Search results for: emergency service
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4509

Search results for: emergency service

4419 Job Stress Among the Nurses of the Emergency Department of Selected Saudi Hospital

Authors: Mahmoud Abdel Hameed Shahin

Abstract:

Job demands that are incompatible with an employee's skills, resources, or needs cause unpleasant emotional and physical reactions known as job stress. Nurses offer care in hospital emergency rooms all around the world, and since they operate in such a dynamic and unpredictable setting, they are constantly under pressure. It has been discovered that job stress has harmful impacts on nurses' health as well as their capacity to handle the demands of their jobs. The purpose of this study was to evaluate the level of job stress experienced by the emergency department nurses at King Fahad Specialist Hospital in Buraidah City, Saudi Arabia. In October 2021, a cross-sectional descriptive study was conducted. 80 nurses were conveniently selected for the study, the bulk of them worked at King Fahad Specialist Hospital's emergency department. An electronic questionnaire with a sociodemographic data sheet and a job stress scale was given to the participating nurses after ethical approval was received from the Ministry of Health's representative bodies. Using SPSS Version 26, both descriptive and inferential statistics were employed to analyze and tabulate the acquired data. According to the findings, the factors that contributed to the most job stress in the clinical setting were having an excessive amount of work to do and working under arbitrary deadlines, whereas the factors that contributed to the least stress were receiving the proper recognition or rewards for good work. In the emergency room of King Fahad Specialist Hospital, nurses had a moderate level of stress (M=3.32 ± 0.567/5). Based on their experience, emergency nurses' levels of job stress varied greatly, with nurses with less than a year of experience notably experiencing the lowest levels of job stress. The amount of job stress did not differ significantly based on the emergency nurses' age, nationality, gender, marital status, position, or level of education. The causes and impact of stress on emergency nurses should be identified and alleviated by hospitals through the implementation of interventional programs.

Keywords: emergency nurses, job pressure, Qassim, Saudi Arabia, job stress

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4418 IT Perspective of Service-Oriented e-Government Enterprise

Authors: Anu Paul, Varghese Paul

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The focal aspire of e-Government (eGovt) is to offer citizen-centered service delivery. Accordingly, the citizenry consumes services from multiple government agencies through national portal. Thus, eGovt is an enterprise with the primary business motive of transparent, efficient and effective public services to its citizenry and its logical structure is the eGovernment Enterprise Architecture (eGEA). Since eGovt is IT oriented multifaceted service-centric system, EA doesn’t do much on an automated enterprise other than the business artifacts. Service-Oriented Architecture (SOA) manifestation led some governments to pertain this in their eGovts, but it limits the source of business artifacts. The concurrent use of EA and SOA in eGovt executes interoperability and integration and leads to Service-Oriented e-Government Enterprise (SOeGE). Consequently, agile eGovt system becomes a reality. As an IT perspective eGovt comprises of centralized public service artifacts with the existing application logics belong to various departments at central, state and local level. The eGovt is renovating to SOeGE by apply the Service-Orientation (SO) principles in the entire system. This paper explores IT perspective of SOeGE in India which encompasses the public service models and illustrated with a case study the Passport service of India.

Keywords: enterprise architecture, service-oriented e-Government enterprise, service interface layer, service model

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4417 Emergency Surgery in the Elderly, What Particularities

Authors: Mekroud Amel

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Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.

Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies

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4416 A Study of the Views of Information Technologies Teachers regarding In-Service Training

Authors: Halit Arslan, Ismail Sahin, Ahmet Oguz Akturk, Ismail Celik

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Today, the means of following the developments in the area of science and technology is to keep up with the pace of the advancements in this area. As is in every profession, apart from their personal efforts, the training of teachers in the period after they start their careers is only possible through in-service training. The aim of the present study is to determine the views of Information Technologies (IT) teachers regarding the in-service training courses organized by the Ministry of National Education. In this study, in which quantitative research methods and techniques were employed, the views of 196 IT teachers were collected by using the “Views on In-service Training” questionnaire developed by the authors of the paper. Independent groups t-test was used to determine whether the views of IT teachers regarding in-service training differed depending on gender, age and professional seniority. One-way analysis of variance (ANOVA) was used to investigate whether the views of IT teachers regarding in-service training differed depending on the number of in-service training courses they joined and the type of in-service training course they wanted to take. According to the findings obtained in the study, the views of IT teachers on in-service training did not show a significant difference depending on gender and age, whereas those views differed depending on professional seniority, the number of in-service training courses they joined and the type of in-service training course they wanted to take.

