Study of management decision making by ward sisters in a hospital and the effects on decision making after the implementation of a decision support sytem

This thesis considers management decision making at the ward level in hospitals especially by ward sisters, and the effectiveness of the intervention of a decision support system. Nursing practice theories were related to organisation and management theories in order to conceptualise a decision making framework for nurse manpower planning and deployment at the ward level. Decision and systems theories were explored to understand the concepts of decision making and the realities of power in an organisation. In essence, the hypothesis was concerned with changes in patterns of decision making that could occur with the intervention of a decision support system and that the degree of change would be governed by a set of `difficulty' factors within wards in a hospital. During the course of the study, a classification of ward management decision making was created, together with the development and validation of measuring instruments to test the research hypothesis. The decision support system used was rigorously evaluated to test whether benefits did accrue from its implementation. Quantitative results from sample wards together with qualitative information collected, were used to test this hypothesis and the outcomes postulated were supported by these findings. The main conclusion from this research is that a more rational approach to management decision making is feasible, using information from a decision support system. However, wards and ward sisters that need the most assistance, where the `difficulty' factors in the organisation are highest, benefit the least from this type of system. Organisational reviews are needed on these identified wards, involving managers and doctors, to reduce the levels of un-coordinated activities and disruption.

Knowledge engineering for mental-health risk assessment and decision support

Mental-health risk assessment practice in the UK is mainly paper-based, with little standardisation in the tools that are used across the Services. The tools that are available tend to rely on minimal sets of items and unsophisticated scoring methods to identify at-risk individuals. This means the reasoning by which an outcome has been determined remains uncertain. Consequently, there is little provision for: including the patient as an active party in the assessment process, identifying underlying causes of risk, and eecting shared decision-making. This thesis develops a tool-chain for the formulation and deployment of a computerised clinical decision support system for mental-health risk assessment. The resultant tool, GRiST, will be based on consensual domain expert knowledge that will be validated as part of the research, and will incorporate a proven psychological model of classication for risk computation. GRiST will have an ambitious remit of being a platform that can be used over the Internet, by both the clinician and the layperson, in multiple settings, and in the assessment of patients with varying demographics. Flexibility will therefore be a guiding principle in the development of the platform, to the extent that GRiST will present an assessment environment that is tailored to the circumstances in which it nds itself. XML and XSLT will be the key technologies that help deliver this exibility.

Decision support for lifecycle planning and risk management of small-scale biomass combined heat and power (bCHP) projects in the UK

Biomass is projected to account for approximately half of the new energy production required to achieve the 2020 primary energy target in the UK. Combined heat and power (CHP) bioenergy systems are not only a highly efficient method of energy conversion, at smaller-scales a significant proportion of the heat produced can be effectively utilised for hot water, space heating or industrial heating purposes. However, there are many barriers to project development and this has greatly inhibited deployment in the UK. Project viability is highly subjective to changes in policy, regulation, the finance market and the low cost incumbent; a high carbon centralised energy system. Unidentified or unmitigated barriers occurring during the project lifecycle may not only negatively impact on the project but could ultimately lead to project failure. The research develops a decision support system (DSS) for small-scale (500 kWe to 10 MWe) biomass combustion CHP project development and risk management in the early stages of a potential project’s lifecycle. By supporting developers in the early stages of project development with financial, scheduling and risk management analysis, the research aims to reduce the barriers identified and streamline decision-making. A fuzzy methodology is also applied throughout the developed DSS to support developers in handling the uncertain or approximate information often held at the early stages of the project lifecycle. The DSS is applied to a case study of a recently failed (2011) small-scale biomass CHP project to demonstrate its applicability and benefits. The application highlights that the proposed development within the case study was not viable. Moreover, further analysis of the possible barriers with the DSS confirmed that some possible modifications to be project could have improved this, such as a possible change of feedstock to a waste or residue, addressing the unnecessary land lease cost or by increasing heat utilisation onsite. This analysis is further supported by a practitioner evaluation survey that confirms the research contribution and objectives are achieved.

