Linda S G L Wauben

Rotterdam University of Applied Sciences & TU Delft

Objective Measure wait times, characterise current information flow and define requirements for a technological information system that supports the patient's journey. Design First, patients were observed during eight random weekdays and the durations of actions performed at each phase of the surgical trajectory were measured. Patients were grouped...

Information technology, such as real-time location (RTL) systems using Radio Frequency IDentification (RFID) may contribute to overcome patient safety issues and high costs in healthcare. The aim of this work is to study if a RFID specific Participatory Design (PD) approach supports the design and the implementation of RTL systems in the Operating...

Lessons learned from other high-risk industries could improve patient safety in the operating room (OR). This review describes similarities and differences between high-risk industries and describes current methods and solutions within a system approach to reduce errors in the OR. PubMed and Scopus databases were systematically searched for relevan...

Operative notes represent an essential element in safe patient care and should therefore be clear and accurate. This comparative study examined whether operative notes accurately represented the laparoscopic cholecystectomy (LC) as performed. Nine Dutch teaching and non-teaching hospitals were invited to record 20 successive LCs each and to collect...

Background: Operative notes are the gold standard for detecting adverse events and near misses and form the basis for scientific research. In order to guarantee safe patient care, operative notes must be objective, complete, and accurate. This study explores the current routine of note writing for laparoscopic cholecystectomy (LC) and the differen...

Introduction Growth monitoring of preterm infants is essential for assessing the nutritional effects on their growth. The current growth monitoring techniques are too stressful, however, for the smallest preterm infants. We performed a systematic review to summarize studies on stress-free techniques for measuring the body size of preterm infants in...

Background Laparoscopy is a minimally-invasive surgical procedure that uses long slender instruments that require much smaller incisions than conventional surgery. This leads to faster recovery times, fewer post-surgical wound infections and shorter hospital stays. For these reasons, laparoscopy could be particularly advantageous to patients in low...

Objective Medical Crew Resource Management (CRM) training courses are designed to increase patient safety by reducing the effects of human errors. These training courses are most popular in surgery and a wide range of medical CRM training courses for surgical teams is now available. However, the effects of these CRM training courses on patient outc...

Background Laparoscopy is a minimally-invasive surgical procedure that uses long slender instruments that require much smaller incisions than conventional surgery. This leads to faster recovery times, fewer infections and shorter hospital stays. For these reasons, laparoscopy could be particularly advantageous to patients in low to middle income co...

Background: Most interventions to improve patient safety (Patient Safety Practices (PSPs)), are introduced without engaging front-line professionals. Administrative staff, managers and sometimes a few professionals, representing only one or two disciplines, decide what to change and how. Consequently, PSPs are not fully adapted to the professional...

Objective To comply to the large global need for surgery, surgical equipment that fits the challenging environment in low- and middle-income countries (LMICs) should be designed. The aim of this study is to present a context-specific design of an electrosurgical unit (ESU) and a monopolar handheld to improve global access to surgery. Scope Extensiv...

3D printing may be a solution to shortages of equipment and spare parts in the healthcare sector of low- and middle-income countries. Polylactic acid (PLA) for 3D printing is widely available and biocompatible, but there is a gap in knowledge concerning its compatibility with chemical disinfectants. In this study, 3D printed PLA tensile samples wer...

Background: Strategies are needed to increase the availability of surgical equipment in low- and middle-income countries (LMICs). This study was undertaken to explore the current availability, procurement, training, usage, maintenance and complications encountered during use of electrosurgical units (ESUs) and laparoscopic equipment. Methods: A...

MIS-SIM is a virtual reality (VR) environment designed and developed for the creation of virtual scenarios that can be used to train and acquire basic and advance laparoscopic skills. The environment is composed by a task editor where a content creator design and develop tasks for the simulator to play. Once they are completed, objective metrics ar...

Introduction Sustained high compliance with hand hygiene prior to patient contact in a neonatal intensive care unit (NICU) could reduce the spread of pathogens and incidence of bloodstream infections of preterm infants. These infections are associated with high mortality, morbidity and additional costs. Behaviour change interventions to promote han...

Introduction: For adequate pain treatment in patients with cancer, it is important to monitor and evaluate pain regularly. Although the Numeric Rating Scale (NRS) is implemented in hospitals in the Netherlands, pain is still not systematically registered during outpatient consultations. The aim of this study was to assess whether home telemonitori...

Background & Objective:The need for surgery is currently not met in Sub-Saharan Africa, requiring both extra workforce and surgical equipment. Currently, there is a gap in the availability of surgical equipment which, among others, limits the provision of safe surgery. To design strategies to increase availability, the use of surgical equipment in...

