Search results for: obstacles to healthcare accessibility

Authors: Terezie Bartusková, Jitka Baňařová, Zuzana Kusněřová

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Importance of strategic planning is unquestionable. However, the practical implementation of a strategic plan faces too many obstacles. The aim of the article is explained the importance of strategic planning and to find how companies in Moravian-Silesian Region deal with strategic planning, and to introduce the model, which helps to set strategic goals in financial indicators area. This model should be part of the whole process of strategic planning and can be use to predict the future values of financial indicators of the company with regard to the factor, which influence these indicators.

Keywords: Planning of Potentials, Planning of Strategic Objectives, Portfolio Planning, Significant Factors, Strategic Planning.

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Authors: P. Phenpun, S. Wareewan

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This qualitative study aimed to describe the opinions in relation to humanized care emerging from the volunteer activities of nursing students at Boromarajonani College of Nursing, Chonburi, Thailand. One hundred and twenty-seven second-year nursing students participated in this study. The volunteer activity model was composed of preparation, implementation, and evaluation through a learning log, in which students were encouraged to write their daily activities after completing practical training at the healthcare center. The preparation content included three main categories: service minded, analytical thinking, and client participation. The preparation process took over three days that accumulates up to 20 hours only. The implementation process was held over 10 days, but with a total of 70 hours only, with participants taking part in volunteer work activities at a healthcare center. A learning log was used for evaluation and data were analyzed using content analysis. The findings were as follows. With service minded, there were two subcategories that emerged from volunteer activities, which were service minded towards patients and within themselves. There were three categories under service minded towards patients, which were rapport, compassion, and empathy service behaviors, and there were four categories under service minded within themselves, which were self-esteem, self-value, management potential, and preparedness in providing good healthcare services. In line with analytical thinking, there were two components of analytical thinking, which were analytical skill for their works and analytical thinking for themselves. There were four subcategories under analytical thinking for their works, which were evidence based thinking, real situational thinking, cause analysis thinking, and systematic thinking, respectively. There were four subcategories under analytical thinking for themselves, which were comparative between themselves, towards their clients that leads to the changing of their service behaviors, open-minded thinking, modernized thinking, and verifying both verbal and non-verbal cues. Lastly, there were three categories under participation, which were mutual rapport relationship; reconsidering client’s needs services and providing useful health care information.

Keywords: Humanized care service, volunteer activity, nursing student, and learning log.

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Authors: Cheng-Chia Yang , Yi-Shun Wang , Sue-Ting Chang, Suh-Er Guo, Mei-Fen Huang

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Object: Review recent publications of patient safety culture to investigate the relationship between leadership behavior, safety culture, and safety performance in the healthcare industry. Method: This study is a cross-sectional study, 350 questionnaires were mailed to hospital workers with 195 valid responses obtained, and a 55.7% valid response rate. Confirmatory factor analysis (CFA) was carried out to test the factor structure and determine if the composite reliability was significant with a factor loading of >0.5, resulting in an acceptable model fit. Results: Through the analysis of One-way ANOVA, the results showed that physicians significantly have more negative patient safety culture perceptions and safety performance perceptions than non- physicians. Conclusions: The path analysis results show that leadership behavior affects safety culture and safety performance in the health care industry. Safety performance was affected and improved with contingency leadership and a positive patient safety organization culture. The study suggests improving safety performance by providing a well-managed system that includes: consideration of leadership, hospital worker training courses, and a solid safety reporting system.

Keywords: Leadership Behavior, Patient Safety, Safety Culture, Safety Performance

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Authors: Haroula N. Delopoulos

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In this article a bibliography research takes place to track down and introduce the barriers and opportunities for the adoption of e-Governance services mainly from the side of citizen, that is to say, the demand side. Although governments invest continuously in producing of e-Governance services, citizens face difficulties to adopt these services. Barriers derive and prevent them from using e-Governance services. Barrier is anything preventing citizens from the adoption of e-Governance services. Barriers impede or do not allow the adoption of e-Governance services by the citizens. If the barriers are pinpointed, it will be possible to take them into consideration while designing e-Governance services which the citizens are likely to use, if the obstacles are raised. The barriers will thus be converted in opportunities that will facilitate the adoption.