Designing multiple user perspectives and functionality for clinical decision support systems

Clinical Decision Support Systems (CDSSs) need to disseminate expertise in formats that suit different end users and with functionality tuned to the context of assessment. This paper reports research into a method for designing and implementing knowledge structures that facilitate the required flexibility. A psychological model of expertise is represented using a series of formally specified and linked XML trees that capture increasing elements of the model, starting with hierarchical structuring, incorporating reasoning with uncertainty, and ending with delivering the final CDSS. The method was applied to the Galatean Risk and Safety Tool, GRiST, which is a web-based clinical decision support system (www.egrist.org) for assessing mental-health risks. Results of its clinical implementation demonstrate that the method can produce a system that is able to deliver expertise targetted and formatted for specific patient groups, different clinical disciplines, and alternative assessment settings. The approach may be useful for developing other real-world systems using human expertise and is currently being applied to a logistics domain. © 2013 Polish Information Processing Society.

Bioenergy decision support systems:worth the effort?

The purpose of this research is to explore the disparity between the existing model-orientated bioenergy decision support system (DSS) functions and what is desired by practitioners, in particular bioenergy project developers. This research has compiled the published bioenergy project development models, to highlight the characteristics emphasised by academics. When contrasted against a UK practitioner’s perspective through the administration of a Likert style questionnaire, it is clear that the general DSS issues still persist. Finally, the research suggests how this ’theory-practice’ divide could be addressed. The research contribute

Towards the Problems of an Evaluation of Data Uncertainty in Decision Support Systems

The question of forming aim-oriented description of an object domain of decision support process is outlined. Two main problems of an estimation and evaluation of data and knowledge uncertainty in decision support systems – straight and reverse, are formulated. Three conditions being the formalized criteria of aimoriented constructing of input, internal and output spaces of some decision support system are proposed. Definitions of appeared and hidden data uncertainties on some measuring scale are given.

Sistema de apoio à decisão espacial para análise do impacte ambiental da dispersão de poluentes atmosféricos

Neste artigo é apresentado um Sistema de Apoio à Decisão Espacial (SADE) onde os decisores podem facilmente definir diferentes tipos de problemas espaciais recorrendo a diferentes categorias de objetos, pré-definidas ou a definir, associando- lhes características com ou sem dependência espacial, e indicando formas de interferência (impactos) entre essas caracte- rísticas/propriedades. A análise espacial para determinação ou avaliação de configurações alternativas para a localização de diferentes tipos de ocorrências espaciais será feita através da utilização interativa do SADE de acordo com conjuntos de regras intrínsecas aos vários elementos gráficos (objetos, categorias, características, impactos) utilizados na definição dos problemas. O teste à generalidade representativa e analítica do SADE proposto é efectuado recorrendo a um problema concreto, suficientemente específico e complexo, relativo à aplicação de modelos gaussianos para o estudo da dispersão atmosférica de eventuais poluentes resultantes do tratamento de resíduos sólidos. A região em estudo está limitada, neste exemplo, ao município de Coimbra, Portugal. Para este município estão acessíveis, e são utilizados, os dados demográficos ao nível da secção de voto (censos oficiais) e, como tal, é possível a realização de um estudo realístico do impacto com populações humanas.

Sistema integrado para tomada de decisão espacial em situações de derramamento de óleo no litoral norte do Estado do RN

The northern coast of Rio Grande do Norte State (RN) shows areas of Potiguar basin with high activity in petroleum industry. With the goal of avoiding and reducing the accident risks with oil it is necessary to understand the natural vulnerability, mapping natural resources and monitoring the oil spill. The use of computational tools for environmental monitoring makes possible better analyses and decisions in political management of environmental preservation. This work shows a methodology for monitoring of environment impacts, with purpose of avoiding and preserving the sensible areas in oil contact. That methodology consists in developing and embedding an integrated computational system. Such system is composed by a Spatial Decision Support System (SDSS). The SDSS shows a computational infrastructure composed by Web System of Geo-Environmental and Geographic Information - SWIGG , the System of Environmental Sensibility Maps for Oil Spill AutoMSA , and the Basic System of Environmental Hydrodynamic ( SisBAHIA a System of Modeling and Numerical Simulating SMNS). In a scenario of oil spill occurred coastwise of Rio Grande do Norte State s northern coast, the integration of such systems will give support to decision agents for managing of environmental impacts. Such support is supplied through a system of supporting to spatial decisions