Keywords: in-service training, IT teachers, professional development, personal development

Procedia PDF Downloads 417
4415 Evaluating the Impact of Cloud Computing on Collaboration Service in Knowledge Management Systems

Authors: Hamid Reza Nikkhah, Abbas Toloei Eshlaghi, Hossein Ali Momeni

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One of the most important services of Knowledge Management Systems (KMS) is collaboration service which plays a decisive role in organization efficiency. Cloud computing as one of the latest IT technologies has brought a new paradigm in delivering services and communications. In this research, we evaluate the impact of cloud computing on the collaboration service of KMS and for doing so, four variables of cloud computing and three variables of the collaboration service were detected to be assessed.It was found that cloud computing has a far-fetching direct impact on the collaboration service.

Keywords: cloud computing, collaboration service, knowledge management systems, cloud computing

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4414 Disparate Use of Chemical and Physical Restraints in the Emergency Department by Race/Ethnicity

Authors: Etta Conteh, Tracy Macintosh

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Introduction: Restraints are often used in the Emergency Department when it is necessary for a patient to be restrained in order to decrease their agitation and better treat them. Chemical and physical restraints may be used on these patients at the discretion of the medical provider. Racism and injustice are rampant within our country, and medicine and healthcare are not spared. While racism and racial bias in medicine and healthcare have been studied, information on the differences in the use of restraints by race are scarce. Objective: The objective of this study is to determine if African Americans and Hispanic-American patients are restrained at higher rates compared to their White counterparts. Methods: This study will be carried out through a retrospective analysis utilizing the Hospital Corporation of America (HCA) national Emergency Department (ED) and inpatient database with patient visits from 2016-2019. All patient visits, with patients aged 18 years or older, will be reviewed, looking specifically for the race and the use and type of restraints. Other factors, such a pre-existing psychiatric condition, will be used for sub-analysis. Rationale: The outcome of this project will demonstrate the absence or presence of a racial disparity in the use of restraints in the Emergency Department. These results can be used as a foundation for improving racial equity in healthcare treatment.

Keywords: emergency medicine, public health, racism, restraint use

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4413 Audit of Urgent and Non-Urgent Patient Visits to the Emergency: A Case-Control Study

Authors: Peri Harish Kumar, Rafique Umer Harvitkar

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Background: The emergency department mandates maximum efficacy in the utilization of the available resources. Non-urgent patient visits pose a serious concern to the treatment, patient triage, and resources available. Aims and Objectives: We conducted a retrospective case-control study of the emergency department patient list from October 2019 to November 2022. A total of 839 patients formed part of the study. Somatic complaints, vital signs, diagnostic test results, admission to the hospital, etc., were some of the criteria used for the categorization of patients. Results: The proportion of non-urgent visits varied from 7.2% to 43%, with a median of 21%. Somatic complaints were the least associated with further hospital admissions (n=28%), while diagnostic test results were the most significant indicator of further hospital admissions (n=74%). Effective triage helped minimize emergency department admissions by 36%. Conclusion: Our study shows that effective triaging, patient counselling, and round-the-clock consumable monitoring helped in the effective management of patients admitted and also significantly helped provide treatment to the patients most in need.

Keywords: urgent visits, non-urgent visits, traiging, emergency department admissions

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4412 Implementing Service Innovation in Public Transport Sector: Drivers and Challenges

Authors: Chaoren Lu

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Public policy is playing as one driving force that influencing service innovation implementation in public sector. However, public policy implications cannot be automatically derived from the analyses of innovation issues, and there lacks of researches about the influences of public policy onto innovation. Moreover, innovation in service system is hard to predictable and whether policy encourages or hidden innovation is still lack of study. Especially, by given the context that multiple actors are active involving within the service delivery process in public transport sector, the complex driving forces and challenges are emerged towards the service operation. This study is aim to analysis the service innovation practices within service operating organizations to understand the drivers and challenges of service operation based on policy requirements, and where the innovation idea generating from. The case studies of Changzhou Transit Group and Nanjing Jiangnan Public Transit Group will be launched. This paper reveals the ambidexterity between top-down and bottom-up demands within the public transport service operating organizations contribute to the innovation ideas. Meanwhile, it contributes to the understanding of fundamental elements of service innovation is the new relationship creation and new way of sharing knowledge. The policy contributes to the trigger of creation of such relationship. The research question is: what are the sources of service innovation practices in local public transport system in China in in facing the policy implementation?

Keywords: public value, service innovation, public transport service, China

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4411 Utilization, Barriers and Determinants of Emergency Medical Services in Mekelle City, Tigray, Ethiopia: A Community-Based Cross-Sectional Study

Authors: Goitom Molalign Takele, Tsegalem Hailemariam Ballo, Kiros Belay Gebrekidan, Birhan Gebresilassie Gebregiorgis

