Yuval Bitan | Ben Gurion University of the Negev (original) (raw)
Papers by Yuval Bitan
Clinical simulation in nursing, Jun 1, 2024
Proceedings of the Human Factors and Ergonomics Society Annual Meeting
BMC Health Services Research
Introduction Telemedicine has been widely used in various medical settings including in Emergency... more 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 participated in a simulation. Participants communicated with the experimenter presenting video clips showing patients that simulated three emergency scenarios: trauma, an unresponsive patient with cardiac arrest, and an opiate overdose. The simulation sessions were conducted through Zoom™, recorded, and then analyzed to document participants’ questions, requests, instructions, and their timings during each scenario. Results The trauma scenario was assessed most promptly, with instructions to handle the bleeding provided by all paramedics. In the unresponsive patient with cardiac arrest scenario, most of the participants achieved a correct init...
Applied Sciences
Background. Arrival times at the scene and provision of initial emergency treatment have importan... more 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. Objective. We examined the effect of a suggested personal protective equipment (PPE) wearing protocol (gown protocol) on shortening pre-hospital treatment times compared to the current coverall protocol. Method. In this prospective simulation-based study, participants were instructed to inject a practice epinephrine syringe into a simulation mannequin after donning either a gown or a coverall PPE kit in the shortest possible time. Participants performed the two protocols in a randomized order. Donning time, physiological measures, and participants’ perceptions were measured after completion of each of the protocols. Results. Donning times and he...
International Journal of Healthcare Management
Human Factors: The Journal of the Human Factors and Ergonomics Society, 2021
Objective To develop a new model to quantify information management dynamically and to identify f... more 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 prehospital phase of a mass-casualty incident (MCI). Lessons learned from past MCIs indicate that poor information management can lead to increased mortality. Various instruments are used to evaluate information management during MCI training simulations, but the challenge of measuring and improving team leaders’ abilities to manage information remains. Method The Dynamic Communication Quantification (DCQ) model was developed based on the knowledge representation typology. Using multi point-of-view synchronized video, the model quantifies and visualizes information management. It was applied to six MCI simulations between 2014 and 2019, to identify factors that led to information gaps, and compared with other evaluation methods. Results Out of...
American Journal of Public Health, 2021
Emergency Medical Services (EMS) in Israel was called on to vaccinate the most vulnerable populat... more 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 vaccinating 126 245 people in two weeks at 756 locations countrywide, focusing on the planning and logistics of this operation. Resilience, flexible logistics, and dedicated personnel provided an efficient public health operation.
Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 2020
Introduction: Information management (also known as “communication” or “gathering and analyzing i... more 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 participant performance is evaluated. As such, varied instruments have been developed to measure information management quality during MCI simulations. Since every instrument could lead to different results, our goal at the current study was to evaluate what are the advantages of applying each one of the instruments. Methods: Three instruments were chosen for the current study: (1) The Self-Assessment Teamwork Tool for Students (SATTS), (2) a set of performance indicators aimed to be scored by an experienced observer, and (3) Dynamic Information Management Quantification Instrument (DIMQI) which allows quantifying information items. All instru...
Ergonomics in Design: The Quarterly of Human Factors Applications, 2020
Emergency response to a pandemic requires health care systems to initiate many activities. One of... more 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 call takers from potentially being infected by other staff members. An ad hoc facility has the flexibility to adjust to evolving demands and constraints. This article presents the need, the concerns, and the guidelines used to design such call center during the COVID-19 pandemic outbreak.
Technology and Health Care, 2020
Ergonomics in Design: The Quarterly of Human Factors Applications, 2019
Fast, effective, and accurate emergency medical treatment can save lives. Quick access to the spe... more 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 organizational standard for the way the medical items it contains are placed inside. With a user-centered method, we designed a kit that better fits first responders’ requirements and found that the kit – a backpack and a vest – is both easier to use and carry, based on emergency care priorities.
Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 2019
Australasian Journal of Paramedicine, 2019
Background Early identification of out-of-hospital cardiac arrest (OHCA) has been proven to incre... more Background Early identification of out-of-hospital cardiac arrest (OHCA) has been 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 OHCA protocol. The criteria-based dispatch (CBD) protocol is a set of guidelines and prompts intended for dispatchers with clinical background and experience, while the medical priority dispatch (MPD) is a scripted caller interrogation protocol intended for non-healthcare dispatchers. The objective of this study was to compare CBD and MPD protocols in terms of accuracy and duration of the identification process. Methods To compare the two protocols we conducted an OHCA simulation of an emergency phone call by a bystander. Two groups participated in the simulation: 1) emergency medical technicians during paramedic vocational training, in the role of CBD dispatchers, and 2) non-healthcare personnel in the role of MPD dispatchers. Disp...
Human Factors: The Journal of the Human Factors and Ergonomics Society, 2019
Objective: To explore cognitive strategies clinicians apply while performing a medication reconci... more 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 clinicians use during reconciliation are unclear. Controlled lab experiments can explore how clinicians make sense of uncertain, missing, or conflicting information and therefore support the development of a human performance model. We hypothesize that clinicians apply varied cognitive strategies to handle this task and that profession and experience affect these strategies. Method: 130 clinicians participated in a tablet-based experiment conducted in a large American teaching hospital. They were asked to simulate medication reconciliation using a card sorting task (CaST) to organize medication and medical condition lists of a specific clinical c...
Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 2018
Pre-Hospital Emergency Medical Service work environments are complex, presenting unique challenge... more 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 situations, to ensure solutions to these challenges are well informed by representative evidence. This requires collecting data regarding human-system interactions occurring between many people with shifting roles, in dynamic and potentially dangerous environments, with complex patients and often acute time constraints. A lot is happening simultaneously, and our ability to learn and provide meaningful insights is challenged. In search for methods that will help us asses these situations we often use mixed methods that are adapted to the unique and changing conditions of each study. The goal of this session was to present Case Studies and methods...
Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 2018
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2018
Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 2017
Paramedics work in changing working environments, under varied constrains. The goal of this study... more 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 found that in 86% of the sessions paramedics changed their equipment positions during patient treatment. Our analysis also found that the monitor and the medication bag moved at the beginning of the sessions, while the air-way bag moved during the middle part of the session. This study demonstrates that paramedics are operating in a working environment that is not designed for the tasks they need to perform. This suboptimal setting results in paramedics’ need to change equipment positions while they are taking care of the patient. Future studies need to be done in order to develop recommendations for how to arrange the equipment around the pa...
Clinical simulation in nursing, Jun 1, 2024
Proceedings of the Human Factors and Ergonomics Society Annual Meeting
BMC Health Services Research
Introduction Telemedicine has been widely used in various medical settings including in Emergency... more 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 participated in a simulation. Participants communicated with the experimenter presenting video clips showing patients that simulated three emergency scenarios: trauma, an unresponsive patient with cardiac arrest, and an opiate overdose. The simulation sessions were conducted through Zoom™, recorded, and then analyzed to document participants’ questions, requests, instructions, and their timings during each scenario. Results The trauma scenario was assessed most promptly, with instructions to handle the bleeding provided by all paramedics. In the unresponsive patient with cardiac arrest scenario, most of the participants achieved a correct init...
Applied Sciences
Background. Arrival times at the scene and provision of initial emergency treatment have importan... more 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. Objective. We examined the effect of a suggested personal protective equipment (PPE) wearing protocol (gown protocol) on shortening pre-hospital treatment times compared to the current coverall protocol. Method. In this prospective simulation-based study, participants were instructed to inject a practice epinephrine syringe into a simulation mannequin after donning either a gown or a coverall PPE kit in the shortest possible time. Participants performed the two protocols in a randomized order. Donning time, physiological measures, and participants’ perceptions were measured after completion of each of the protocols. Results. Donning times and he...
International Journal of Healthcare Management
Human Factors: The Journal of the Human Factors and Ergonomics Society, 2021
Objective To develop a new model to quantify information management dynamically and to identify f... more 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 prehospital phase of a mass-casualty incident (MCI). Lessons learned from past MCIs indicate that poor information management can lead to increased mortality. Various instruments are used to evaluate information management during MCI training simulations, but the challenge of measuring and improving team leaders’ abilities to manage information remains. Method The Dynamic Communication Quantification (DCQ) model was developed based on the knowledge representation typology. Using multi point-of-view synchronized video, the model quantifies and visualizes information management. It was applied to six MCI simulations between 2014 and 2019, to identify factors that led to information gaps, and compared with other evaluation methods. Results Out of...
