitoring, to establish whether or not they could be used successfully in critical care. A series of recommendations on how future novel PM designs and evaluations can be enhanced are provided.

A national survey to investigate the education of teachers in computer-related ergonomics was carried out by postal questionnaire. The use of computers by primary school children (age 4-12 years) was also investigated. Data were collected from a random sample of 25% (n = 830) of primary schools in the Republic of Ireland. Questionnaires (n = 1863) were returned from 416 schools giving a response rate of 50.1%. Almost all schools (99.7%) had computers for children's use. The computers were most often (69.8%) used in the classroom. The majority (56.3%) of children worked in pairs. Most teachers (89.6%) had received computer training, but few (17.6%) had received ergonomics information during the training. Respondents were not satisfied with their current knowledge of ergonomics. Over 90% stated that they would like to receive further information by printed format or during a training course, rather than by computer (web or CD-ROM).