Keywords: adoption, barriers, e-governance services, eparticipation, opportunities.

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Authors: T.C. Manjunath,

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This paper features the trajectory planning design of a indigenously developed 4-Axis SCARA robot which is used for doing successful robotic manipulation task in the laboratory. Once, a trajectory is being designed and given as input to the robot, the robot's gripper tip moves along that specified trajectory. Trajectories have to be designed in the work space only. The main idea of this paper is to design a continuous path trajectory model for the indigenously developed SCARA robot arm during its maneuvering from one point to another point (during pick and place operations) in a workspace avoiding all the obstacles in its path of motion.

Keywords: SCARA, Trajectory, Planning.

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Authors: Leslie Beale

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Being a patient with a chronic disease is both a physical and emotional experience. The ability to recognize a patient’s emotional health is an important part of a health care provider’s skills. For the purposes of this paper, emotional health is viewed as the way that we feel, and the way that our feelings affect us. Understanding the patient’s emotional health leads to improved provider-patient relationships and health outcomes. For example, when a patient first hears his or her diagnosis from a provider, they might find it difficult to cope with their emotions. Struggling to cope with emotions interferes with the patient’s ability to read, understand, and act on health information and services. As a result, the patient becomes more frustrated and confused, creating barriers to accessing healthcare services. These barriers are challenging for both the patient and their healthcare providers. There are five basic emotions that are part of who we are and are always with us: fear, anger, sadness, joy, and compassion. Living with a chronic disease however can cause a patient to experience and express these emotions in new and unique ways. Within the provider-patient relationship, there needs to be an understanding that each patient experiences these five emotions and, experiences them at different times. In response to this need, the paper highlights a health promotion framework for patients with chronic disease. This framework emphasizes the emotional health of patients.

Keywords: Health promotion, emotional health, patients with chronic disease, patient-centered care.

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Authors: Chien-Hua Wang, Meng-Ying Chou, Chin-Tzong Pang

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This paper applies fuzzy AHP to evaluate the service quality of online auction. Service quality is a composition of various criteria. Among them many intangible attributes are difficult to measure. This characteristic introduces the obstacles for respondents on reply in the survey. So as to overcome this problem, we invite fuzzy set theory into the measurement of performance and use AHP in obtaining criteria. We found the most concerned dimension of service quality is Transaction Safety Mechanism and the least is Charge Item. Other criteria such as information security, accuracy and information are too vital.

Keywords: Fuzzy set theory, AHP, Online auction, Service quality

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Authors: V. Durmus, M. Uydaci

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In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.

Keywords: Malpractice mediation, medical disputes, reconciliation, health litigation, Turkish Health Law.

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Authors: Wei-Hsuan Lee, Chien-Hua Wang, Chin-Tzong Pang

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This paper applies fuzzy set theory to evaluate the service quality of online auction. Service quality is a composition of various criteria. Among them many intangible attributes are difficult to measure. This characteristic introduces the obstacles for respondent in replying to the survey. So as to overcome this problem, we invite fuzzy set theory into the measurement of performance. By using AHP in obtaining criteria and TOPSIS in ranking, we found the most concerned dimension of service quality is Transaction Safety Mechanism and the least is Charge Item. Regarding to the most concerned attributes are information security, accuracy and information.

Keywords: AHP, Fuzzy set theory, TOPSIS, Online auction, Servicequality

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Authors: M. Kebisek, L. Spendla, M. Kopcek, T. Skulavik

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In our paper we describe the security capabilities of data collection. Data are collected with probes located in the near and distant surroundings of the company. Considering the numerous obstacles e.g. forests, hills, urban areas, the data collection is realized in several ways. The collection of data uses connection via wireless communication, LAN network, GSM network and in certain areas data are collected by using vehicles. In order to ensure the connection to the server most of the probes have ability to communicate in several ways. Collected data are archived and subsequently used in supervisory applications. To ensure the collection of the required data, it is necessary to propose algorithms that will allow the probes to select suitable communication channel.

Keywords: Communication, computer network, data collection, probe.