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Background: Emergency medical services (EMS) are services that provide out-of-hospital emergency medical care to injured or ill peoples, and transporting to definitive care. EMS is an integral part of the emergency medical system and has been associated with decreased morbidity and mortality related to emergency cases. The aim of this study was to assess the utilization, barriers, and determinants of EMS in Mekelle, Ethiopia. Methods: A community-based cross-sectional study was conducted in selected sub-cities of Mekelle. A multistage sampling method was employed to recruit study participants, and data were collected by trained data collectors using an interviewer-administered questionnaire. Multivariate logistic regression analysis was used to examine the statistical association of the determinants of EMS utilization. Results: Half (50.5%) of the respondents had experienced or witnessed an emergency incident in the past year. The common means of transportations used were Bajaj’s (39.2%) and ambulances (22.7%). Majority (88.1%) of the respondents did not knew the EMS access phone number of an ambulance. As their preferred mode of transportation in case of emergency conditions, 42.2% of the participants reported an ambulance, followed by Bajaj 33.7%. Where participants who had gynecologic emergencies were 9.4 times (AOR=9.4, 95% CI: 1.04, 85, p=0.046), and those who knew any ambulance numbers were 3.6 times (AOR=3.6, 95% CI: 1.22, 10.8, p=0.02) more likely to use ambulance services in case of emergencies. Conclusion: The ambulance utilization level in Mekelle city was low and victims of emergency conditions were being transported mainly using public transports such as Bajaj’s and taxis. Even though the perception of the public towards EMS services is favorable, lack of awareness of EMS access, and lack of integrated EMS system in the city are the barriers that may have contributed to the low utilization. Actions to improve EMS access and integrating the system are warranted to promote the services utilization.

Keywords: emergency medical services, utilization, Mekelle, barriers

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4410 Application of Soft Systems Methodology in Solving Disaster Emergency Logistics Problems

Authors: Alhasan Hakami, Arun Kumar, Sung J. Shim, Yousef Abu Nahleh

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In recent years, many high intensity earthquakes have occurred around the world, such as the 2011 earthquake in Tohoku, Japan. These large-scale disasters caused huge casualties and losses. In addition, inefficient disaster response operations also caused the second wave of casualties and losses, and expanded the damage. Effective disaster management can be used to respond to the chaotic situation, and reduce the damage. However, some inefficient disaster response operations are still used. Therefore, this case study chose the 921 earthquakes for analysing disaster emergency logistics problems and proposed the Soft Systems Methodology (SSM) to solve disaster emergency logistics problems. Moreover, it analyses the effect of human factors on system operation, and suggests a solution to improve the system.

Keywords: soft systems methodology, emergency logistics, earthquakes, Japan, system operation

Procedia PDF Downloads 440
4409 ‘Call Before, Save Lives’: Reducing Emergency Department Visits through Effective Communication

Authors: Sandra Cardoso, Gaspar Pais, Judite Neves, Sandra Cavaca, Fernando Araújo

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In 2021, Portugal has 63 emergency department (ED) visits per 100 people annually, the highest numbers in Europe. While EDs provide a critical service, high use is indicative of inappropriate and inefficient healthcare. In Portugal, all ED have the Manchester Triage System (MTS), a clinical risk management tool to enable that patients are seen in order of clinical priority. In 2023, more than 40% of the ED visits were of non-urgent conditions (blue and green), that could be better managed in primary health care (PHC), meaning wrong use of resources and lack of health literacy. From 2017, the country has a phone line, SNS24 (Contact Centre of the National Health Service), for triage, counseling, and referral service, 24 hours/7 days a week. The pilot project ‘Call before, save lives’ was implemented in the municipalities of Póvoa de Varzim and Vila do Conde (around 150.000 residents), in May 2023, by the executive board of the Portuguese Health Service, with the support of the Shared Services of the Ministry of Health, and local authorities. This geographical area has short travel times, 99% of the population a family doctor and the region is organized in a health local unit (HLU), integrating PHC and the local hospital. The purposes of this project included to increase awareness to contact SNS 24, before going to an ED, and non-urgent conditions oriented to a family doctor, reducing ED visits. The implementation of the project involved two phases, beginning with: i) development of campaigns using local influencers (fishmonger, model, fireman) through local institutions and media; ii) provision of telephone installed on site to contact SNS24; iii) establishment of open consultation in PHC; iv) promotion of the use of SNS24; v) creation of acute consultations at the hospital for complex chronic patients; and vi) direct referral for home hospitalization by PHC. The results of this project showed an excellent level of access to SNS24, an increase in the number of users referred to ED, with great satisfaction of users and professionals. The second phase, initiated in January 2024, for access to the ED, the need for prior referral was established as an admission rule, except for certain situations, as trauma patients. If the patient refuses, their registration in the ED and subsequent screening in accordance with the MTS must be ensured. When the patient is non-urgent, shall not be observed in the ED, provided that, according to his clinical condition, is guaranteed to be referred to PHC or to consultation/day hospital, through effective scheduling of an appointment for the same or the following day. In terms of results, 8 weeks after beginning of phase 2, we assist of a decrease in self-reported patients to ED from 59% to 15%, and a reduction of around 7% of ED visits. The key for this success was an effective public campaign that increases the knowledge of the right use of the health system, and capable of changing behaviors.

