School of Informatics, University of Edinburgh, UK.
Artif Intell Med. 2011 Nov;53(3):139-60. doi: 10.1016/j.artmed.2011.08.005. Epub 2011 Sep 7.
The problem of designing and managing teams of workers that can collaborate working together towards common goals is a challenging one. Incomplete or ambiguous specification of responsibilities and accountabilities, lack of continuity in teams working in shifts, inefficient organization of teams due to lack of information about workers' competences and lack of clarity to determine if the work is delegated or assigned are examples of important problems related to collaborative work in healthcare teams. Here we address these problems by specifying goal-based patterns for abstracting the delegation and assignment of services. The proposed patterns should provide generic and reusable solutions and be flexible enough to be customizable at run time to the particular context of execution. Most importantly the patterns should support a mechanism for detecting abnormal events (exceptions) and for transferring responsibility and accountability for recovering from exceptions to the appropriate actor.
To provide a generic solution to the problematic issues arising from collaborative work in teams of health workers we start from definitions of standard terms relevant for team work: competence, responsibility, and accountability. We make explicit the properties satisfied by service assignment and delegation in terms of competences, responsibilities, and accountability in normal scenarios and abnormal situations that require the enactment of recovery strategies. Based on these definitions we specify (1) a basic terminology, (2) design patterns for service assignment and delegation (with and without supervision), and (3) an exception manager for detecting and recovering from exceptions. We use a formal framework to specify design patterns and exceptions.
We have proved using Owicki-Gries Theory that the proposed patterns satisfy the properties that characterize service assignment and delegation in terms of competence, responsibility and accountability in normal and abnormal (exceptional) scenarios. We show that although abstract, the proposed patterns can be instantiated in an executable COGENT prototype, and can be mapped into the Tallis tool that enacts PROforma language specifications of medical guidelines.
The proposed patterns are generic and abstract enough to capture the normal and abnormal scenarios of assignment and delegation of tasks in collaborative work in health care teams.
设计和管理能够共同协作实现共同目标的工人团队是一项具有挑战性的任务。职责和责任不完整或不明确、轮班工作团队的连续性缺失、由于缺乏工人能力信息而导致团队组织效率低下以及缺乏明确性以确定工作是委托还是分配，这些都是与医疗保健团队协作工作相关的重要问题的例子。在这里，我们通过指定基于目标的模式来抽象服务的委托和分配来解决这些问题。所提出的模式应提供通用且可重复使用的解决方案，并具有足够的灵活性，以便在运行时针对特定的执行上下文进行定制。最重要的是，这些模式应支持一种用于检测异常事件（异常）并将责任和问责制从异常转移到适当的参与者的机制。
为了为医疗工作者团队协作工作中出现的问题提供通用解决方案，我们从与团队工作相关的标准术语的定义开始：能力、责任和问责制。我们明确了在正常场景和需要实施恢复策略的异常场景中，服务分配和委托在能力、责任和问责制方面满足的属性。基于这些定义，我们指定了（1）基本术语，（2）具有和不具有监督的服务分配和委托设计模式，以及（3）用于检测和从异常中恢复的异常管理器。我们使用正式框架来指定设计模式和异常。
我们已经使用 Owicki-Gries 理论证明了所提出的模式满足了在正常和异常（异常）场景中根据能力、责任和问责制来描述服务分配和委托的属性。我们表明，尽管是抽象的，但所提出的模式可以在可执行的 COGENT 原型中实例化，并可以映射到 Tallis 工具中，该工具可以执行医疗指南的 PROforma 语言规范。
所提出的模式具有足够的通用性和抽象性，可以捕获医疗保健团队协作工作中任务分配和委托的正常和异常场景。
