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Hindawi Journal of Electrical and Computer Engineering Volume 2022, Article ID 2351648, 7 pages https://doi.org/10.1155/2022/2351648 Research Article Analysis of Human Reliability in Fever Clinics during the Epidemic Based on the DEMATEL Method Ange Lin and Xiongfeng Chen e First Aliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China Correspondence should be addressed to Xiongfeng Chen; chenxf@wmu.edu.cn Received 7 March 2022; Revised 24 March 2022; Accepted 20 April 2022; Published 5 May 2022 Academic Editor: Wei Liu Copyright © 2022 Ange Lin and Xiongfeng Chen. �is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To explore the method and process of human reliability analysis in epidemic prevention and control system in the complex environment of fever clinics. Methods. Based on the actual situation in the fever clinic of a level A tertiary hospital in Wenzhou, factors that aƒect clinical safety are sorted out. �e Delphi method is used when evaluating the interrelationship among the contributing factors, and then, the DEMATEL method is used to further sort it out to build an impact model. Finally, the data of the experimental model are analyzed, and the impact of factors on human reliability is summarized. Results. �rough the data analysis of 23 factors in the fever clinic of the hospital, the impact, prominence, and relation of each factor are conˆrmed. It is concluded that layout design, disinfection, and isolation setting and on-the-job training are the core factors impacting the operation of the fever clinic. Conclusion. Conducting a human factor reliability analysis with the help of the DEMATEL method can quantitatively describe the inŽuence and interrelationship of human factors in epidemic prevention and control system and eƒectively promote the safety enhancement of fever clinics. establishment and improvement of its safety is largely based 1. Introduction on the empirical guidance of personnel, and the evaluation With the normalization of the prevention and control of the method is concise and intuitive. However, it is impossible to coronavirus pneumonia epidemic in China, fever clinics and comprehensively assess the overall state of and the potential reserved observation rooms need to be standardized in dangers in the safety system [6]. �is study combines the general hospitals at the secondary level and above in ac- method of expert evaluation with quantitative analysis, in cordance with the joint prevention and control mechanism order to accurately quantify the reliability of fever outpa- of the State Council to cope with the spread of the epidemic tients, and uses data indicators to evaluate various risk in local areas [1]. �e scientiˆc design and eƒective operation factors, so as to scientiˆcally and comprehensively improve of fever clinics is an important part of the current epidemic the operation safety of fever clinics [7, 8]. Decision-making trial and evaluation laboratory (DEMATEL) was proposed prevention and control and is closely related to the estab- lishment of the overall prevention and control system [2, 3]. by A. Gabus and E. Fontela at the Geneva Conference to �e speciˆc design of fever clinics is related to the actual cope with complex and diŸcult problems in real scenarios, situation of the hospital where they are located, and human which uses graph theory and matrix tools to analyze system factors play a decisive role in their safe and reliable use. security [9]. DEMATEL is used in complex work scenarios Human error is also an important cause of nosocomial focusing on human factors to improve system reliability, infections, and improving the reliability of human factors is eliminate potential hazards, and oƒer guidance for the a guarantee for lowering the risk of infections occurring improvement of project procedures [10–12]. Unlike the within the hospital [4, 5]. �ere are great diƒerences in the currently widely used interpretative structural modeling (ISM) method, which focuses on revealing the qualitative design of fever clinics in diƒerent hospitals, and the 2 Journal of Electrical and Computer Engineering Table 1: Factors affecting the reliability of fever clinics. Types Factors Codes Location independence F1 Architectural planning Zoning and layout F2 Medical equipment F3 Independent air conditioning F4 Equipment and facilities Ventilation equipment F5 Disinfection and isolation design F6 Information technology equipment F7 Allocation of doctors F8 Staffing Allocation of nurses F9 Induction training F10 Service