Keywords: contact centre of the national health service, emergency department visits, public campaign, health literacy, SNS24

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4408 Rescue Emergency Drone for Fast Response to Medical Emergencies Due to Traffic Accidents

Authors: Anders S. Kristensen, Dewan Ahsan, Saqib Mehmood, Shakeel Ahmed

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Traffic accidents are a result of the convergence of hazards, malfunctioning of vehicles and human negligence that have adverse economic and health impacts and effects. Unfortunately, avoiding them completely is very difficult, but with quick response to rescue and first aid, the mortality rate of inflicted persons can be reduced significantly. Smart and innovative technologies can play a pivotal role to respond faster to traffic crash emergencies comparing conventional means of transportation. For instance, Rescue Emergency Drone (RED) can provide faster and real-time crash site risk assessment to emergency medical services, thereby helping them to quickly and accurately assess a situation, dispatch the right equipment and assist bystanders to treat inflicted person properly. To conduct a research in this regard, the case of a traffic roundabout that is prone to frequent traffic accidents on the outskirts of Esbjerg, a town located on western coast of Denmark is hypothetically considered. Along with manual calculations, Emergency Disaster Management Simulation (EDMSIM) has been used to verify the response time of RED from a fire station of the town to the presumed crash site. The results of the study demonstrate the robustness of RED into emergency services to help save lives. 

Keywords: automated external defibrillator, medical emergency, response time, unmanned aerial system

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4407 Pediatric Emergency Dental Visits at King Abdulaziz University Dental Hospital during the COVID-19 Lockdown: A Retrospective Study

Authors: Sara Alhabli, Eman Elashiry, Osama Felemban, Abdullah Almushayt, Faisal Dardeer, Ahmed Mohammad, Fajr Orri, Nada Bamashmous

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Background: In December of 2019, the coronavirus (SARS-CoV-2) first appeared and quickly spread to become a worldwide pandemic. This study aimed to evaluate the prevalence and types of pediatric dental emergencies during the COVID-19 lockdown in Jeddah, Saudi Arabia, at the University Dental Hospital (UDH) of King Abdulaziz University (KAU) and identified the management provided for these dental emergency visits. Materials and Methods: Data collection was done retrospectively from electronic dental records for children aged 0-18 that attended the UDH emergency clinic during the period from March 1st, 2020, to September 30th, 2020. An electronic form formulated specifically for this study was used to collect the required data from electronic patient records, including demographic data, emergency classification, management, and referrals. Results: A total of 3146 patients were seen at the emergency clinics during this period, of which 661 were children (21%). Types of emergency conditions included 0.8% emergency cases, 34% urgent, and 65.2% non-urgent conditions. Severe dental pain (73.1%) and abscesses (20%) were the most common urgent dental conditions. Most non-urgent conditions presented for initial or periodic visits, recalls, or routine radiographs (74%). Treatments rarely involved restorations, with 8% among urgent conditions and 5.4% among non-urgent conditions. Antibiotics were only prescribed to 6.9% of urgent conditions. Conclusions: The largest group of children presenting at the emergency dental clinics were found to be children with non-urgent conditions. Tele dentistry can be a solution to avoid large numbers of non-urgent patients presenting to emergency clinics. Additionally, dental care for non-urgent conditions during the pandemic should focus more on procedures with less aerosol generation.

Keywords: COVID-19 pandemic, dental emergencies, oral health, pediatric dentistry, children

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4406 Global Healthcare Village Based on Mobile Cloud Computing

Authors: Laleh Boroumand, Muhammad Shiraz, Abdullah Gani, Rashid Hafeez Khokhar

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Cloud computing being the use of hardware and software that are delivered as a service over a network has its application in the area of health care. Due to the emergency cases reported in most of the medical centers, prompt for an efficient scheme to make health data available with less response time. To this end, we propose a mobile global healthcare village (MGHV) model that combines the components of three deployment model which include country, continent and global health cloud to help in solving the problem mentioned above. In the creation of continent model, two (2) data centers are created of which one is local and the other is global. The local replay the request of residence within the continent, whereas the global replay the requirements of others. With the methods adopted, there is an assurance of the availability of relevant medical data to patients, specialists, and emergency staffs regardless of locations and time. From our intensive experiment using the simulation approach, it was observed that, broker policy scheme with respect to optimized response time, yields a very good performance in terms of reduction in response time. Though, our results are comparable to others when there is an increase in the number of virtual machines (80-640 virtual machines). The proportionality in increase of response time is within 9%. The results gotten from our simulation experiments shows that utilizing MGHV leads to the reduction of health care expenditures and helps in solving the problems of unqualified medical staffs faced by both developed and developing countries.