Shortages of medical equipment in low-and-middle income countries (LMICs) have been found by several previous studies that assessed surgical capacity. To increase surgical capacity, there is a need to identify the availability of specific types of surgical equipment on a local, regional and national level. A survey was conducted among surgeons atte...

This paper presents an insight into end-users' perception of smart grid products for households. The analysed products included three types of home energy management products (HEMPs) namely: smart thermostats, smart plugs and smart wall sockets. The analysis involved existing commercial HEMPs, as well as newly designed HEMPs from a students' projec...

Human performance is not without error, and as a consequence errors occur. Studies have shown that 30–50 % of errors can be prevented. Adopting a system approach could reduce the occurrence of preventable patient safety incidents and could also be used to identify which technology needs to be developed or adapted to further improve patient safety....

Two residential Smart Grid pilots, PowerMatching City, Groningen (NL) and Pecan Street, Austin Texas (USA) have been compared regarding their energy performance and the experiences of users in these pilots. The objective of the comparison was to gain new insights that could support the successful deployment of future residential Smart Grids. Measur...

Patient safety increasingly depends on health professionals' ability to deal with the technological, organisational and social complexity of their working environment.1 The operating room (OR) is such a complex dynamic environment, not just because of the increasing use of technology, such as information technology (IT), monitoring and surgical dev...

Operating Room (OR) scheduling is crucial to allow efficient use of ORs. Currently, the predicted durations of surgical procedures are unreliable and the OR schedulers have to follow the progress of the procedures in order to update the daily planning accordingly. The OR schedulers often acquire the needed information through verbal communication w...

Background: Unavailability of instruments is recognised to cause delays and stress in the operating room, which can lead to additional risks for the patients. The aim was to provide an overview of the hazards in the entire delivery process of surgical instruments and to provide insight into how Information Technology (IT) could support this proces...

Purpose – The purpose of this paper is to collect information about barriers and enablers experienced by international experts when transferring medical equipment to countries affected by humanitarian emergencies and to discuss the suitability of the principles of “openness”, “interconnections” and “non-linearity” of systems to understand the natur...

The unavailability of the required surgical instruments at the start of a procedure is undesirable. It causes delays and stress in the operating room (OR), which can lead to additional risks for the patients. Issues with availability of surgical instruments may become visible just before the start of the procedure but are induced earlier in the del...

Efficiency in the Operating Room (OR) is a topic of growing interest. Planning of care is a crucial element to ensure optimal use of the ORs. Currently, OR scheduling is considered as a complex task based on predictions of surgery duration. The latter are often based on average times, but turn out to be inaccurate in practice because of various fac...

Safety challenges related to the use of medical equipment were investigated during the training of nurse anaesthetists in Haiti, using a systems approach to Human Factors and Ergonomics (HFE). The Observable Performance Obstacles tool, based on the Systems Engineering Initiative for Patient Safety (SEIPS) model, was used in combination with explora...

This study focuses on the role of Systems Design in addressing the challenges of healthcare provision by international emergency relief organizations in developing countries. More specifically the challenges related to the safety and performance of medical equipment that is transferred in the aftermath of a humanitarian crisis. The aim of this pape...

This research reflects on the potential of innovation networks made up of ‘creative hubs’ as facilitators of design in a local context, by using the SPRNG! project from Leeuwarden as a case study, analyzing the initiative based on a systemic multilevel design perspective. In this approach, an iterative four-phase cyclic design process is being comb...

The transition of the electricity system to smart grids requires residential end-users to be more involved in managing energy demand and supply. New innovative products and services could help to support end-users to play a more active role in the management of the future electric power system. This paper evaluates the role of Industrial Design Met...

Background: Since the increase of the number of technological aids in the operating room (OR), equipment-related incidents have come to be a common kind of adverse events. This underlines the importance of adequate equipment management to improve the safety in the OR. Objective: A system was developed to monitor the safety status (periodic maint...

This study focuses on the safety of use of medical devices during a training program of nurse anaesthetists in Haiti. Our aim is to describe five observable near misses from the perspective of Human Factors and Ergonomics. The results reveal specific challenges related to the vulnerable learning environment of the nurse anaesthetists. In the discus...

In this study, we evaluate smart grid projects in the world and in the Dutch province of Friesland with the objective to explore the current focus of smart grids deployment, and based on those findings to further sustainable energy transition ambitions of Friesland, especially around the water sector. Information about smart grids worldwide and sus...

