<strong>Background:</strong> The implementation of resilience engineering for an operating room is difficult;however, its study would become important for the surgeon’s personal and surgical team in order...<strong>Background:</strong> The implementation of resilience engineering for an operating room is difficult;however, its study would become important for the surgeon’s personal and surgical team in order to develop a new surgical safety management. An expert operator must perform an operation with his surgical team that includes an anesthetist, scrub nurse, and young assistant. However, there exist some gaps among these multi-professionals. <strong>Objective:</strong> From the viewpoint of an expert operator, to have an operation go well, we would describe how to reconcile their gaps. We will explain the gaps among the multi-professionals in a surgical team, such as hidden interactions between the operator and anesthetist, surgeon and scrub nurse, and expert operator and young assistant. <strong>Material and Methods:</strong> We assumed three types of interactions among the multi-professionals in the operating theater and we clarified how to bridge the gaps by revealing what the operator thinks, what the anesthetist thinks, what the scrub nurse thinks, and what the young assistant thinks in the surgical team, and by understanding how they perform during surgery. <strong>Outcomes:</strong> What the expert operator thinks and how he performs in surgery is summarized by the following three items: 1) safety is first, 2) achieving the operative purpose, and 3) fast surgery. We interviewed the surgical team members. In order for the surgery to go well, what the important thing is “safety first” for any surgical professionals. The sentence, “safety is first” is the magic words, such as “open sesame”. They can communicate with each other on the spot and build the team and system. To develop a strong and resilient surgical team, these four behaviors are important to improve the performance as a system: 1) sharing the same goal and same priority, 2) understanding gaps with clear verbal communication. Coming out from own professional boundaries (takotsubo), speaking in words, 3) all of us, having a strong will (iron heart), and learning anger management, and 4) improvising even in difficult situations. <strong>Conclusion:</strong> We would like to summarize the items learned from my three described scenes, which are 1) to develop a strong and resilient surgical team, 2) what we have to do, and how we have to perform, and 3) how we can develop a team and system.展开更多
Due to the directionality of light, the hidden device problem and the obstruction cannot be ignored for carrier sense multiple access with collision avoidance(CSMA/CA)-based uplink visible light communication(VLC). In...Due to the directionality of light, the hidden device problem and the obstruction cannot be ignored for carrier sense multiple access with collision avoidance(CSMA/CA)-based uplink visible light communication(VLC). In this paper, we introduce multipacket reception(MPR) to handle the hidden device problem in VLC system. We model the traffic of the device with on/off Markov source. With the unsaturated traffic, we formulate a two dimensional(2D) Markov chain to model the CSMA/CA-based slotted random access procedure to evaluate the effects of hidden devices and obstructions on the performance of MPR-aided VLC system, which are mapped into the transition probabilities of the Markov chain. Then, we analyze the throughput and the reception power efficiency(RE) of MPR-aided VLC system with the obstructed optical channel. Numerical results show that the effect is negative when hidden devices or obstructions appear solely. But when they appear simultaneously, they will interact with each other to mitigate the negative effects.展开更多
文摘<strong>Background:</strong> The implementation of resilience engineering for an operating room is difficult;however, its study would become important for the surgeon’s personal and surgical team in order to develop a new surgical safety management. An expert operator must perform an operation with his surgical team that includes an anesthetist, scrub nurse, and young assistant. However, there exist some gaps among these multi-professionals. <strong>Objective:</strong> From the viewpoint of an expert operator, to have an operation go well, we would describe how to reconcile their gaps. We will explain the gaps among the multi-professionals in a surgical team, such as hidden interactions between the operator and anesthetist, surgeon and scrub nurse, and expert operator and young assistant. <strong>Material and Methods:</strong> We assumed three types of interactions among the multi-professionals in the operating theater and we clarified how to bridge the gaps by revealing what the operator thinks, what the anesthetist thinks, what the scrub nurse thinks, and what the young assistant thinks in the surgical team, and by understanding how they perform during surgery. <strong>Outcomes:</strong> What the expert operator thinks and how he performs in surgery is summarized by the following three items: 1) safety is first, 2) achieving the operative purpose, and 3) fast surgery. We interviewed the surgical team members. In order for the surgery to go well, what the important thing is “safety first” for any surgical professionals. The sentence, “safety is first” is the magic words, such as “open sesame”. They can communicate with each other on the spot and build the team and system. To develop a strong and resilient surgical team, these four behaviors are important to improve the performance as a system: 1) sharing the same goal and same priority, 2) understanding gaps with clear verbal communication. Coming out from own professional boundaries (takotsubo), speaking in words, 3) all of us, having a strong will (iron heart), and learning anger management, and 4) improvising even in difficult situations. <strong>Conclusion:</strong> We would like to summarize the items learned from my three described scenes, which are 1) to develop a strong and resilient surgical team, 2) what we have to do, and how we have to perform, and 3) how we can develop a team and system.
文摘Due to the directionality of light, the hidden device problem and the obstruction cannot be ignored for carrier sense multiple access with collision avoidance(CSMA/CA)-based uplink visible light communication(VLC). In this paper, we introduce multipacket reception(MPR) to handle the hidden device problem in VLC system. We model the traffic of the device with on/off Markov source. With the unsaturated traffic, we formulate a two dimensional(2D) Markov chain to model the CSMA/CA-based slotted random access procedure to evaluate the effects of hidden devices and obstructions on the performance of MPR-aided VLC system, which are mapped into the transition probabilities of the Markov chain. Then, we analyze the throughput and the reception power efficiency(RE) of MPR-aided VLC system with the obstructed optical channel. Numerical results show that the effect is negative when hidden devices or obstructions appear solely. But when they appear simultaneously, they will interact with each other to mitigate the negative effects.