Keywords: cloud computing (MCC), e-healthcare, availability, response time, service broker policy

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4405 Salinity Response of Some Cowpea Genotypes in Germination of Periods

Authors: Meryem Aydin, Serdar Karadas, Ercan Ceyhan

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The research was conducted to determine effects of salt concentrations on emergence of cowpea genotypes. Trials were performed during the year of 2014 on the laboratory of Agricultural Faculty, Selcuk University. Emergency trial was set up according to “Randomized Plots Design” by two factors and four replications with three replications. Samandag, Akkiz-86, Karnikara and Sarigobek cowpea genotypes have been used as trial material in this study. Effects of the five doses of salt concentrations (control, 30 mM, 60 mM, 90 mM and 120 mM) on the ratio of emergency, speed of emergency, average time for emergency, index of sensibility were evaluated. Responses of the cowpea genotypes for salt concentrations were found different. Comparing to the control, all of the investigated characteristics on the cowpea genotypes showed significant reduction by depending on the increasing salt application. According to the effects of salt application, the cowpea genotypes Samandag and Karnikara were the most tolerant in respect to index of sensibility while the Sarigobek genotypes was the most sensitive.

Keywords: cowpea, Vigna sinensis, emergence, salt tolerant

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4404 Investigation into Micro-Grids with Renewable Energy Sources for Use as High Reliability Electrical Power Supply in a Nuclear Facility

Authors: Gerard R. Lekhema, Willie A Cronje, Ian Korir

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The objective of this research work is to investigate the use of a micro-grid system to improve the reliability and availability of emergency electrical power in a nuclear facility. The nuclear facility is a safety-critical application that requires reliable electrical power for safe startup, operation and normal or emergency shutdown conditions. The majority of the nuclear facilities around the world utilize diesel generators as emergency power supply during loss of offsite power events. This study proposes the micro-grid system with distributed energy sources and energy storage systems for use as emergency power supply. The systems analyzed include renewable energy sources, decay heat recovery system and large scale energy storage system. The configuration of the micro-grid system is realized with guidelines of nuclear safety standards and requirements. The investigation results presented include performance analysis of the micro-grid system in terms of reliability and availability.

Keywords: emergency power supply, micro-grid, nuclear facility, renewable energy sources

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4403 Evaluating Electronic Service Quality in Banking Iran

Authors: Vahid Bairami Rad

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With the rapid growth of the Internet and the globalization of the market, most enterprises are trying to attract and win customers in the highly competitive electronic market. Better e-service quality will enhance the relationship with customers and their satisfaction. So the measurement of eservice quality is very important but it is a complex process due to the complex nature of services. Literature predicts that there is a lack of universal definition of e-service quality. The e-service quality measures in banking have great importance in achieving high customer base. This paper proposes a conceptual model for measuring e-service quality in Iranian Banking Iran. Nine dimensions reliability, ease of use, personalization, security and trust, website aesthetic, responsiveness, contact and speed of delivery had been identified. The results of this paper may help to develop a proper scale to measure the e-service quality in Iranian Banking Industry, which may assist to maintain and improve the performance and effectiveness of e-service quality to retain customers.

Keywords: electronic banking, Dimensions, customer service quality, electronic, communication

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4402 Assessment of the Simulation Programs Usable to Support Decision Making Processes of the Critical Infrastructure Emergency Management

Authors: Jiří Barta, Oldřich Svoboda

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This article deals with the issue of practical training of the management staff during emergency events in the frame of critical infrastructure. Critical infrastructure represents one of the possible targets of destructive activities as well as operational accidents and incidents which can seriously influence the functioning of the system of ensuring the basic needs of the inhabitants. Therefore, protection of critical infrastructure and training of the staff in dealing with emergencies becomes a broadly discussed topic. Nowadays, the market offers a wide range of simulation tools which proclaim that they are suitable for practical training of management staff and completing their tasks. Another group of programs declares that they are not primarily designed for this type of simulations. However, after some minor adaptations, for example by adding or changing users‘ roles, they are able to fulfil the needs of practical training as well as the process of emergency simulation. This paper characterises and selects simulators and programs for simulating emergency events.

Keywords: computer simulation, Symos´97, simulation software, harmful substances, Konstruktivní simulace, SIMEX

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4401 Validating the Theme Park Service Quality Scale: A Case Study of Zhuhai Chimelong Ocean Kingdom

Authors: Kat Jingjing Luo

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The development of theme parks in China has been through a rapid growth in the past decades. Increasing competition within service quality has forced theme park managers concerned the relationship between service quality and visitors’ satisfaction. Even though those existing service quality measurements such as SERVQUAL and THEMEQUAL have been applied in related researches, none of them is exclusive for Chinese theme park service quality. This study aims to investigate the service quality of the most popular theme park in China currently and develop a unique, reliable and valid scale. The reliability and validity analysis results from a survey of over 200 tourists in Chimelong ocean kingdom in Zhuhai city, south of China, indicate that the dimension of waiting time is a discover factor in the measurement of Chinese theme park service quality excluding in the THEMEQUAL instrument (i.e., tangibles, reliability, responsiveness and access, assurance, empathy and courtesy). The newly developed scale gives a better understand service quality in Chinese theme park industry, and the managerial implications in regard to the research, how to improve theme park service quality are discussed.

