Skip to main content

Agent-Based Modelling for Risk Assessment of Routine Clinical Processes

  • Conference paper
Book cover Principles and Practice of Multi-Agent Systems (PRIMA 2010)

Part of the book series: Lecture Notes in Computer Science ((LNAI,volume 7057))

Abstract

Prospective risk analysis is difficult in complex sociotechnical systems where humans interact with one other and with information systems. Traditional prospective risk analysis methods typically capture one risk at a time and rely on the specification of a chronological sequence of errors occurring in combination. The aim here is to introduce agent-based risk assessment (ABRA), which addresses these issues by simulating multiple concurrent and sequential interactions amongst autonomous agents that act according to their own goals. The methodology underlying the construction, simulation and validation of ABRA models is detailed along with practical considerations associated with implementation, for which the Brahms agent-based simulation framework is used. The challenges of implementing agent-based risk assessment models include the need for well-defined work processes and reliable observational data, and difficulties associated with behavioural validation. As an example illustrating the technique, a simple race condition hazard is implemented using an ABRA model. The work process involves a human operator and a machine interface that interact to sometimes produce the erroneous transfer of information. The correctness of the model is confirmed by comparing the simulated results against the well-defined theoretical baseline.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Baird, D.R., Henry, M., Liddell, K.G., Mitchell, C.M., Sneddon, J.G.: Post-Operative Endophthalmitis: The Application of Hazard Analysis Critical Control Points (HACCP) to an Infection Control Problem. Journal of Hospital Infection 49, 14–22 (2001)

    Article  Google Scholar 

  2. Barlas, Y.: Formal Aspects of Model Validity and Validation in System Dynamics. System Dynamics Review 12, 183–210 (1996)

    Article  Google Scholar 

  3. Bharathy, G., Silverman, B.: Validating Agent Based Social Systems Models. In: Proceedings of the 2010 Winter Simulation Conference, pp. 441–453 (2010)

    Google Scholar 

  4. Bonan, B., Martelli, N., Berhoune, M., Maestroni, M.-L., Havard, L., Prognon, P.: The Application of Hazard Analysis and Critical Control Points and Risk Management in the Preparation of Anti-Cancer Drugs. International Journal for Quality in Health Care 21, 44–50 (2009)

    Article  Google Scholar 

  5. Bonnabry, P., Cingria, L., Sadeghipour, F., Ing, H., Fonzo-Christe, C., Pfister, R.E.: Use of a Systematic Risk Analysis Method to Improve Safety in the Production of Paediatric Parenteral Nutrition Solutions. Quality and Safety in Health Care 14, 93–98 (2005)

    Article  Google Scholar 

  6. Burgmeier, J.: Failure Mode and Effect Analysis: An Application in Reducing Risk in Blood Transfusion. Joint Commission Journal on Quality Improvement 28, 331–339 (2002)

    Article  Google Scholar 

  7. Chiozza, M.L., Ponzetti, C.: FMEA: A Model for Reducing Medical Errors. Clinica Chimica Acta 404, 75–78 (2009)

    Article  Google Scholar 

  8. Cohen, M.R., Senders, J., Davis, N.M.: Failure Mode and Effects Analysis: A Novel Approach to Avoiding Dangerous Medication Errors and Accidents. Hospital Pharmacy 29, 319–330 (1994)

    Google Scholar 

  9. Dunn, A.G., Ong, M.-S., Westbrook, J.I., Magrabi, F., Coiera, E., Wobcke, W.R.: A Simulation Framework for Mapping Risks in Clinical Processes: The Case of In-Patient Transfers. Journal of the American Medical Informatics Association (to appear, 2011)

    Google Scholar 

  10. Duwe, B., Fuchs, B.D., Hansen-Flaschen, J.: Failure Mode and Effects Analysis Application to Critical Care Medicine. Critical Care Clinics 21, 21–30 (2005)

    Article  Google Scholar 

  11. Epstein, J.M.: Why Model? Journal of Artificial Societies and Social Simulation 11(4), 12 (2008)

    Google Scholar 

  12. Griffith, C., Obee, P., Cooper, R.: The Clinical Application of Hazard Analysis Critical Control Points (HACCP). American Journal of Infection Control 33, e39 (2005)