Emergency medical services and surgery are an essential part of the local response to natural and humanitarian disasters. The aim of this study is to identify performance obstacles regarding the use of medical devices in medical emergencies. The case study, conducted in the Dr. Sardjito General Hospital in Indonesia, entails semi-structured intervi...

Healthcare has an increasing presence in the agenda of both design practice and design research. In the particular case of surgical care, the specialized products designed to be used in advanced operating rooms (OR), sometimes have specific characteristics that do not allow for proper functioning in poor- resourced settings or in contexts of emerge...

To evaluate the use of floor marking on the positioning of surgical devices within the clean air flow in an operating room (OR) to minimise infection risk. Laminar flow clean air systems are important in preventing infection in ORs but, for optimal results, surgical devices must be correctly positioned. The authors evaluated floor marking in four O...

To assess surgical team members' differences in perception of non-technical skills. Questionnaire design. Operating theatres (OTs) at one university hospital, three teaching hospitals and one general hospital in the Netherlands. Sixty-six surgeons, 97 OT nurses, 18 anaesthetists and 40 nurse anaesthetists. All surgical team members, of five hospita...

Surgical patients are at risk of avoidable damage. A ‘time out procedure’ plus debriefing (TOPplus) to check relevant operative items systematically with all team members was designed for five Dutch hospitals in order to reduce avoidable damage during and after a surgical procedure. The overall aim of this study was to evaluate if participatory des...

Laparoscopic cholecystectomy (LC) is the most performed minimal invasive surgical procedure and has a relatively high complication rate. As complications are often revealed postoperatively, clear, accurate, and timely written operative notes are important in order to recall the procedure and start follow-up treatment as soon as possible. In additio...

Due to the advances in high-tech technology in the operating theatre, the increased number of persons involved, and the increased complexity of surgical procedures, medical errors are inflicted. To answer the main question: How to improve patient safety in the operating theatre during surgery? this thesis is split into three parts. Part A focuses o...

At the start of a design process the design team often knows little about the user group, the context and the interaction between the user and their environment. When a design team is involved in the development of a healthcare system, they need to gain a total overview that often goes beyond their own knowledge. Medical specialists are professiona...

Introduction: In the Netherlands each year 1.5 million surgeries are performed, which are recorded by means of operative notes. As a rule operative notes are still (hand) written subjective testimonies of performed actions, preferably written after surgery. Technology creates the possibility to add video and photo print (image) easily to the operat...

Since several years, design approaches have shifted from being either technology-centred or being human-centred towards a combined method, focussing on relationships between system elements. Although several frameworks have been described in literature, the framework described by Kim Vicente (2006), the Human-tech approach, is most comparable to th...

When a person becomes ill different stages have to be completed before he or she is ‘cured’: visits to general practitioner (GP), visits to specialist, possibly medication and therapy, admission into hospital, possibly surgery, release from hospital, checkups with the specialist or GP, etc. During surgery several people are involved: anesthetists,...

Healthcare is one of the most dynamic and expanding areas in the world. This introduces a multi-disciplinary approach to deal with, on one side the technology-driven trends and on the other side the social-economic consequences on the healthcare system. Regardless of the field of application, in healthcare the human plays a central role. Healthcare...

The importance of measuring intra-abdominal pressure (IAP) has increased since the negative effects of sustained increased IAP, also known as intra-abdominal hypertension (IAH), have become known. The relation between IAP and abdominal wall tension has been included in several reports. We have developed a device to measure abdominal wall tension by...

TOPICS: Rating system for non-medical assessors KEYWORDS: Operating team, rating system, patient safety, non-technical skills, communication, teamwork

TOPICS: Human and Technology interaction KEYWORDS: Illuminance, reflection, operating area, questionnaire

TOPICS: Safety by Product Design KEYWORDS: Feedforward information, light, text, sound, colour, image, wire- model, 3D model, photo

Iatrogenic bile duct injury remains a current complication of laparoscopic cholecystectomy. One uniform and standardized protocol, based on the "critical view of safety" concept of Strasberg, should reduce the incidence of this complication. Furthermore, owing to the rapid development of minimally invasive surgery, technicians are becoming more fre...

This study aimed to obtain an answer for the question: Are ergonomic guidelines applied in the operating room and what are the consequences? A total of 1,292 questionnaires were sent by email or handed out to surgeons and residents. The subjects worked mainly in Europe, performing laparoscopic and/or thoracoscopic procedures within the digestive, t...

The disadvantages of laparoscopy for the operating team are becoming more known. Ergonomic research has led to ergonomic guidelines presented in literature, which deal with the positioning of equipment leading to ergonomically correct postures. The aim of this study is to answer the questions: ‘Are these guidelines known and are they applied in the...