Keywords: theme park, scale development, China, service quality

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4400 A Framework to Assess the Maturity of Customer Involvement in the Service Design of Product-Service Systems

Authors: Taghreed Abu-Salim

Abstract:

This paper develops and investigates a framework for the assessment of customer involvement in the service design process of result oriented product-service systems in order to improve the service offering in a business to business (B2B) context. The framework comprises five main criteria and fifteen sub-criteria that contribute to customer involvement in a hierarchy using a maturity grid to highlight the strengths and weaknesses for each criterion. To develop the customer involvement framework, an extensive literature review related to service design, result oriented product-service system (PSS) and customer involvement in service design was carried out. Key factors that significantly influence customer involvement from industry and literature were identified to develop an initial framework. This framework was tested in six companies from four different sectors of industry: district cooling, medical equipment, transportation and oil storage. Validation of the framework was carried out using expert opinions and industrial case studies. A major contribution of the developed framework includes a hierarchy of appropriate criteria for assessing customer involvement in the service design process within results oriented PSS; the definition of four maturity levels which are suitable to describe the whole spectrum of customer involvement in the service design process; and finally, The paper concludes by enabling service providers to: take proactive decisions; screen and evaluate new services; improve perceived service quality; and provide barriers against imitation.

Keywords: customer involvement, maturity grid, new service development, result oriented product-service system, service design

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4399 Long-Term Outcome of Emergency Response Team System in In-Hospital Cardiac Arrest

Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

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Introduction: To improve early detection and mortality rate of in-hospital cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditons and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90 mmHg, respiratory rate <8 or >28 breaths per minute, O2 saturation <90%, acute change in conscious state, acute chest pain or worry about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in in-hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in in-hospital cardiac arrest and overall hospital mortality rate, we conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed chi-square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010, 139 calls in 2011 and 245 calls in 2012. The number of ERT calls per 1000 admissions in year 2009-10 was 7.69; 5.61 in 2011 and 9.38 in 2013. The number of code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001 ). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, but we have not found difference in overall hospital mortality rate.

Keywords: cardiac arrest, outcome, in-hospital, ERT

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4398 Autopoietic Socio-technical Systems: A New Lens for Understanding Anticipation

Authors: Gregory Vigneaux

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The capacity to anticipate future events across varying time scales is integral to the effective operation of both emergency management and emergency services organizations. This paper provides fresh insight into anticipation by first offering a novel conceptualization of organizations in both fields by twisting together socio-technical systems and autopoietic theory. The result of this intertwining of theory is a view of emergency management and emergency services organizations as self-reproducing systems driven by socio-technical processes contingent upon both inflows and outflows across a boundary produced by the system’s own activity. Flowing from this perspective is an approach to anticipation that extends from a system’s intent of continuing to reproduce its identity over a dynamic landscape. This discussion takes a pragmatic turn through Maturana and Verden-Zöller’s domains of structural change, classifying anticipated events and connecting them with types of responses involving inflows, outflows, and socio-technical processes.

Keywords: risk, anticipation, organizations, planning, transformation, identity

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4397 Assessing Professionalism, Communication, and Collaboration among Emergency Physicians by Implementing a 360-Degree Evaluation

Authors: Ahmed Al Ansari, Khalid Al Khalifa

Abstract:

Objective: Multisource feedback (MSF), also called the 360-Degree evaluation is an evaluation process by which questionnaires are distributed amongst medical peers and colleagues to assess physician performance from different sources other than the attending or the supervising physicians. The aim of this study was to design, implement, and evaluate a 360-Degree process in assessing emergency physicians trainee in the Kingdom of Bahrain. Method: The study was undertaken in Bahrain Defense Force Hospital which is a military teaching hospital in the Kingdom of Bahrain. Thirty emergency physicians (who represent the total population of the emergency physicians in our hospital) were assessed in this study. We developed an instrument modified from the Physician achievement review instrument PAR which was used to assess Physician in Alberta. We focused in our instrument to assess professionalism, communication skills and collaboration only. To achieve face and content validity, table of specification was constructed and a working group was involved in constructing the instrument. Expert opinion was considered as well. The instrument consisted of 39 items; were 15 items to assess professionalism, 13 items to assess communication skills, and 11 items to assess collaboration. Each emergency physicians was evaluated with 3 groups of raters, 4 Medical colleague emergency physicians, 4 medical colleague who are considered referral physicians from different departments, and 4 Coworkers from the emergency department. Independent administrative team was formed to carry on the responsibility of distributing the instruments and collecting them in closed envelopes. Each envelope was consisted of that instrument and a guide for the implementation of the MSF and the purpose of the study. Results: A total of 30 emergency physicians 16 males and 14 females who represent the total number of the emergency physicians in our hospital were assessed. The total collected forms is 269, were 105 surveys from coworkers working in emergency department, 93 surveys from medical colleague emergency physicians, and 116 surveys from referral physicians from different departments. The total mean response rates were 71.2%. The whole instrument was found to be suitable for factor analysis (KMO = 0.967; Bartlett test significant, p<0.00). Factor analysis showed that the data on the questionnaire decomposed into three factors which counted for 72.6% of the total variance: professionalism, collaboration, and communication. Reliability analysis indicated that the instrument full scale had high internal consistency (Cronbach’s α 0.98). The generalizability coefficients (Ep2) were 0.71 for the surveys. Conclusions: Based on the present results, the current instruments and procedures have high reliability, validity, and feasibility in assessing emergency physicians trainee in the emergency room.

