A Perioperative Safety Checklist System Based On Flexible Modeling

The safety checklist is a tool to prevent human errors,and reduce mortality and morbidity in perioperative processes.The key of an electronic safety checklist system is its workflow model,which is critical in tracking work processes and distributing patient-personalized checklists to medical staff at appropriate points.However,there are two limitations in conventional modeling methods for perioperative process.One is that conventional methods are too rigid to maintain and extend models for flexible medical work processes.The other is that they are unable to describe complex dependent relations among perioperative activities.Therefore,a safety checklist system with conventional modeling methods is not suitable for complicated and flexible perioperative processes.In this thesis,we propose a perioperative safety checklist system with a novel flexible modeling method that can solve above limitations.This system adopts the flexible modeling method to describe the real perioperative processes,and works on key points and status of activities in these processes to provide personalized safety checklists and assistant service.The major contents of this paper are as follows:1)A flexible modeling method is proposed to meet the needs of complex perioperative workflow modeling.We analyzed the features of perioperative workflow,extracted the modeling demands,and then raised a flexible modeling method based on "CMMN +production rule" referring to the idea of multi-language modeling from BPCMN.2)With the flexible modeling method,we designed a safety check mechanism.The mechanism describes the key points and their contents in perioperative activities,to accurately distribute safety checklists and remind medical staff at proper points.3)On the basis of the flexible modeling method and above mechanism,we developed a perioperative safety checklist system.By configuring the knowledge-based rules for specified perioperative workflow,the system is able to provide expected safety check service,and fit the flexible safety check processes.4)The perioperative safety checklist system was applied in a cardiology department of a tier-three hospital in China.Firstly,we defined 5 key points in the perioperative work mechanism for percutaneous coronary intervention(PCI)with the flexible modeling method by interviews,observations and literature research.Then,based on the local paper checklist and the suggestions from doctors,105 checklist templates,347 checklist generation rules and other 489 rules for enhancing the performance of checklist are collected.The result shows that system can present complex perioperative workflow and provide expected safety check service on configuration of knowledge-based rules,which meets the demands of perioperative safety check for PCI.