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Authors: Zhenkun Wang, Simon S. Gao

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Using a scoring system, this paper provides a comparative assessment of the quality of data between XBRL formatted financial reports and non-XBRL financial reports. It shows a major improvement in the quality of data of XBRL formatted financial reports. Although XBRL formatted financial reports do not show much advantage in the quality at the beginning, XBRL financial reports lately display a large improvement in the quality of data in almost all aspects. With the improved XBRL web data managing, presentation and analysis applications, XBRL formatted financial reports have a much better accessibility, are more accurate and better in timeliness.

Keywords: Data Quality; Financial Report; Information; XBRL

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Authors: Christopher C. Anyadubalu

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Biological, psychological and social experiences and perceptions of healthcare services in patients medically diagnosed of coronary heart disease were investigated using a sample of 10 participants whose responses to the in-depth interview questions were analyzed based on inter-and-intra-case analyses. The results obtained revealed that advancing age, single status, divorce and/or death of spouse and the issue of single parenting negatively impacted patients- biopsychosocial experiences. The patients- experiences of physical signs and symptoms, anxiety and depression, past serious medical conditions, use of self-prescribed medications, family history of poor mental/medical or physical health, nutritional problems and insufficient physical activities heightened their risk of coronary attack. Collectivist culture served as a big source of relieve to the patients. Patients- temperament, experience of different chronic life stresses/challenges, mood alteration, regular drinking, smoking/gambling, and family/social impairments compounded their health situation. Patients were satisfied with the biomedical services rendered by the healthcare personnel, whereas their psychological and social needs were not attended to. Effective procedural treatment model, a holistic and multidimensional approach to the treatment of heart disease patients was proposed.

Keywords: Biopsychosocial, Coronary Heart Disease, Experience, Patients, Perception, Perspective.

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Authors: Ibrahim A. Alkali

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There is no reservation on the outstanding contribution of patient families in restoration of hospitalised patients, hence their consideration as essential component of hospital ward regimen. The psychological and emotional support a patient requires has been found to be solely provided by the patient’s family. However, consideration of their presence as one of the major functional requirements of an inpatient setting design have always been a source of disquiet, especially in developing countries where policies, norms and protocols of healthcare administration have no consideration for the patients’ family. This have been a major challenge to the hospital ward facilities, a concern for the hospital administration and patient management. The study therefore is aimed at obtaining a consensus opinion on the best approach for family integration in the design of an inpatient setting.  A one day visioning charrette involving Architects, Nurses, Medical Doctors, Healthcare assistants and representatives from the Patient families was conducted with the aim of arriving at a consensus opinion on practical design approach for sustainable family integration. Patient’s family are found to be decisive character of hospital ward regimen that cannot be undermined. However, several challenges that impede family integration were identified and subsequently a recommendation for an ideal approach. This will serve as a guide to both architects and hospital management in implementing much desired Patient and Family Centred Care.

Keywords: Caregiving, Inpatient setting, Integration, Patient Families.

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Authors: Jiraporn Adchariyaprasit

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Thai language is difficult in all four language skills, especially reading. The first year students may have different abilities in reading, so a teacher is required to find out a student’s reading level so that the teacher can help and support them till they can develop and resolve each problem themselves. This research is aimed to study the prosody problem among Thai students and will be focused on first year Thai students in the second semester. A total of 58 students were involved in this study. Four obstacles were found: 1. Interpretation from what they read and write 2. Incorrectness Pronunciation of Prosody 3. Incorrectness in Rhythm of the Poem 4. Incorrectness of the Thai Poem Pronunciation

Keywords: Interpretation, Pronunciation, Prosody, Reading.

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Authors: Rawinun Praserttaweelap, Somyot Kiatwanidvilai

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Obstacle avoidance is the one key for the robot system in unknown environment. The robots should be able to know their position and safety region. This research starts on the path planning which are SLAM and AMCL in ROS system. In addition, the best parameters of the obstacle avoidance function are required. In situation on Hard Disk Drive Manufacturing, the distance between robots and obstacles are very serious due to the manufacturing constraint. The simulations are accomplished by the SLAM and AMCL with adaptive velocity and safety region calculation.

Keywords: Obstacle avoidance, simultaneous localization and mapping, adaptive Monte Carlo localization, KLD sampling.