Keywords: MSF system, emergency, validity, generalizability

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4396 Aspects Regarding the Structural Behaviour of Autonomous Underwater Vehicle for Emergency Response

Authors: Lucian Stefanita Grigore, Damian Gorgoteanu, Cristian Molder, Amado Stefan, Daniel Constantin

Abstract:

The purpose of this article is to present an analytical-numerical study on the structural behavior of a sunken autonomous underwater vehicle (AUV) for emergency intervention. The need for such a study was generated by the key objective of the ERL-Emergency project. The project aims to develop a system of collaborative robots for emergency response. The system consists of two robots: unmanned ground vehicles (UGV) on tracks and the second is an AUV. The system of collaborative robots, AUV and UGV, will be used to perform missions of monitoring, intervention, and rescue. The main mission of the AUV is to dive into the maritime space of an industrial port to detect possible leaks in a pipeline transporting petroleum products. Another mission is to close and open the valves with which the pipes are provided. Finally, you will need to be able to lift a manikin to the surface, which you can take to land. Numerical analysis was performed by the finite element method (FEM). The conditions for immersing the AUV at 100 m depth were simulated, and the calculations for different fluid flow rates were repeated. From a structural point of view, the stiffening areas and the enclosures in which the command-and-control elements and the accumulators are located have been especially analyzed. The conclusion of this research is that the AUV meets very well the established requirements.

Keywords: analytical-numerical, emergency, FEM, robotics, underwater

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4395 Discrete-Time Bulk Queue with Service Capacity Depending on Previous Service Time

Authors: Yutae Lee

Abstract:

This paper considers a discrete-time bulk-arrival bulkservice queueing system, where service capacity varies depending on the previous service time. By using the generating function technique and the supplementary variable method, we compute the distributions of the queue length at an arbitrary slot boundary and a departure time.

Keywords: discrete-time queue, bulk queue, variable service capacity, queue length distribution

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4394 Research on Health Emergency Management Based on the Bibliometrics

Authors: Meng-Na Dai, Bao-Fang Wen, Gao-Pei Zhu, Chen-Xi Zhang, Jing Sun, Chang-Hai Tang, Zhi-Qiang Feng, Wen-Qiang Yin

Abstract:

Based on the analysis of literature in the health emergency management in China with recent 10 years, this paper discusses the Chinese current research hotspots, development trends and shortcomings in this field, and provides references for scholars to conduct follow-up research. CNKI(China National Knowledge Infrastructure), Weipu, and Wanfang were the databases of this literature. The key words during the database search were health, emergency, and management with the time from 2009 to 2018. The duplicate, non-academic, and unrelated documents were excluded. 901 articles were included in the literature review database. The main indicators of abstraction were, the number of articles published every year, authors, institutions, periodicals, etc. There are some research findings through the analysis of the literature. Overall, the number of literature in the health emergency management in China has shown a fluctuating downward trend in recent 10 years. Specifically, there is a lack of close cooperation between authors, which has not constituted the core team among them yet. Meanwhile, in this field, the number of high-level periodicals and quality literature is scarce. In addition, there are a lot of research hotspots, such as emergency management system, mechanism research, capacity evaluation index system research, plans and capacity-building research, etc. In the future, we should increase the scientific research funding of the health emergency management, encourage collaborative innovation among authors in multi-disciplinary fields, and create high-quality and high-impact journals in this field. The states should encourage scholars in this field to carry out more academic cooperation and communication with the whole world and improve the research in breadth and depth. Generally speaking, the research in health emergency management in China is still insufficient and needs to be improved.