American Journal of Public Health, 2021
Emergency Medical Services (EMS) in Israel was called on to vaccinate the most vulnerable populat... more 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 vaccinating 126 245 people in two weeks at 756 locations countrywide, focusing on the planning and logistics of this operation. Resilience, flexible logistics, and dedicated personnel provided an efficient public health operation.
Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 2020
Introduction: Information management (also known as “communication” or “gathering and analyzing i... more 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 participant performance is evaluated. As such, varied instruments have been developed to measure information management quality during MCI simulations. Since every instrument could lead to different results, our goal at the current study was to evaluate what are the advantages of applying each one of the instruments. Methods: Three instruments were chosen for the current study: (1) The Self-Assessment Teamwork Tool for Students (SATTS), (2) a set of performance indicators aimed to be scored by an experienced observer, and (3) Dynamic Information Management Quantification Instrument (DIMQI) which allows quantifying information items. All instru...
Ergonomics in Design: The Quarterly of Human Factors Applications, 2020
Emergency response to a pandemic requires health care systems to initiate many activities. One of... more 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 call takers from potentially being infected by other staff members. An ad hoc facility has the flexibility to adjust to evolving demands and constraints. This article presents the need, the concerns, and the guidelines used to design such call center during the COVID-19 pandemic outbreak.
Technology and Health Care, 2020
Ergonomics in Design: The Quarterly of Human Factors Applications, 2019
Fast, effective, and accurate emergency medical treatment can save lives. Quick access to the spe... more 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 organizational standard for the way the medical items it contains are placed inside. With a user-centered method, we designed a kit that better fits first responders’ requirements and found that the kit – a backpack and a vest – is both easier to use and carry, based on emergency care priorities.
Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 2019
Australasian Journal of Paramedicine, 2019
Background Early identification of out-of-hospital cardiac arrest (OHCA) has been proven to incre... more Background Early identification of out-of-hospital cardiac arrest (OHCA) has been 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 OHCA protocol. The criteria-based dispatch (CBD) protocol is a set of guidelines and prompts intended for dispatchers with clinical background and experience, while the medical priority dispatch (MPD) is a scripted caller interrogation protocol intended for non-healthcare dispatchers. The objective of this study was to compare CBD and MPD protocols in terms of accuracy and duration of the identification process. Methods To compare the two protocols we conducted an OHCA simulation of an emergency phone call by a bystander. Two groups participated in the simulation: 1) emergency medical technicians during paramedic vocational training, in the role of CBD dispatchers, and 2) non-healthcare personnel in the role of MPD dispatchers. Disp...
Human Factors: The Journal of the Human Factors and Ergonomics Society, 2019
Objective: To explore cognitive strategies clinicians apply while performing a medication reconci... more 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 clinicians use during reconciliation are unclear. Controlled lab experiments can explore how clinicians make sense of uncertain, missing, or conflicting information and therefore support the development of a human performance model. We hypothesize that clinicians apply varied cognitive strategies to handle this task and that profession and experience affect these strategies. Method: 130 clinicians participated in a tablet-based experiment conducted in a large American teaching hospital. They were asked to simulate medication reconciliation using a card sorting task (CaST) to organize medication and medical condition lists of a specific clinical c...
Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 2018
Pre-Hospital Emergency Medical Service work environments are complex, presenting unique challenge... more 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 situations, to ensure solutions to these challenges are well informed by representative evidence. This requires collecting data regarding human-system interactions occurring between many people with shifting roles, in dynamic and potentially dangerous environments, with complex patients and often acute time constraints. A lot is happening simultaneously, and our ability to learn and provide meaningful insights is challenged. In search for methods that will help us asses these situations we often use mixed methods that are adapted to the unique and changing conditions of each study. The goal of this session was to present Case Studies and methods...
Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 2018
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2018
Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 2017
Paramedics work in changing working environments, under varied constrains. The goal of this study... more 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 found that in 86% of the sessions paramedics changed their equipment positions during patient treatment. Our analysis also found that the monitor and the medication bag moved at the beginning of the sessions, while the air-way bag moved during the middle part of the session. This study demonstrates that paramedics are operating in a working environment that is not designed for the tasks they need to perform. This suboptimal setting results in paramedics’ need to change equipment positions while they are taking care of the patient. Future studies need to be done in order to develop recommendations for how to arrange the equipment around the pa...