Yuval Bitan

Yuval Bitan
Ben-Gurion University of the Negev | bgu · Department of ​Health Policy and Management

Ph.D.

About

76
Publications
16,419
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
406
Citations
Citations since 2016
50 Research Items
231 Citations
2016201720182019202020212022010203040
2016201720182019202020212022010203040
2016201720182019202020212022010203040
2016201720182019202020212022010203040
Introduction
Yuval Bitan is a Human Factors engineer, specialized in ways to improve patient safety through the implementation of human factors approach in the healthcare complex working environment. Yuval’s current research interests include alarm systems, and implementing safer procedures and processes in medical devices, electronic medical records, and paramedic services (EMS).
Additional affiliations
October 2015 - present
Ben-Gurion University of the Negev
Position
  • Professor (Associate)
August 2013 - June 2015
University Health Network
Position
  • Research Associate
September 2003 - September 2006
The University of Chicago Medical Center
Position
  • Research Associate
Education
October 1996 - September 2003
Ben-Gurion University of the Negev
Field of study
  • Industrial Engineering and Management

Publications

Publications (76)
Article
This study compares response time and accuracy in a binary data labeling task on two platforms: a desktop computer and a mobile phone. Three methods were used on the computer: a keyboard, a mouse, and a mouse with perceptual variability that was designed to combat vigilance decrement. Three additional methods were used on the mobile phone: a tap, a...
Conference Paper
Full-text available
Introduction: Mass casualty incident (MCI) commanders face difficult challenges when managing MCIs in the prehospital phase. Modeling and optimizing the commander's decision-making process can increase survivability. This study explored decision-making models that describe MCI commander decision-making. Methods: Quantitative data from eight simulat...
Article
Full-text available
Introduction Telemedicine has been widely used in various medical settings including in Emergency Medical Services (EMS). The goal of this study was to assess the possible roles of real-time video communication between paramedics and bystanders at scenes of emergency, in the analysis and treatment of patients. Methods 44 experienced paramedics par...
Article
Objective Present a collection of papers focusing on improving healthcare practice through the implementation of human factors and ergonomics principles that were presented at the International Ergonomics Association (IEA) 2021 international conference. Background The mission of the IEA is to elaborate and advance ergonomics science and practice a...
Article
Full-text available
Background. Arrival times at the scene and provision of initial emergency treatment have importance in pre-hospital care settings. Donning proper protective equipment by medical personnel, as was needed during the COVID-19 pandemic, prolongs the time between the arrival of medical personnel to a patient and provision of primary medical care. Object...
Article
Decision making is based on information, but in the early days of the COVID-19 pandemic, information was scarce, while healthcare organizations and individual caregivers were pressured to make decisions about working protocols and clinical procedures. This study examined decision-making of individual clinicians that were involved in clinical and op...
Article
Full-text available
A common way to describe requirements in Agile software development is through user stories, which are short descriptions of desired functionality. Nevertheless, there are no widely accepted quantitative metrics to evaluate user stories. We propose a novel metric to evaluate user stories called instability, which measures the number of changes made...
Article
Full-text available
Aims and objectives This study retrospectively examined patient records from the Emergency Department to investigate how nurse experience in this department affected triage decisions. Background Triage is a crucial aspect of Emergency Department care, and studies have found that experience affects clinical decision making. The Emergency Severity I...
Preprint
BACKGROUND The exponential growth in computing power and increasing digitization of information have advanced the machine learning (ML) research field substantially. However, ML algorithms are often considered “black boxes”, and this fosters distrust. In medical domains, in which mistakes can result in fatal outcomes, practitioners may be especiall...
Article
Objective : Poor clinical data quality might affect clinical decision making and patient treatment. This study identifies quality defects in clinical data collected automatically by bedside monitoring devices in the Intensive Care Unit (ICU) and examines their effect on clinical decisions. Methods : Real-world data collected from 7,688 patients ad...
Article
Full-text available
Emergency Medical Services (EMS) in Israel was called on to vaccinate the most vulnerable population—the elderly in assisted living facilities and their caregivers. Two parameters led the operation: (1) maximum use of the scarce COVID-19 vaccine, and (2) minimizing the time it took to reach this entire population. We present the process of vaccinat...
Article
Full-text available
Objective: To develop a new model to quantify information management dynamically, and to identify factors that lead to information gaps. Background: Information management is a core task for Emergency Medical Service (EMS) team leaders during the pre-hospital phase of a Mass-Casualty Incident (MCI). Lessons learned from past MCIs indicate that po...
Article
Full-text available
The overall goal of the novel Functionality, Usability, Look-and-Feel, and Evaluation (FULE) user-centered methodology for product design proposed in this paper is to develop usable and aesthetic products. Comprising several product design methods, this novel methodology we devised focuses on the product designer’s role and responsibility. Followin...
Article
Introduction: Information management (also known as “communication” or “gathering and analyzing information”) is one of the core tasks of MCI (Mass-Casualty Incident) commanders during the chaotic prehospital phase.1 To train EMS (emergency medical service) personnel on how to manage an MCI efficiently, simulation drills are conducted in which part...
Article
Emergency response to a pandemic requires health care systems to initiate many activities. One of these activities is providing the public with information and guidance about the symptoms and the actions that need to be taken. A dedicated call center should facilitate the public need. Such a call center needs to be carefully designed to protect the...
Article
Full-text available
Studies reveal that the false alarm rate (FAR) demonstrated by intensive care unit (ICU) vital signs monitors ranges from 0.72 to 0.99. We applied machine learning (ML) to ICU multi-sensor information to imitate a medical specialist in diagnosing patient condition. We hypothesized that applying this data-driven approach to medical monitors will hel...
Presentation
Full-text available
Using Deep Learning to Provide Real Time Information During Mass-Casualty Incident
Article
Full-text available
Background: Video communications during cardiopulmonary resuscitation (CPR) can improve the quality of information exchange between a bystander performing CPR and an emergency medical dispatcher (EMD). Objective: To improve chest compression effectiveness, a filming protocol instructing video camera placements around a patient was developed. Thi...
Article
Full-text available
Fast, effective, and accurate emergency medical treatment can save lives. Quick access to the specific equipment that emergency medical personnel need facilitates more efficacious treatment during emergencies. This project focuses on designing an improved emergency response kit for medical first responders. The kit currently in use has no organizat...
Article
A two phase project is described for redesigning and evaluating paramedic response bags, one of the key pieces of equipment used by emergency medical services. Adopting a user-centred approach, Phase I involved first educating active service paramedics about ergonomic principles, and then collaborating with them to conceptualise a new type of respo...
Article
The intensive care unit (ICU) is one of the most complex areas in hospital care, as patients require continuous monitoring by physicians and nurses. Currently, clinicians are informed about the patients’ physiological conditions through visual color-coded signals and auditory alarms. Previous studies have shown that vibrotactile cues can be used to...
Article
Full-text available
This study investigates how the positions of paramedic equipment bags affect paramedic performance and biomechanical loads during out-of-hospital Cardiopulmonary Resuscitation (CPR). An experiment was conducted in which 12 paramedic teams (each including two paramedics) performed in-situ simulations of a cardiac-arrest scenario. CPR quality was eva...
Article
Full-text available
Background: Early identification of out-of-hospital cardiac arrest (OHCA) has proven to increase survival rates. Toward this goal, emergency medical dispatchers commonly use one of two types of emergency medical dispatcher systems, each with a unique out-of-hospital cardiac arrest protocol. The criteria-based dispatch (CBD) protocol is a set of gui...
Article
Full-text available
Objective: To explore cognitive strategies clinicians apply while performing a medication reconciliation task, handling incomplete and conflicting information. Background: Medication reconciliation is a method clinicians apply to find and resolve inconsistencies in patients' medications and medical conditions lists. The cognitive strategies clin...
Presentation
Full-text available
Information management is a core task of MCI (Mass-Casualty incident) commanders and EMS (Emergency Medical Service) team members during the prehospital phase. Lessons learned from past MCI’s indicate that inadequate information exchange has a negative effect on casualties’ clinical outcomes, evacuation duration, and optimal distribution of casualt...
Article
Full-text available
Modern smart infusion pumps are wirelessly connected to a network server for easy data communications. The two-way communication allows uploading of infusion data and downloading of drug library updates. We have discovered significant delays in library updates. This research aimed at studying the drug library update process of one vendor pump and t...
Article
Objective: Our previous study showed that the issue of drug library update delays on wireless intravenous (IV) infusion pumps of one major vendor was widespread and significant. However, the impact of such a delay was unclear. The objective of this study was to quantify the impact of pump library update delays on patient safety in terms of missed...
Article
Purpose: Results of a study to estimate the prevalence and severity of delays in wireless updates of smart-pump drug libraries across a large group of U.S. hospitals are reported. Methods: A prolonged smart-pump drug library update may result in patient harm if a pump is programmed with an incorrect limit setting at the time of drug administrati...
Conference Paper
Early identification of out-of-hospital cardiac arrest (OHCA) has proven to increase survival rates. Toward this goal, emergency medical dispatchers commonly use one of two types of emergency medical dispatcher systems, each with a unique out-of-hospital cardiac arrest protocol. The criteria-based dispatch (CBD) protocol is a set of guidelines and...
Article
Full-text available
Pre-Hospital Emergency Medical Service work environments are complex, presenting unique challenges for the design of environments and equipment, digital technologies, and inter-organizational operational strategies. As researchers, our challenge is to understand how providers operate in these complex environments, especially during emergency situat...
Article
In this paper, we will present the planning and design process of a triage decision-support application, aimed to be used for both research data gathering and real-time triage decision-making. Triage is an initial classification of emergency department (ED) patients, according to the severity level of their medical condition. The need of fast and a...
Article
Full-text available
Introduction The correlation between patient outcomes and the safety culture in healthcare organisations draws special attention to tools that can measure safety culture in such organisations. One of the advantages of such tools is their ability to identify changes in safety climate, which can support healthcare organisations in detecting and unde...
Article
Paramedics work in changing working environments, under varied constrains. The goal of this study is to evaluate the way paramedics arrange their equipment when they are working in a trauma scene. We analyzed video that was captured during seven training simulation sessions, counting equipment movements at the scene during patient treatment. We fou...
Article
Healthcare working environments are complex, and intensive care units (ICUs) are particularly complex due to the influx of data to the healthcare professionals who are providing continuous care to the most critically ill patients. Systems that are designed to work in these environments should take into consideration varied patient conditions, the c...
Article
Full-text available
Interoperability is a major challenge in current healthcare systems. It brings big hope for data exchange, but also raises some concern about patient safety. We study the wireless updating of modern infusion pumps and demonstrate the possible flaws in this process. Through analyzing data on drug limit libraries (DLL) versions in one hospital we cou...
Article
Full-text available
We report the results of a study which aims to improve our understanding of how clinicians make sense of medication and disease information (medical reconciliation), performed by clinicians in a major US hospital. A card sorting simulation experiment running on an Android tablet was utilized to record the steps taken by 130 clinicians to reconcile...
Article
The goal of this project is to improve clinical decision-making in the intensive care unit (ICU) environment. Making the optimal decisions depends on the quality and timeliness of the information available to the clinician. We believe that healthcare professionals will make better clinical decisions when the relevant information is collected and or...
Article
Full-text available
Motivated by the premise that well designed paramedic response bags can improve paramedics’ performance and patient safety, our objectives in this study were to evaluate performance and preferences when comparing traditional response bags with new ergonomically designed bags. A usability study based on two emergency scenarios was carried out, using...
Article
Full-text available
Paramedics work in a challenging environment which can affect the health and safety of both paramedics and their patients. Our objectives in this study were to work with the paramedics on changing one of the essential tools they use on a daily bases, and to make it safer to use both for them and for their patients. Our intervention started by provi...
Article
The overarching goal of this project is to develop engineering requirements for future information resources in the ICU. We describe a method and related instrumentation for collecting data about information requirements from a clinical team in situ. Video records are collected using three consumer-grade video cameras, augmented by a wireless micro...
Article
Full-text available
Introduction High-stakes industries, such as healthcare, are complex systems prone to influence by various constraining factors. Expert practitioners in these domains work at the “sharp end” of these constraints and must reconcile limitations in the context of operations. When a major constraining factor is changed abruptly, it can induce a rapid s...
Article
Full-text available
In spite of the vast literature demonstrating the safety benefits of having Human Factors engineers on board, only few medical organizations employ a Human Factors engineer as part of their staff. Following a safety training seminar, the hospital management decided to include a Human Factors engineer in the process of designing three new clinics in...
Poster
Full-text available
A resilient design that takes the human cognitive and physical limitations into consideration can generate a safer working environment that will result in safer medical treatments and procedures. This project demonstrates the early implementation of Human Factors principles into the healthcare working environment.
Article
Full-text available
Objectives: Alarm fatigue from high false alarm rate is a well described phenomenon in the intensive care unit (ICU). Progress to further reduce false alarms must employ a new strategy. Highly sensitive alarms invariably have a very high false alarm rate. Clinically useful alarms have a high Positive-Predictive Value. Our goal is to demonstrate one...
Article
Full-text available
Objectives: Alarm fatigue from high false alarm rate is a well described phenomenon in the intensive care unit (ICU). Progress to further reduce false alarms must employ a new strategy. Highly sensitive alarms invariably have a very high false alarm rate. Clinically useful alarms have a high Positive-Predictive Value. Our goal is to demonstrate one...
Article
Full-text available
Patients are most at risk during transitions in care across settings and providers. The communication and reconciliation of an accurate medication list throughout the care continuum are essential in the reduction in transition-related adverse drug events. Most current research focuses on the outcomes of reconciliation interventions, yet not on the...
Article
Full-text available
Medication omissions and dosing failures are frequent during transitions in patient care. Medication reconciliation (MR) requires bridging discrepancies in a patient’s medical history as a setting for care changes. MR has been identified as vulnerable to failure, and a clinician’s cognition during MR remains poorly described in the literature. We s...
Chapter
The modern intensive care unit (ICU) arose when physicians located intense monitoring and specialized therapeutics in one specific place. The physicians assumed that an intense level of care would improve outcomes. Many agree the assumption has been correct. Today’s ICU is filled with many promising, albeit incompletely explored, innovations, some...
Article
Full-text available
Labelling of high-risk drug infusions and lines is a well-recognised safety strategy to prevent medication errors. Although hospital wards characterised by multiple high-risk drug infusions use different types of labelling, little is known about the contribution of a colour-coded label (CCL) to patient safety. A quality improvement programme audit...
Article
We report on a human factors evaluation project at a major urban teaching hospital that was intended to use human factors methods to assist the selection of a new infusion device among 4 commercially available models. The project provided an expert evaluation of the pumps, collected data on programming each pump by a sample of practitioners, tabula...
Article
Full-text available
Objective: This study sought to determine whether infusion device event logs could support accident investigation. Methods: An incident reporting database was searched for information about log file use in investigations. Log file data from devices in clinical use were downloaded and electronically searched for characteristics (signatures) matching...
Article
Full-text available
Operators often need to combine self-initiated and respondent actions. Two experiments dealt with the relative importance of these two types of actions as a function of the predictability of the system and the available information. Participants monitored three stations with different frequencies at which interventions were required. They were aide...
Article
Full-text available
Thorough, objective investigation of medical adverse events rarely happens due to the com- plexity of the environment, litigation, risk, and socio-political implications. Special concerns can, and do, undermine investigation depth, breadth, and quality. Healthcare's distinct differ- ence from other high hazard sectors requires a unique approach to...
Article
Objectives: Automated piggybacks are purported to make drug administration safer and more reliable. We evaluated the human factors of piggyback infusion, investigated the practice in our institution, and analyzed incidents from an anonymous database to better characterize the practice and substantiate these assertions. Methods: To find examples of...
Article
Full-text available
Neonatal intensive care units (NICUs), like other intensive care units, are intended to provide immediate responses to any change in the patient’s condition. Patient-monitoring alarms and alarms from other medical equipment are very common in these units, and most alarms have no clinical significance. This study addresses the question of how alarms...
Conference Paper
Operators of complex systems combine actions they schedule and initiate, and actions they perform as responses to events (such as alarms). Previous studies showed qualitative changes in the effect of scheduling and responding, but no quantitative measures of the relative weight of scheduled and respondent actions were available. The paper sugges...
Article
Descriptions of a dynamic warning system usually assign the system certain diagnostic values. Operators should adjust their responses to these values when considering the output of the system for their decisions. This approach is not necessarily appropriate for complex systems that are controlled by human operators. Here the operators' actions are...
Article
Operators of complex systems must perform routine actions while attending to and responding to unexpected events. The current study extends previous laboratory experiments on the performance of such complex tasks to the analysis of the medical staff’s actions in a Neonatal Intensive Care Unit (NICU). Observations showed that the attendants usually...
Article
Operators of complex systems respond to external signals and events that guide their actions, but they also initiate and schedule the performance of various acts. An experiment was conducted in which the interdependence of scheduling and responding was studied. Participants had to monitor three stations that required different rates of intervention...
Article
Full-text available
Two experiments assessed the effect of various static and dynamic computer 'wait' message displays on (1) subjective estimates of the duration of intervals during which a subject had to wait for the computer's response, and (2) subjective preferences among the different displays. All the static displays led to identical duration estimates. For dyna...