Utilizzo delle bande dell’Infrarosso Termico in tecniche di remote sensing per applicazioni in ambito urbano

Il presente studio si concentra sulle diverse applicazioni del telerilevamento termico in ambito urbano. Vengono inizialmente descritti la radiazione infrarossa e le sue interazioni con l’atmosfera terrestre, le leggi principali che regolano lo scambio di calore per irraggiamento, le caratteristiche dei sensori e le diverse applicazioni di termografia. Successivamente sono trattati nel dettaglio gli aspetti caratteristici della termografia da piattaforma satellitare, finalizzata principalmente alla valutazione del fenomeno dell'Urban Heat Island; vengono descritti i sensori disponibili, le metodologie di correzione per gli effetti atmosferici, per la stima dell'emissività delle superfici e per il calcolo della temperatura superficiale dei pixels. Viene quindi illustrata la sperimentazione effettuata sull'area di Bologna mediante immagini multispettrali ASTER: i risultati mostrano come sull'area urbana sia riscontrabile la presenza dell'Isola di Calore Urbano, anche se la sua quantificazione risulta complessa. Si procede quindi alla descrizione di potenzialità e limiti della termografia aerea, dei suoi diversi utilizzi, delle modalità operative di rilievo e degli algoritmi utilizzati per il calcolo della temperatura superficiale delle coperture edilizie. Tramite l’analisi di alcune esperienze precedenti vengono trattati l’influenza dell’atmosfera, la modellazione dei suoi effetti sulla radianza rilevata, i diversi metodi per la stima dell’emissività. Viene quindi introdotto il progetto europeo Energycity, finalizzato alla creazione di un sistema GeoWeb di supporto spaziale alle decisioni per la riduzione di consumi energetici e produzione di gas serra su sette città dell'Europa Centrale. Vengono illustrate le modalità di rilievo e le attività di processing dei datasets digitali per la creazione di mappe di temperatura superficiale da implementare nel sistema SDSS. Viene infine descritta la sperimentazione effettuata sulle immagini termiche acquisite nel febbraio 2010 sulla città di Treviso, trasformate in un mosaico georiferito di temperatura radiometrica tramite correzioni geometriche e radiometriche; a seguito della correzione per l’emissività quest’ultimo verrà trasformato in un mosaico di temperatura superficiale.

Geographic information system-based decision support for soil conservation planning in Tajikistan

Soil erosion on sloping agricultural land poses a serious problem for the environment, as well as for production. In areas with highly erodible soils, such as those in loess zones, application of soil and water conservation measures is crucial to sustain agricultural yields and to prevent or reduce land degradation. The present study, carried out in Faizabad, Tajikistan, was designed to evaluate the potential of local conservation measures on cropland using a spatial modelling approach to provide decision-making support for the planning of spatially explicit sustainable land use. A sampling design to support comparative analysis between well-conserved units and other field units was established in order to estimate factors that determine water erosion, according to the Revised Universal Soil Loss Equation (RUSLE). Such factor-based approaches allow ready application using a geographic information system (GIS) and facilitate straightforward scenario modelling in areas with limited data resources. The study showed first that assessment of erosion and conservation in an area with inhomogeneous vegetation cover requires the integration of plot-based cover. Plot-based vegetation cover can be effectively derived from high-resolution satellite imagery, providing a useful basis for plot-wise conservation planning. Furthermore, thorough field assessments showed that 25.7% of current total cropland is covered by conservation measures (terracing, agroforestry and perennial herbaceous fodder). Assessment of the effectiveness of these local measures, combined with the RUSLE calculations, revealed that current average soil loss could be reduced through low-cost measures such as contouring (by 11%), fodder plants (by 16%), and drainage ditches (by 53%). More expensive measures such as terracing and agroforestry can reduce erosion by as much as 63% (for agroforestry) and 93% (for agroforestry combined with terracing). Indeed, scenario runs for different levels of tolerable erosion rates showed that more cost-intensive and technologically advanced measures would lead to greater reduction of soil loss. However, given economic conditions in Tajikistan, it seems advisable to support the spread of low-cost and labourextensive measures.