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Authors: Mohammad Shaifur Rahman, Jung Hyun Lee, Youngil Park, Ki-Doo Kim

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In this paper, an overview of the radio over fiber (RoF) technology is provided. Obstacles for reducing the capital and operational expenses in the existing systems are discussed in various perspectives. Some possible RoF deployment scenarios for WiMAX data transmission are proposed as a means for capital and operational expenses reduction. IEEE 802.16a standard based end-to-end physical layer model is simulated including intensity modulated direct detection RoF technology. Finally the feasibility of RoF technology to carry WiMAX signals between the base station and the remote antenna units is demonstrated using the simulation results.

Keywords: IMDD, Radio over Fiber, Remote Antenna Unit, WiMAX.

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Authors: František Bozek, Alexandr Bozek, Alena Bumbova, Eduard Bakos, Jiri Dvorak

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The article deals with the classification of alternative water resources in terms of potential risks which is the prerequisite for incorporating these water resources to the emergency plans. The classification is based on the quantification of risks resulting from possible damage, disruption or total destruction of water resource caused by natural and anthropogenic hazards, assessment of water quality and availability, traffic accessibility of the assessed resource and finally its water yield. The aim is to achieve the development of an integrated rescue system, which will be capable of supplying the population with drinking water on the whole stricken territory during the states of emergency.

Keywords: Classification, Emergency Supply, Risk, Water Standby Resource.

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Authors: Guosheng Wu, Luning Wang, Changyuan Fan, Xi Zhu

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This paper provides a new approach to solve the motion planning problems of flying robots in uncertain 3D dynamic environments. The robots controlled by this method can adaptively choose the fast way to avoid collision without information about the shapes and trajectories of obstacles. Based on sphere coordinates the new method accomplishes collision avoidance of flying robots without any other auxiliary positioning systems. The Self-protection System gives robots self-protection abilities to work in uncertain 3D dynamic environments. Simulations illustrate the validity of the proposed method.

Keywords: Collision avoidance, Mobile robots, Motion-planning, Sphere coordinates, Self-protection.

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Authors: Rujijan Vichivanives

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This research aims to create a knowledge-based system as a database for self-healthcare analysis, diagnosis of simple illnesses, and the use of Thai herbs instead of modern medicine by using principles of Thai traditional medication theory. These were disseminated by website network programs within Suan Sunandha Rajabhat University. The population used in this study was divided into two groups: the first group consisted of four experts of Thai traditional medication and the second group was 300 website users. The methods used for collecting data were paper questionnaires and poll questionnaires on the website. The statistics used for analyzing data was at an average level. The results were divided into three parts: the first part was the development of a knowledge-based system and the second part was applied programs on website. Both parts could be fulfilled and achieved according to the set goal. The third part was the evaluation of the study: The evaluation of the viewpoints of the experts towards website designs were evaluated at a good level of 4.20. The satisfaction evaluation of the users was found at a good level of average satisfactory level at 4.24. It was found that the young population of those under the age of 16 had less cares about their health than the population of other teenagers, working age adults and those of older age. The research findings should be extended in order to encourage the lifestyle modifications to people of all ages by using the self-healthcare principles.

Keywords: Developing, Herbs, Knowledge-based system, Medical treatment.

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Authors: Suriyon Tansuriyavong, Yuuta Suzuki, Boonmee Choompol

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Wheel-running type moving robot has the restriction on the moving range caused by obstacles or stairs. Solving this weakness, we studied the development of moving robot using airship. Our airship robot moves by recognizing arrow marks on the path. To have the airship robot recognize arrow marks, we used edge-based template matching. To control propeller units, we used PID and PD controller. The results of experiments demonstrated that the airship robot can move along the marks and can go up and down the stairs. It is shown the possibility that airship robot can become a robot which can move at wide range facilities.

Keywords: Template matching, moving robot, airship robot, PID control.