    Google Scholar 

  13. Iedema, R.A.M., Jorm, C., Long, D., Braithwaite, J., Travaglia, J., Westbrook, M.: Turning the Medical Gaze in Upon Itself: Root Cause Analysis and the Investigation of Clinical Error. Social Science & Medicine 62, 1605–1615 (2006)

    Article  Google Scholar 

  14. Klügl, F.: A Validation Methodology for Agent-Based Simulations. In: Proceedings of the 2008 ACM Symposium on Applied Computing, pp. 39–43 (2008)

    Google Scholar 

  15. Koppel, R., Wetterneck, T., Telles, J.L., Karsh, B.-T.: Workarounds to Barcode Medication Administration Systems: Their Occurences, Causes, and Threats to Patient Safety. Journal of the American Medical Informatics Association 15, 408–423 (2008)

    Article  Google Scholar 

  16. Leveson, N., Turner, C.S.: An Investigation of the Therac-25 Accidents. IEEE Computer 26(7), 18–41 (1993)

    Article  Google Scholar 

  17. Marx, D.A., Slonim, A.D.: Assessing Patient Safety Risk Before the Injury Occurs: An Introduction to Sociotechnical Probabilistic Risk Modelling in Health Care. Quality and Safety in Health Care 12, ii33–ii38 (2003)

    Article  Google Scholar 

  18. Ong, M.-S., Coiera, E.: Safety Through Redundancy: A Case Study of In-Hospital Patient Transfers. Quality and Safety in Health Care (2010) (to appear)

    Google Scholar 

  19. Rasmussen, J., Nixon, P., Warner, F.: Human Error and the Problem of Causality in Analysis of Accidents [and Discussion]. Philosophical Transactions of the Royal Society of London, Series B, Biological Sciences 327, 449–462 (1990)

    Article  Google Scholar 

  20. Reason, J.: Human Error: Models and Management. British Medical Journal 320, 768–770 (2000)

    Article  Google Scholar 

  21. Robinson, D.L., Heigham, M., Clark, J.: Using Failure Mode and Effects Analysis for Safe Administration of Chemotherapy to Hospitalized Children with Cancer. Joint Commission Journal on Quality and Patient Safety 32, 161–166 (2006)

    Article  Google Scholar 

  22. Runciman, B., Merry, A., Walton, M.: Safety and Ethics in Healthcare, Ashgate, Aldershot (2007)

    Google Scholar 

  23. Sierhuis, M., Clancey, W.J., van Hoof, R.J.J.: Brahms: A Multi-Agent Modelling Environment for Simulating Work Processes and Practices. International Journal of Simulation and Process Modelling 3, 134–152 (2007)

    Article  Google Scholar 

  24. Spear, S.J., Schmidhofer, M.: Ambiguity and Workarounds as Contributors to Medical Error. Annals of Internal Medicine 142, 627–630 (2005)

    Article  Google Scholar 

  25. West, E.: Organisational Sources of Safety and Danger: Sociological Contributions to the Study of Adverse Events. Quality and Safety in Health Care 9, 120–126 (2000)

    Article  Google Scholar 

  26. Windrum, P., Fagiolo, G., Moneta, A.: Empirical Validation of Agent-Based Models: Alternatives and Prospects. Journal of Artificial Societies and Social Simulation 10(2), 8 (2007)

    Google Scholar 

  27. Wooldridge, M., Jennings, N.R.: Intelligent Agents: Theory and Practice. The Knowledge Engineering Review 10, 115–152 (1995)

    Article  Google Scholar 

  28. Woolf, S.H., Kuzel, A.J., Dovey, S.M., Phillips Jr., R.L.: A String of Mistakes: The Importance of Cascade Analysis in Describing, Counting, and Preventing Medical Errors. Annals of Family Medicine 2, 317–326 (2004)

    Article  Google Scholar 

  29. Wreathall, J., Nemeth, C.: Assessing Risk: The Role of Probabilistic Risk Assessment (PRA) in Patient Safety Improvement. Quality and Safety in Health Care 13, 206–212 (2004)

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Wobcke, W., Dunn, A. (2012). Agent-Based Modelling for Risk Assessment of Routine Clinical Processes. In: Desai, N., Liu, A., Winikoff, M. (eds) Principles and Practice of Multi-Agent Systems. PRIMA 2010. Lecture Notes in Computer Science(), vol 7057. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-25920-3_37

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-25920-3_37

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-25919-7

  • Online ISBN: 978-3-642-25920-3

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics