Modelling With Common Kads Computer Science Essay

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Introduction to the Problem and Solutions by use of commonKADS modelling knowledge tool. The Emergency Medical Service is in serious problems, which involve structural problems, service problems and financial problems and management problems. The first solution is to ensure Geographical presence by use of Organisational model OM design with these geographical regions as a pedestal in the structure for EMS as shown in the FIG 1.

Second solution to do this the seventeen municipalities must each set up a Sub Ems centre by franchising the EMS service through stationing paramedics at the General practitioners clinics.

Third solution is to set up EMS centres using the entire 17

Municipalities hence 17 EMS centre.

Fourth solution is to divide entire population into equal number of households to be assigned the nearest Ems centre for proximity and premedical screening for prediction purposes since prevention better than cure.

Fifth solution is to divide the already existing population figure of approximately 1.250.000 citizens into EMS sub-units of 1000Ea persons each serving approximately 1250 citizens per centre.

Sixth solution in service based solution involve assigning ten customer care specialist to handle 400 calls each to average of 20 calls at day and 20 calls at night since day is 24 hrs schedule. This means that average calls per hour are two. Now a well-trained paramedic can handle two patients per hour and this is enough time to do triage before the next caller.

Seventh solution is to station the ambulances at each geographical region and an expert doctor strained in AMI to eliminate the need to travel faro hospital hence eliminate delays in both patient and GP as they are near an EMS centre. The GP may need to be trained in AMI to deal and assist EMS on fee basis modality with the 250 to 300 of which require transport to a hospital. The transport distance problem will be removed.

Eighth solution is to train all General Practitioners to do coronary repercussion therapy, as they are the one who have earliest expert diagnosis acute myocardial infarction (AMI).

Ninth solution is set up educational tasks for heart foundation to educate citizens on onset of heart problem symptoms since this therapy depends on the time elapsed from symptoms to treatment.

Tenth solution is improvements during emergency management by alerting on Patient delay: the patient to avoid delay of one hour.

Eleventh solution is to The Netherlands Heart foundation expands the role of the Netherlands Foundation to also deal with other fatal diseases as a way of reducing psychological barriers to self-assessment.

Twelfth solution is to educate people to call even outside office hours, even if not sure of heart condition.

Thirteenth solution is to get rid of GP arrival delay by allowing mobile access emergency using patients telephone lines so that EMS arrives earlier because it takes about one and a half hour before the GP is with the patient and has made a judgement about the disease.

Fourteenth solution is for Treatment delay: is to send paramedic to start treatment at patient home using the coronary repercussion therapy because if treatment is delayed until arrival at the hospital another 25 minutes is lost.

Fifteenth solution is bypass the Gp and increase of calls is good as it educates the citizens about EMS and the non-urgent problems are an opportunity to eradicate psychological barriers

To solve these problems we will embark on modelling using common Kads, which helps us focus on the EMS processes.

Analysis of EMS case study

His biggest problem involves the deaths caused by preventable condition of AMI heart failure in Netherlands. To solve this problem we will use common KADS modelling knowledge tool to get the main cause, cause s, and remove the root cause of this problem by use of communards.

Other roots causes of these deaths are

2-.the size of the size area covered by Ems is largest area in the Netherlands. The service area of 1015.34 km2 is too large for centralised system of emergency. This means the design of the EMS has to use size as a parameter to ensure services reach the patients in time due to distances from Hospitals therefore, The analysis of complementary changes that are required such as their is need for changes in workflow processes and agent capabilities, as well Business and Technical feasibility . There are advantages and disadvantages of the new changes due to common KADS tool applied to management functions for efficiency.

It will entail to Streamline EMS by Merge the Two units of the EMS: the dispatch centre and the ambulance service. The dispatch centre and the ambulance service which are physically Separated should be joined and thirdly department of information services of The Municipal Medical and Sanitary Service. Two types of functions should be integrated together for one team action into both support and emergency and should not be distinguished at the EMS so that they can be performed by multi-skilled employees .Further integration of the three emergency-management functions: (I) communication &

Coordination, (ii) emergency medical care, and (iii) the ambulance function together with the Support functions of archiving, evaluation, policymaking, and supervision will mean a multi skilled staff performed at one point of action by one person at once. This is to avoid duplication of time and wastage of resources, reduce the number of staff, and increase the skills of few well-trained paramedics

The staff at dispatch centre nurse dispatchers will be retrenched as they are redundant due to the new processes and there roles absorbed by multiskilled paramedics who solve the TRIAGE deficit at EMS while carrying out the communication & coordination function as one multi skill job by one person at a go. This will also reduce staff and costs at the ambulance service, now supervised by paramedic who is a peer to each ambulance paramedic, and the driver should be a trained paramedic to carries out emergency medical care as well. The paramedics should also be able to be good drivers who will responsible for the ambulance function in an emergency to assist in transport and delivery also… All the paramedics will integrate the roles of the system manager and be responsible for the archiving function. They will be in charge of both the dispatch centre and the ambulance service as a team responsible to team goals in carrying out evaluation, policy making and supervision functions.

Only the manager of the entire EMS service is senior over all the staff regardless of their roles since the skills of system manager and of the dispatchers are integrated into multi skilled paramedics .The cases are assigned to several paramedics who in turn are in charge of drivers and an ambulance each. In addition, calls directly from citizens are received by paramedics who are trained in triage hence reducing chance of non-emergencies and heuristics tendencies. The ambulance service is a multiskilled role for the paramedic and driver. The manager of the General and Social Sanitary Service will remain as head of one EMS with streamlined integrated function of not both departments. We shall have eliminated the dispatch centre and the dispatchers, replaced with senior paramedics in charge of handling medical emergencies, and in this role coordinated and not controls peer paramedics who now formally perform the ambulance function, and be formally their supervisor. The ambulance personnel and dispatchers do will now socialize as both peers and as one team. Information support system of the EMS, which uses IBM RISC/600/320 machines under UNIX, to run and it, performs other tasks including

Emergency issues as well as finance and some medical statistics, will now be fully integrated and more useful as the same staff that developed it the information services department of the Municipal Medical and Sanitary Service will now use it. The use of Graphical terminals that are not used now will be explored.

Business Feasibility

To address the above business engineering using common KADS knowledge management-modelling tool, will means a complete re-engineering of the systems at EMS.it is feasible provided the costing is reduced by employing less workers who are more skilled hence more efficient and effective. Business Feasibility goal will be achieved by reduces the staff numbers by making them multi skilled .Ensure removing the drivers and nurses from the EMS. Retrench dispatch manager and his function skills are integrate d in the work of the ambulance manager. The Ems must integrate the service process as well as the staff then we empower the GP and integrate them to EMS service. To involve the GP Empower the GP with the EMS function.

Technical Feasibility

The new processes and work flows are technically easy implement since the IT department will now integrate all functions including both electronic as well as manual queuing and prioritization scheduling and will no longer be the only way to determines outcomes but juts one among many other Ems support functions done by professionals with professionalism.

Advantages and disadvantages of using commonKADS knowledge models

Use of commonKads is a knowledge intensive task

They help us from working from scratch and ths means they can be re used in different scenario by ensuring we do not re-invent the wheel. CommonKADs are cost saving. They are efficient in terms of refocusing organisations to theory mission and goals. They are simplification in regards to complex work situations and tasks. They help in assuring managers on quality execution of duties.

Figure 1 - Emergency medical Service (EMS) Organization Structure

MUNICIPAL MEDICAL & SANITARY SERVICE



EMS CONTROL CENTRE



PATIENTS AND GENERAL PRACTITIONERS

A. Organizational Model OM-1

Table 1 - Worksheet OM-1; ORGANISATION MODEL-1

Organization Model

Problems and Opportunities OM-1

Problems and solutions

Opportunities

Inefficiency, poor organisational structural, financial constraints, psychological barriers, teamwork poor coordination, inadequate skills,

New power relationships and new processes

Context

Mission:

Save lives while generating extra income to cater for sustainability fund to expand role of EMS in health care

Goal:

To increase life expectancy of all by predicting and eliminating emergencies in long term and short term.

The first solution is to ensure Geographical presence by use of Organisational model OM design with these geographical regions as a pedestal in the structure of EMS

Second solution to do this the seventeen municipalities must each set up a Sub Ems centre by franchising the EMS service through stationing paramedics at the General practitioners clinics.

Third solution is to set up EMS centres using the entire 17 Municipalities hence 17 EMS centre.

Fourth solution is to divide entire population into equal number of households to the nearest Ems centre for proximity and premedical screening for prediction purposes since prevention better than cure.

Fifth solution is to divide the already existing population figure of approximately 1.250.000 citizens into EMS sub-units of 1000, each serving approximately 1250 citizens per centre.

Sixth solution in service based solution involve assigning ten customer care specialist to handle 400 calls each to average of 20 calls at day and 20 calls at night since day is 24 hrs schedule. This means that average calls per hour are two. Now a well-trained paramedic can handle two patients per hour and this is enough time to do triage before the next caller.

Seventh solution is to station the ambulances at each geographical region and an expert doctor strained in AMI to eliminate the need to travel far to hospital. hence eliminate delays in both patient and GP as they are near a EMS c enter and the GP may be need to be trained in AMI to deal with the 250 to 300 of which require transport to a hospital. The transport distance will be removed.

The Eighth, solutions is to train all General Practitioners to do coronary repercussion therapy, as they are the one who have earliest expert diagnosis acute myocardial infarction (AMI).

Ninth solution is set up educational tasks for heart foundation to educate citizens on onset for heart problem symptoms since this therapy depends on the time elapsed from symptoms to treatment.

Tenth solution is improvements during emergency management by alerting on Patient delay: the patient to avoid delay of one hour.

Eleventh solution is to The Netherlands Hear expand the role of the Netherlands Foundation to also deals with other fatal diseases as a way of reducing psychological barriers to self-assessment.

Twelfth solution is to educate people to call even outside "office hours", even if not sure of heart condition.

Thirteenth solution is to get rid of GP arrival delay by allowing mobile access emergency using patients telephone lines so that EMS arrives earlier because it takes about one and a half hour before the GP is with the patient and has made ajudgement about the disease.

Fourteenth solution is for Treatment delay: is to send paramedic to start treatment at patient home using the coronary repercussion therapy because if treatment is delayed until arrival at the hospital another 25 minutes is lost.

Fifteenth solution is bypass the Gp and increase of calls is good as it educates the citizens about EMS and the non-urgent problems are an opportunity to eradicate psychological barriers

B. Worksheet OM-2 (see table 2) describes the analysis done on the process.

Table 2 - Worksheet OM-2 TASK MODEL -TM-2

TASK MODEL

DESCRIPTION

Structure

The new structure has only the ems centre headed by one manager. Under him is the senior paramedic and under them is the ambulance and driverS

Process

One major task of saving lives by early diagnosis.

People

One senior paramedic manager for EMS centre

Team of paramedics at the centre who do triage dispatch ambulance and coordination archiving and citizen education campaign in liaison with heart foundation

Driver supervised by paramedics

General practitioner as collaborator with EMS

Patient's callers who need service

Resources

First aid tool kits

Ambulances

Human resources e.g. paramedics and drivers

Knowledge

Multi-skilled in medical and

Mechanical knowledge for drivers

Self-assessment for patients

Customer care for all staff and general practitioners

Collaboration government department for heart foundation

Table 3 - Worksheet OM-3-EXPERTISE MODEL-EM-3

EXPERTISE MODEL

DUTIES AND ROLE Worksheet OM-3

No.

Task

Report

To

Supervisor of

Knowledge Asset

SENIOR PARAMEDIC

Manager of Ems

Customer care

GMSS

Paramedic's team

Multi skilled paramedic

PARAMEDICS

Receive call s and do triage

And customer care

EMS

Manager

Ambulance drivers

Multiple skill sets

Worksheet OM-4 KNOWLEDGE COMMUNICATION MODEL-CM-4

KNOWLEDGE MODEL MODEL

Knowledge asset Asset

Pos-possessed by

Used In

Right Form?

Right Place?

Right Time?

Right Quality?

Medical expertise and customer care

PARAMEDICS & General Practitioner

TRIAGE

Yes

Yes

YES

Yes

IT support system

PARAMEDICS

Scheduling& policymaking,

Yes)

Yes

Yes

Yes

HEART FOUNDATION INFORMATION

Para- medic and Drivers

Reduce psychological barriers

Yes

Yes

Yes

Yes

Traffic code

Knowledge

Driver

Hospital transport

Yes

Yes

Yes

Yes

Figure 2 - New Service Flow scheme process

SENIOR PARAMEDIC-MANAGER EMS CONTROL CENTRE



PARAMEDICS TEAM

(Receive Triage calls)(IT, INFORMATION SYSTEM, archiving scheduling)

 

AMBULANCE PARAMEDIC (AND DRIVERS

 

GENERAL PRACTITIONER and PATIENTS (callers)

Figure 3: Data /information Flow Scheme

Senior paramedics (Ems control centre)



Paramedics and ambulance driver (evacuation and first aid Emergency treatment)



Direct Callers information both patients & General practitioners

Conclusion

In conclusion, the use of CommonKADS the knowledge model makes it easy to designate knowledge and conceptualise the relevant domains, tasks, sub-task to be done, and inferences to be made. This tool has helped us to refocus the EMS specific knowledge and the information assets that are needed in the solutions to challenges facing EMS from structural problems to informal and formal power employee client relations to professional doctor's oaths objectives to be achieved.

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