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Authors: Farhan Ismaeel Dakheel, Raoof Smko, K. Negrat, Abdelsalam Almarimi

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In this paper we used data mining techniques to identify outlier patients who are using large amount of drugs over a long period of time. Any healthcare or health insurance system should deal with the quantities of drugs utilized by chronic diseases patients. In Kingdom of Bahrain, about 20% of health budget is spent on medications. For the managers of healthcare systems, there is no enough information about the ways of drug utilization by chronic diseases patients, is there any misuse or is there outliers patients. In this work, which has been done in cooperation with information department in the Bahrain Defence Force hospital; we select the data for Cardiac patients in the period starting from 1/1/2008 to December 31/12/2008 to be the data for the model in this paper. We used three techniques for finding the drug utilization for cardiac patients. First we applied a clustering technique, followed by measuring of clustering validity, and finally we applied a decision tree as classification algorithm. The clustering results is divided into three clusters according to the drug utilization, for 1603 patients, who received 15,806 prescriptions during this period can be partitioned into three groups, where 23 patients (2.59%) who received 1316 prescriptions (8.32%) are classified to be outliers. The classification algorithm shows that the use of average drug utilization and the age, and the gender of the patient can be considered to be the main predictive factors in the induced model.

Keywords: Data Mining, Clustering, Classification, Drug Utilization..

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Authors: Ntokozo C. Mthembu

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The notion of sustainable chemistry has become significant in the discourse for a global post-colonial era, including South Africa, especially when it comes to access to the general health system and related policies in relation to disease or ease of human life. In view of the stubborn vestiges of coloniality in the daily lives of indigenous African people in general, the fundamentals of present Western medical and traditional medicine systems and related policies in the democratic era were examined in this study. The situation of traditional healers in relation to current policy was also reviewed. The advent of democracy in South Africa brought about a variety of development opportunities and limitations, particularly with respect to indigenous African knowledge systems such as traditional medicine. There were high hopes that the limitations of previous narrow cultural perspectives would be rectified in the democratic era through development interventions, but some sections of society, such as traditional healers, remain marginalised. The Afrocentric perspective was explored in dissecting government interventions related to traditional medicine. This article highlights that multiple medical systems should be adopted and that health policies should be aligned in order to guarantee mutual respect and to address the remnants of colonialism in South Africa, Africa and the broader global community.

Keywords: Traditional healing system, healers, pluralist healthcare system, post-colonial era.

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Authors: Imane Chikhi, Hafida Abed

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The significant growth in the use of technologies in all life domains created numerous hurdles that derailed many knowledge management projects. Cloud computing choices are commencement to untangle these obstacles. Linking Cloud computing with knowledge management (KM) is a challenging task. Small amount of researches have been done regarding cloud computing and KM. In this paper, we consider Cloud-based KM as a new KM approach, and study the contribution of Cloud Computing to organizational KM. In fact, KM and cloud computing have many things in common, this similarity allows deriving very interesting features. Our approach is based on these features and focuses on the advantages of Cloud computing in the context of organizational KM. Finally, we highlight some challenges that have to be addressed when adopting a Cloud Computing approach to KM.

Keywords: Knowledge management, cloud computing, knowledge management approaches, cloud-based knowledge management.

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Authors: Walid MOUDANI

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The healthcare environment is generally perceived as being information rich yet knowledge poor. However, there is a lack of effective analysis tools to discover hidden relationships and trends in data. In fact, valuable knowledge can be discovered from application of data mining techniques in healthcare system. In this study, a proficient methodology for the extraction of significant patterns from the Coronary Heart Disease warehouses for heart attack prediction, which unfortunately continues to be a leading cause of mortality in the whole world, has been presented. For this purpose, we propose to enumerate dynamically the optimal subsets of the reduced features of high interest by using rough sets technique associated to dynamic programming. Therefore, we propose to validate the classification using Random Forest (RF) decision tree to identify the risky heart disease cases. This work is based on a large amount of data collected from several clinical institutions based on the medical profile of patient. Moreover, the experts- knowledge in this field has been taken into consideration in order to define the disease, its risk factors, and to establish significant knowledge relationships among the medical factors. A computer-aided system is developed for this purpose based on a population of 525 adults. The performance of the proposed model is analyzed and evaluated based on set of benchmark techniques applied in this classification problem.

Keywords: Multi-Classifier Decisions Tree, Features Reduction, Dynamic Programming, Rough Sets.

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Authors: Carlos V. Regueiro, Jose E. Domenech, Roberto Iglesias, Jose L. Correa

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In this work a visual and reactive contour following behaviour is learned by reinforcement. With artificial vision the environment is perceived in 3D, and it is possible to avoid obstacles that are invisible to other sensors that are more common in mobile robotics. Reinforcement learning reduces the need for intervention in behaviour design, and simplifies its adjustment to the environment, the robot and the task. In order to facilitate its generalisation to other behaviours and to reduce the role of the designer, we propose a regular image-based codification of states. Even though this is much more difficult, our implementation converges and is robust. Results are presented with a Pioneer 2 AT on a Gazebo 3D simulator.