Keywords: health emergency management, research situation, bibliometrics, literature

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4393 Introduction of Digital Radiology to Improve the Timeliness in Availability of Radiological Diagnostic Images for Trauma Care

Authors: Anuruddha Jagoda, Samiddhi Samarakoon, Anil Jasinghe

Abstract:

In an emergency department ‘where every second count for patient’s management’ timely availability of X- rays play a vital role in early diagnosis and management of patients. Trauma care centers rely heavily on timely radiologic imaging for patient care and radiology plays a crucial role in the emergency department (ED) operations. A research study was carried out to assess timeliness of availability of X-rays and total turnaround time at the Accident Service of National Hospital of Sri Lanka which is the premier trauma center in the country. Digital Radiology system was implemented as an intervention to improve the timeliness of availability of X-rays. Post-implementation assessment was carried out to assess the effectiveness of the intervention. Reduction in all three aspects of waiting times namely waiting for initial examination by doctors, waiting until X –ray is performed and waiting for image availability was observed after implementation of the intervention. However, the most significant improvement was seen in waiting time for image availability and reduction in time for image availability had indirect impact on reducing waiting time for initial examination by doctors and waiting until X –ray is performed. The most significant reduction in time for image availability was observed when performing 4-5 X rays with DR system. The least improvement in timeliness was seen in patients who are categorized as critical.

Keywords: emergency department, digital radilogy, timeliness, trauma care

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4392 A Conceptualization of the Relationship between Frontline Service Robots and Humans in Service Encounters and the Effect on Well-Being

Authors: D. Berg, N. Hartley, L. Nasr

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This paper presents a conceptual model of human-robot interaction within service encounters and the effect on the well-being of both consumers and service providers. In this paper, service providers are those employees who work alongside frontline service robots. The significance of this paper lies in the knowledge created which outlines how frontline service robots can be effectively utilized in service encounters for the benefit of organizations and society as a whole. As this paper is conceptual in nature, the main methodologies employed are theoretical, namely problematization and theory building. The significance of this paper is underpinned by the shift of service robots from manufacturing plants and factory floors to consumer-facing service environments. This service environment places robots in direct contact with frontline employees and consumers creating a hybrid workplace where humans work alongside service robots. This change from back-end to front-end roles may have implications not only on the physical environment, servicescape, design, and strategy of service offerings and encounters but also on the human parties of the service encounter itself. Questions such as ‘how are frontline service robots impacting and changing the service encounter?’ and ‘what effect are such changes having on the well-being of the human actors in a service encounter?’ spring to mind. These questions form the research question of this paper. To truly understand social service robots, an interdisciplinary perspective is required. Besides understanding the function, system, design or mechanics of a service robot, it is also necessary to understand human-robot interaction. However not simply human-robot interaction, but particularly what happens when such robots are placed in commercial settings and when human-robot interaction becomes consumer-robot interaction and employee-robot interaction? A service robot in this paper is characterized by two main factors; its social characteristics and the consumer-facing environment within which it operates. The conceptual framework presented in this paper contributes to interdisciplinary discussions surrounding social robotics, service, and technology’s impact on consumer and service provider well-being, and hopes that such knowledge will help improve services, as well as the prosperity and well-being of society.

Keywords: frontline service robots, human-robot interaction, service encounters, well-being

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4391 Flexible Development and Calculation of Contract Logistics Services

Authors: T. Spiegel, J. Siegmann, C. F. Durach

Abstract:

Challenges resulting from an international and dynamic business environment are increasingly being passed on from manufacturing companies to external service providers. Especially providers of complex, customer-specific industry services have to cope with continuously changing requirements. This is particularly true for contract logistics service providers. They are forced to develop efficient and highly flexible structures and strategies to meet their customer’s needs. One core element they have to focus on is the reorganization of their service development and sales process. Based on an action research approach, this study develops and tests a concept to streamline tender management for contract logistics service providers. The concept of modularized service architecture is deployed in order to derive a practice-oriented approach for the modularization of complex service portfolios and the design of customized quotes. These findings are evaluated regarding their applicability in other service sectors and practical recommendations are given.

Keywords: contract logistics, modularization, service development, tender management

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4390 The Impact of a Staff Well-Being Service for a Multi-Site Research Study

Authors: Ruth Elvish, Alex Turner, Jen Wells

Abstract:

Over recent years there has been an increasing interest in the topic of well-being at work, and staff support is an area of continued growth. The present qualitative study explored the impact of a staff well-being service that was specifically attached to a five-year multi-site research programme (the Neighbourhoods and Dementia Study, funded by the ESRC/NIHR). The well-being service was led by a clinical psychologist, who offered 1:1 sessions for staff and co-researchers with dementia. To our knowledge, this service was the first of its kind. Methodology: Interviews were undertaken with staff who had used the service and who opted to take part in the study (n=7). Thematic analysis was used as the method of analysis. Findings: Themes included: triggers, mechanisms of change, impact/outcomes, and unique aspects of a dedicated staff well-being service. Conclusions: The study highlights stressors that are pertinent amongst staff within academic settings, and shows the ways in which a dedicated staff well-being service can impact on both professional and personal lives. Positive change was seen in work performance, self-esteem, relationships, and coping. This exploratory study suggests that this well-being service model should be further trialled and evaluated.

Keywords: academic, service, staff, support, well-being

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