Hierarchical Task Analysis Reimagined as a Planning Tool for Surgery During Exploration Space Flight

Background: Preparation for exploration class space flight requires planning to support human life in many circumstances including healthcare emergencies such as the need for acute surgical care, a notable example of which is appendicitis. Although performing a laparoscopic appendectomy on Earth is routine for a trained general surgeon, it is far from routine for a non-surgeon working in microgravity where IVs do not drip, drains do not drain, and gaseous anesthetic is out of the question. Because the procedure for laparoscopic appendectomy is so well documented, it was the ideal procedure on which to base a study on how to deconstruct a surgical procedure to examine all actions, skills, equipment, and supplies needed for success by non-surgeons working in an extreme environment. Study Design: Our challenge was to develop a task analysis model robust enough to include 3 performers (in the roles of surgeon, assistant, and anesthesiologist) including each action and instrument or supply item needed in chronological order, while indicating which actions were completed independently and which were done in tandem. We also had to indicate where variations in the actions would be determined by the negative response of the patient (failure mode), and which actions and supply items needed further research to accommodate working in microgravity. We opted to begin with a hierarchical task analysis model (HTA) because the steps in the task are sequential; but we expanded the typical linear presentation of data to a multi-column spread sheet with active links to instructional video clips where needed. Content development was an iterative process beginning with a scoping review of literature to select a baseline task analysis of the procedure. The SAGES 2010 approach was selected as most comprehensive, but logically focused on the surgeon’s performance with few references to the assistant or anesthesiologist. Those gaps were filled using content from training materials developed for surgical technicians and nurse anesthetists. The second step was an expert review of the spread sheet to identify gaps and inadequacies. The third step was a minute comparison of spread sheet content to actions and equipment as documented on 2 videotapes of the procedure performed by our team surgeon on otherwise healthy patients. The final review was accomplished by replicating the procedure on 360° video (with narration) using the spread sheet as a guide, then cross checking and correcting the spread sheet to correspond with the 360° video. This test procedure was performed on a lightly preserved, fresh cadaver since working at that very slow, deliberate pace would not be in the best interest of an actual patient. Results: In this study, simulation was actually used to test the expanded HTA rather than to evaluate a learner. The final spread sheet included 178 lines, 13 columns, 13 illustrations, and 4 active links to instructional video clips. Thirteen items or issues were identified as needing further research, 8 action sequences were identified as generalizable skills, and 27 supply or equipment items were identified as multipurpose. Excluding the pharmaceuticals necessary for IV general anesthesia (that research is on-going), we were able to replicate a laparoscopic appendectomy on a fresh cadaver using no more than 30 items. The procedure was done using 3 trocars with very few instrument exchanges through the trocars since the surgical assistant assumed the role of laparoscopic camera operator during the procedure. Conclusion: An expanded HTA of a surgical procedure can produce many useful outcomes including integrated training for all team members, review of instrumentation and supplies and, in our case, identifying areas for adapting to an extreme environment. Using an interdisciplinary team including instructional designers, subject matter experts from medicine and biomedical engineering, and media production enriched the process.

Desain Tampilan Aplikasi Sistem Pelayanan Masyarakat Desa Dengan Metode Goal-Directed Design

Desa merupakan tonggak awal dari suksesnya pemerintahan, semua data-data pemerintahan berawal berasal dari desa yang nanti data tersebut diproses lebih lanjut. Dengan demikian dibutuhkan suatu aplikasi agar data tersebut dapat diproses dengan mudah. Banyaknya kendala yang dialami oleh desa, khususnya desa sukamanah diSerang banten. Dimana pelayanan merupakan bagian dari permasalah yang sering terjadi dikarenakan masih menggunakan pelayanan yang bersifat manual. Komputer yang pada desa sukaman Serang banten Hanya sebagai proses penyimpanan data, namun kegiatan pelayanannya warga masih harus datang dan kadang dalam mengurus kartu keluarga warga bisa beberapa Kali harus datang ke desa tersebut. Sehingga diharapkan dengan adanya aplikasi pelayanan desa membuat proses pelayannya kepada warga desa menjadi lebih cepat. Penelitian ini bertujuan untuk merancang aplikasi pelayanan masyarakat desa berdasarkan kebutuhan pihak desa Sukamanah pada sistem informasi desa dengan menggunakan metode Goal-Directed Design yang terdiri dari 6 fase. Fase research, mencari kebutuhan sistem yang diinginkan oleh pengguna. Fase modelling,mencari karakteristik pengguna dengan membuat user persona. Fase requirement, menghasilkan skenario pengguna dan menjelaskan kebutuhan sistem dengan menggunakan Hierarchical Task Analysis. Fase framework definition, membuat struktur antar muka dalam bentuk wireframing. Fase refinement, menyempurnakan struktur antar muka ke bentuk high-fidelity. Fase development support, merupakan fase pengujian kualitatif kepada pengguna dengan menggunakan penilaian berdasarkan System Usability Scale (SUS) untuk mendapatkan umpan balik terhadap prototype sistem informasi desa yang sesuai dengan kebutuhan.

The Impact Of Covid-19 Pandemic On Nurses’ Behavior For Updating Assessment Results By Using The Electronic Medical Record Log Data In A Non- Covid Intensive Care Unit

The primary objective of this paper is to explore whether COVID-19 affects nurses’ behavior on updating assessment results in EMRs in an intensive care unit (ICU) and analyze how the patterns of updating assessment results can be different. The study considered information from March (before the pandemic) and July (during the pandemic) in terms of average process time and frequency. In this study, the response-time measurement system data was used to analyze ICU nurses’ workflow related to EMR documentation. After that, multiple hierarchical task analysis (HTA) charts were developed to find different EMR documentation patterns for assessment results. The results revealed that these patterns were significantly different in terms of average process time and frequency before and during the pandemic. The finding of this study might reveal the possible impact of COVID-19 pandemic on the patterns of updating patient assessment results and how nurses’ preferences can be different in terms of average process time and frequency.

FAKTOR-FAKTOR KESELAMATAN PENGOPERASIAN ALAT TANGKAP PURSE SEINE DI KEPULAUAN RIAU

Safety work on board in connection with capture fisheries specifically has the aim of preventing or reducing accidents and their consequences in the possibility of hazards and risks when carrying out activities on board. The purpose of this study was to describe the fishing operation activities using purse seine fishing gear that can pose risks and identify opportunities for failure and possible consequences that will occur when carrying out fishing activities and to determine the role of safety work on board. The research method used Hierarchical Task Analysis (HTA) to examine every activity involved in the operation of the purse seine fishing gear by dividing each activity into sub-activities carried out in the plan and descriptively utilizing problem-solving procedures investigated by describing the condition of the subject or object. The operation of purse seine fishing gear in Batam City has the potential to cause fatigue, injury, drowning, injury consequences. There are 58 activities out of 8 activity stages in the operation of the purse seine fishing gear with a Total Work Intensity (IKT) value of 557 OA (Activity Person). The value of Primary Work Intensity (IKP) at the hauling stage was the highest (0.317) with a total work intensity of 154 OA.

Combining hierarchical task analysis and usage scenarios to help embed human factors in design

The introductory design course in Mechanical and Industrial Engineering at Ryerson University combines Human Factors (HF) and Design. Due to its unique character, we have developed custom courseware. In recent years the instructors have noticed four specific shortcomings in students’ abilities to incorporate HF into their designs. We are developing new courseware that focuses on embedding HF considerations into the requirements specification stage. The courseware incorporates a novel combination of Hierarchical Task Analysis (a well-known method) with Usage Scenarios (a method of Salustri’s invention, based on the work of Stone and Wood). We further alter the courseware in several other ways to minimize the amount of documentation that students need to provide, while still capturing their decision-making process well enough to allow appropriate assessments. A plan for implementing and assessing the proposed work is also presented. Keywords: engineering design, human factors, hierarchical task analysis, courseware, user experience

Analisis Human Reliability Assessment (HRA) dengan Metode HEART dan SPAR-H (Studi Kasus PT.X)

PT. X merupakan perusahaan yang bergerak dibidang kontruksi jalan dan jembatan. Penelitian ini dilakukan pada proyek pembuatan drainase, dengan 5 tahap yaitu persiapan, pemotongan, perakitan, pengecoran dan pemasangan. Terdapat beberapa kemungkinan kecelakaan kerja yang disebabkan oleh human error, dengan penerapan Human Reliability Assessment yang merupakan suatu cara analisis kegagalan dari manusia untuk penilaian resiko dan penyebab resiko diharapkan mampu mengurangi tingkat kecelakaan kerja yang ada. Metode yang digunakan yaitu metode HEART (Human Error Assessment) dan SPAR-H (Standarized Plant Analysis Risk Human Reliability Assesment). Pada penelitian ini juga menggunakan Hierarchical Task Analysis dan Fault Tree Analysis yang berguna untuk membantu identifikasi kemungkinan-kemungkinan kecelakaan kerja serta untuk mengetahui nilai kecelakaan kerja terbesar dari masing-masing sub pekerjaan, nilai persentase HEP terbesar diperoleh dari hasil metode HEART yaitu 5,39% untuk tahap persiapan, 2,78% pada tahap pemotongan 1,88% pada tahap perakitan 5,52% pada tahap pengecoran dan 16,89% pada tahap pemasangan, sedangkan hasil persentase HEP dengan metode SPAR-H sebesar 4,26% untuk tahap persiapan, 1,06% pada tahap pemotongan, 1,67% pada tahap perakitan, 5,31% pada tahap pengecoran dan 16,76% pada tahap pemasangan, nilai tersebut kemudian diberikan beberapa rekomendasi sesuai dengan hasil dari kuesioner yang didapatkan seperti memberikan cukup waktu istirahat untuk pekerja agar mengurangi tingkat stress pekerja dan rekomendasi lainnya.

Combining hierarchical task analysis and usage scenarios to help embed human factors in design

The introductory design course in Mechanical and Industrial Engineering at Ryerson University combines Human Factors (HF) and Design. Due to its unique character, we have developed custom courseware. In recent years the instructors have noticed four specific shortcomings in students’ abilities to incorporate HF into their designs. We are developing new courseware that focuses on embedding HF considerations into the requirements specification stage. The courseware incorporates a novel combination of Hierarchical Task Analysis (a well-known method) with Usage Scenarios (a method of Salustri’s invention, based on the work of Stone and Wood). We further alter the courseware in several other ways to minimize the amount of documentation that students need to provide, while still capturing their decision-making process well enough to allow appropriate assessments. A plan for implementing and assessing the proposed work is also presented. Keywords: engineering design, human factors, hierarchical task analysis, courseware, user experience