Keywords: Image-based State Codification, Mobile Robotics, ReinforcementLearning, Visual Behaviour.

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Authors: Tarig Mohamed Ahmed

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The usage of internet is rapidly increasing and the usage of mobile agent technology in internet environment has a great demand. The security issue one of main obstacles that restrict the mobile agent technology to spread. This paper proposes Secure-Image Mechanism (SIM) as a new mechanism to protect mobile agents against malicious hosts. . SIM aims to protect mobile agent by using the symmetric encryption and hash function in cryptography science. This mechanism can prevent the eavesdropping and alteration attacks. It assists the mobile agents to continue their journey normally incase attacks occurred.

Keywords: Agent protection, cryptography, mobile agent security.

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Authors: Syadiah Nor Wan Shamsuddin, Valerie Lesk , Hassan Ugail

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Early detection of dementia by testing the spatial memory can be applied using a virtual environment. This paper presents guidelines on how to design a virtual environment specifically for elderly in early detection of dementia. The specific design needs to be considered because the effectiveness of the technology relies on the ability of the end user to use it. The primary goal of these guidelines is to promote accessibility. Based on these guidelines, a virtual simulation was developed and evaluated. The results on usability of acceptance and satisfaction that are tested on young (control group) and elderly participants indicate that these guidelines are reliable and useful for use with elderly people.

Keywords: Virtual Environment, spatial memory, design, guidelines

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Authors: Babak Tashakori Bafghi, Laleh Tashakori, Reza Allahyari Soeini, Mohammad Mokhtari

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Supplier selection is a multi criteria decision-making process that comprises tangible and intangible factors. The majority of previous supplier selection techniques do not consider strategic perspective. Besides, uncertainty is one of the most important obstacles in supplier selection. For the first, time in this paper, the idea of the algorithm " Knapsack " is used to select suppliers Moreover, an attempt has to be made to take the advantage of a simple numerical method for solving model .This is an innovation to resolve any ambiguity in choosing suppliers. This model has been tried in the suppliers selected in a competitive environment and according to all desired standards of quality and quantity to show the efficiency of the model, an industry sample has been uses.

Keywords: Knapsack, linear programming, supplier select, supply chain management.

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Authors: G. Feletti, D. Tedesco, P. Trucco

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The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of a first phase of revision of the technical-scientific literature concerning the indicators currently in use for the performance measurement of EMS. It emerges that current studies focus on two distinct areas and independent objectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). Conversely, the perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal covers the end-to-end healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid even to EMS aspects that in current literature tend to be neglected or underestimated. In particular, the integration of the two processes enables to evaluate the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering, besides the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating firstly the ones not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draw us to exclude additional indicators due to unavailability of data required for their computation. The final dashboard, that was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness on EDs accessibility in real time. The association of each KPI to the EMS phase it refers to enabled the design of a well-balanced dashboard, covering both efficiency and effectiveness performance objectives of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient care are covered by traditional KPIs. Future developments could be directed to building a hierarchical dashboard, composed by a high-level minimal set of KPIs for measuring the basic performance of the EMS system, at an aggregate level, and lower levels of KPIs that bring additional and more detailed information on specific performance dimensions or EMS phases.

Keywords: Emergency Medical Services, Key Performance Indicators, Dashboard, Decision Support.

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Authors: Rabi W. Yousif, Mohd Asri Hj Mansor

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In this paper, we present a novel technique called Self-Learning Expert System (SLES). Unlike Expert System, where there is a need for an expert to impart experiences and knowledge to create the knowledge base, this technique tries to acquire the experience and knowledge automatically. To display this technique at work, a simulation of a mobile robot navigating through an environment with obstacles is employed using visual basic. The mobile robot will move through this area without colliding with any obstacle and save the path that it took. If the mobile robot has to go through a similar environment again, then it will apply this experience to help it move through quicker without having to check for collision.

Keywords: Expert system, knowledge base, mobile robot, visual basic.

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