Health and social care ergonomics: patient safety in practice

Towards Ethical AI: Empirically Investigating Dimensions of AI Ethics, Trust Repair, and Performance in Human-AI Teaming

OBJECTIVE

Determining the efficacy of two trust repair strategies (apology and denial) for trust violations of an ethical nature by an autonomous teammate.

BACKGROUND

While ethics in human-AI interaction is extensively studied, little research has investigated how decisions with ethical implications impact trust and performance within human-AI teams and their subsequent repair.

METHOD

Forty teams of two participants and one autonomous teammate completed three team missions within a synthetic task environment. The autonomous teammate made an ethical or unethical action during each mission, followed by an apology or denial. Measures of individual team trust, autonomous teammate trust, human teammate trust, perceived autonomous teammate ethicality, and team performance were taken.

RESULTS

Teams with unethical autonomous teammates had significantly lower trust in the team and trust in the autonomous teammate. Unethical autonomous teammates were also perceived as substantially more unethical. Neither trust repair strategy effectively restored trust after an ethical violation, and autonomous teammate ethicality was not related to the team score, but unethical autonomous teammates did have shorter times.

CONCLUSION

Ethical violations significantly harm trust in the overall team and autonomous teammate but do not negatively impact team score. However, current trust repair strategies like apologies and denials appear ineffective in restoring trust after this type of violation.

APPLICATION

This research highlights the need to develop trust repair strategies specific to human-AI teams and trust violations of an ethical nature.

Hazard Assessment and Remediation Tool for Simulation-Based Healthcare Facility Design Testing

OBJECTIVES

To develop an objective, structured observational tool to enable identification and measurement of hazards in the built environment when applied to audiovisual recordings of simulations by trained raters.

BACKGROUND

Simulation-based facility design testing is increasingly used to optimize safety of healthcare environments, often relying on participant debriefing or direct observation by human factors experts.

METHODS

Hazard categories were defined through participant debriefing and detailed review of pediatric intensive care unit in situ simulation videos. Categories were refined and operational definitions developed through iterative coding and review. Hazard detection was optimized through the use of structured coding protocols and optimized camera angles.

RESULTS

Six hazard categories were defined: (1) slip/trip/fall/injury risk, impaired access to (2) patient or (3) equipment, (4) obstructed path, (5) poor visibility, and (6) infection risk. Analysis of paired and individual coding demonstrated strong overall reliability (0.89 and 0.85, Gwet's AC1). Reliability coefficients for each hazard category were >0.8 for all except obstructed path (0.76) for paired raters. Among individual raters, reliability coefficients were >0.8, except for slip/trip/fall/injury risk (0.68) and impaired access to equipment (0.77).

CONCLUSIONS

Hazard Assessment and Remediation Tool (HART) provides a framework to identify and quantify hazards in the built environment. The tool is highly reliable when applied to direct video review of simulations by either paired raters or trained single clinical raters. Subsequent work will (1) assess the tool's ability to discriminate between rooms with different physical attributes, (2) develop strategies to apply HART to improve facility design, and (3) assess transferability to non-ICU acute care environments.

The impact of power on health care team performance and patient safety: a review of the literature

Communication failure within health care teams is a major cause of patient harm across health care settings. Factors which contribute to communication failure include actual or perceived 'power'. Whilst a great deal of ergonomics research has focussed on teamwork in health care, the role of power in relation to measurable patient safety and performance outcomes remains relatively unknown. This article presents the findings from a review of the literature on power within multidisciplinary health care team settings. Following a systematic literature search, nineteen studies were evaluated in terms of research design, methods and analyses across the included studies. The main impacts resulting from power imbalances include negative effects on team collaboration, decision-making, communication and overall performance. Wider patient safety research, and more specifically the ergonomics discipline, is encouraged to address the complex interplay between power and teamwork in the health care sector.Practitioner Statement: We conducted a review of studies focussed on the influence of power on teamwork in health care. The findings show that power can have negative impacts on collaboration, decision-making, communication, and team performance. We conclude that power represents an important area for ergonomics, both in health care and other settings.Abbreviations: CRM: crew resource management; TEM: threat and error management; SNA: social network analysis; EAST: event analysis of systemic teamwork.

Security or Safety: Quantitative and Comparative Analysis of Usage in Research Works Published in 2004-2019

This article is devoted to the statistical analysis of security and safety frequency in the context of categories connected with social institutions and personality features in research works from 2004-2019. Research was based on the following methods: quantitative analysis of safety frequency in the context with coded "categories" related to social institutions and personality features; analysis was conducted with computer-assisted content analysis QDA Miner Lite v. 1.4 and Fisher's F-test. An analysis of 1157 works showed that the terms "security" and "safety" were quantitatively more frequent when used with concepts related to social institutions than with concepts related to personality features. In our opinion, this qualitative trend shows the prevailing significance of social aspects of security over its personal (psychological) traits for research analysis and practical social aspects. The priority usage of the terms "security" and "safety" can be related to the securitization of society, (i.e., to the increased role and significance of social ways of providing security and protection from threats), primarily with the help of external law-enforcing actors such as the state, police, and army. Securitization counterweights the development of social and psychological mechanisms of security-developing motivation for safe behavior, personal self-regulation, and self-production of security as an internal feeling of protection.