A modelling approach to studying variations in newborn life support procedure

Tan, Alfian; Remenyte-Prescott, Rasa; Valstar, Michel; Sharkey, Don

Abstract

Variations in clinical practice are common. However, some variations may cause undesired consequences. Careful consideration of their causes and effects is necessary to assure the quality of healthcare delivery. A modelling approach that could capture these aspects would help to achieve this goal. In this paper, a Newborn Life Support procedure is modelled. This activity is considered prone to error with reduced outcomes for the patient. Hence, it is necessary to understand the nature of the activity and its variations. A Coloured Petri Net (CPN) approach and a simulation technique are used for this purpose. The CPN colours are used to represent the characteristics of babies and to control the flow of tokens representing the resuscitation procedure. Probabilistic modelling aspects include the duration of individual tasks, the choice of treatment and the condition of the baby. The model outputs consist of the percentage of babies with an unsatisfactory outcome, the percentage of babies who need full resuscitation, and the duration of the procedure until a satisfactory condition is achieved. The modelling approach is demonstrated using a number of scenarios on some common NLS variations, relating to the maximum number of ventilation and the probability of errors in the inflation procedure.

Citation

Tan, A., Remenyte-Prescott, R., Valstar, M., & Sharkey, D. (2024). A modelling approach to studying variations in newborn life support procedure. Proceedings of the Institution of Mechanical Engineers, Part O: Journal of Risk and Reliability, 238(4), 777-796. https://doi.org/10.1177/1748006X231173595

• Journal Article Type: Article
• Acceptance Date: Apr 14, 2023
• Online Publication Date: May 12, 2023
• Publication Date: 2024-08
• Deposit Date: Apr 18, 2023
• Publicly Available Date: Apr 19, 2023
• Journal: Proceedings of the Institution of Mechanical Engineers, Part O: Journal of Risk and Reliability
• Print ISSN: 1748-006X
• Electronic ISSN: 1748-0078
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 238
• Issue: 4
• Pages: 777-796
• DOI: https://doi.org/10.1177/1748006X231173595
• Keywords: Coloured Petri Nets; Simulation; Newborn Life Support; Clinical Practice Variation
• Public URL: https://nottingham-repository.worktribe.com/output/19760937
• Publisher URL: https://journals.sagepub.com/doi/full/10.1177/1748006X231173595