Municipal solid waste management system: decision support through systems analysis

Thesis submitted to the Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia for the degree of Doctor of Philosophy in Environmental Engineering

Knowledge Management and Decision Support for Sustainable Land Management

Much research has focused on desertification and land degradation assessments without putting sufficient emphasis on prevention and mitigation, although the concept of sustainable land management (SLM) is increasingly being acknowledged. A variety of SLM measures have already been applied at the local level, but they are rarely adequately recognised, evaluated, shared or used for decision support. WOCAT (World Overview of Technologies and Approaches) has developed an internationally recognised, standardised methodology to document and evaluate SLM technologies and approaches, including spatial distribution, allowing the sharing of SLM knowledge worldwide. The recent methodological integration into a participatory process allows now analysing and using this knowledge for decision support at the local and national level. The use of the WOCAT tools stimulates evaluation (self-evaluation as well as learning from comparing experiences) within SLM initiatives where all too often there is not only insufficient monitoring but also a lack of critical analysis. The comprehensive questionnaires and database system facilitate to document, evaluate and disseminate local experiences of SLM technologies and their implementation approaches. This evaluation process - in a team of experts and together with land users - greatly enhances understanding of the reasons behind successful (or failed) local practices. It has now been integrated into a new methodology for appraising and selecting SLM options. The methodology combines a local collective learning and decision approach with the use of the evaluated global best practices from WOCAT in a concise three step process: i) identifying land degradation and locally applied solutions in a stakeholder learning workshop; ii) assessing local solutions with the standardised WOCAT tool; iii) jointly selecting promising strategies for implementation with the help of a decision support tool. The methodology has been implemented in various countries and study sites around the world mainly within the FAO LADA (Land Degradation Assessment Project) and the EU-funded DESIRE project. Investments in SLM must be carefully assessed and planned on the basis of properly documented experiences and evaluated impacts and benefits: concerted efforts are needed and sufficient resources must be mobilised to tap the wealth of knowledge and learn from SLM successes.

A Multi-agent System for Emergency Decision Support

This paper describes the multi-agent organization of a computer system that was designed to assist operators in decision making in the presence of emergencies. The application was developed for the case of emergencies caused by river floods. It operates on real-time receiving data recorded by sensors (rainfall, water levels, flows, etc.) and applies multi-agent techniques to interpret the data, predict the future behavior and recommend control actions. The system includes an advanced knowledge based architecture with multiple symbolic representation with uncertainty models (bayesian networks). This system has been applied and validated at two particular sites in Spain (the Jucar basin and the South basin).

Hydrologic models for emergency decision support using Bayesian networks

In the presence of a river flood, operators in charge of control must take decisions based on imperfect and incomplete sources of information (e.g., data provided by a limited number sensors) and partial knowledge about the structure and behavior of the river basin. This is a case of reasoning about a complex dynamic system with uncertainty and real-time constraints where bayesian networks can be used to provide an effective support. In this paper we describe a solution with spatio-temporal bayesian networks to be used in a context of emergencies produced by river floods. In the paper we describe first a set of types of causal relations for hydrologic processes with spatial and temporal references to represent the dynamics of the river basin. Then we describe how this was included in a computer system called SAIDA to provide assistance to operators in charge of control in a river basin. Finally the paper shows experimental results about the performance of the model.

Decision support and the criminal justice system:an assessment of the potential for utilising technological decision support in undertaking the prosecutorial decision

DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT