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Facilitating the application of systems-theoretic process analysis in healthcare: Creating control structures using

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Risk Analysis : an Official Publication of the Society for Risk Analysis
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Summary

This study introduces a method to simplify safety analysis in healthcare using process maps to build control structures for Systems-Theoretic Process Analysis (STPA). This approach streamlines hazard identification and risk assessment in clinical settings.

Keywords:
STPAcontrol structurehealthcare safetyprocess mapsystems-theoretic process analysis

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Area of Science:

  • Healthcare Safety
  • Systems Engineering
  • Risk Management

Background:

  • Systems-theoretic process analysis (STPA) is a valuable prospective safety assessment tool in healthcare.
  • A significant barrier to STPA adoption is the complexity of creating control structures for system modeling.
  • Existing healthcare process maps offer a potential data source for control structure development.

Purpose of the Study:

  • To propose and validate a method for utilizing existing process maps to construct control structures for STPA in healthcare.
  • To quantify the contribution of process maps to control structure information.
  • To demonstrate the structured creation of control structures from process maps.

Main Methods:

  • A four-step method was developed: extracting information from process maps, defining control structure boundaries, transferring data, and supplementing with additional information.
  • Two case studies were performed: ambulance patient offloading in the emergency department and ischemic stroke care with intravenous thrombolysis.
  • The proportion of information derived from process maps for control structures was quantified.

Main Results:

  • On average, 68% of the information required for control structures was successfully extracted from process maps.
  • Additional control actions and feedback were incorporated from non-process map sources for comprehensive modeling.
  • The method demonstrated a structured approach to control structure creation from process maps.

Conclusions:

  • Existing healthcare process maps contain substantial information applicable to creating STPA control structures.
  • The proposed method facilitates a more efficient and structured approach to system modeling for safety analysis in healthcare.
  • This technique can enhance the proliferation and application of STPA in clinical environments.