guidance F11 Close inspection of patients F12 24-hour consultation F13 Closed-loop management of patients F14 Operation management Reporting of suspicious cases F15 Transfer of suspected or confirmed cases F16 Environmental cleaning and disinfection F17 Waste disposal F18 Standard prevention F19 Personal protective equipment F20 Staff protection Reasonable selection of protective equipment F21 Proper donning and doffing of protective equipment F22 Staff health monitoring F23 systematically and comprehensively reflect the procedure for structural forms within a system, it can effectively quantify the influence of constituents in a large and complex system medical treatment in fever clinics in hospitals [21–24]. and the degree of interaction with other constituents [13]. (e influencing factors are divided into five categories: (e DEMATEL method is used in a wide range of fields such architectural planning, equipment and facilities, staffing, as construction management of nuclear power plant facil- operation management, and medical staff protection, as ities, assessment of mechanical engineering, and analysis of shown in Table 1. the development of sustainable energy industries [14–16]. Based on the existing studies, we sort out and summarize the 3. Establishment of the DEMATEL Model for factors affecting the reliability of the operation system of Fever Clinics fever clinics through expert discussion, surveys, and field research [17, 18]. (e DEMATEL method is introduced to 3.1. Establishment of Relation Matrix Based on Expert construct the human factors reliability analysis model, so as Evaluation. To analyze the overall system with the to identify key influencing factors [19]. Correlations among DEMATEL method, it is necessary to confirm the rela- the factors are analyzed to assess the specific status of the tionship between the influencing factors first. Due to the system safety in fever clinics and to provide quantitative existence of certain ambiguity in human linguistic de- reference for the establishment and improvement of system scriptions, precise measurement of the factors is impossible. reliability in fever clinics [20]. (is study demonstrates a In this study, a 5-level scale is used to measure the impact method to enhance the ability of medical institutions to of the influencing factors, and different levels of impact are respond to infectious diseases through theoretical analysis graded as 0, 1, 2, 3, and 4, respectively, as shown in Table 2. without resorting to additional applied equipment. It has Four experts were invited to assess the relationship positive implications for exploring the level of medical safety between the 23 influencing factors with the Delphi method, and protection enhancement in global epidemics. and the factor relationship diagram is shown in Figure 1. 2. Factors Affecting the Reliability of Fever 3.2. Establishment of Comprehensive Influence Matrix. (e Clinics direct influence matrix M is established according to the (e fever clinic of a level A tertiary hospital in Wenzhou was relationship diagram. Based on the normalized results of the matrix M, the canonical influence matrix N is established, selected as the research object for the study and analysis. After the review of policy documents and research papers on which is calculated as [25] epidemic prevention and control and field research by the aij authors of this study, 23 influencing factors related to the (1) N � . Max var n×n safety in the fever clinic system were summarized, which can Journal of Electrical and Computer Engineering 3 Table 2: Expert evaluation scale. Linguistic description No impact Low impact Moderate impact High impact Extreme impact Scale 0 1 2 3 4 F1 F23 F2 F22 F3 F21 F4 F20 F5 F19 F6 F7 F18 F8 F17 F9 F16 F15 F10 F11 F14 F13 F12 Scale Corresponding lines 1 3 2 4 Figure 1: Relation diagram. Both direct and indirect relations can be found among the comprehensive inŽuence degree of each row’s elements the inŽuencing factors, and the factors are superimposed on on the rest of the elements, and the set is denoted as D: each other to establish a comprehensive inŽuence matrix T, D D ,D ,D , . . . ,D , (3) 1 2 3 n which was calculated as [17] where D tij, (i 1, 2, 3, ... ,n) i j1 2 3 k k − 1 T N + N + N + .. . + N N ⟶ T N(I − N) , �e degree of being impacted reŽects the comprehensive k1 inŽuence of elements of each column in the matrix Tfrom all (2) other elements. �e sum of the values of each column of the − 1 matrix T is the comprehensive inŽuence degree of each where I is the unit matrix and (I − N) is the inverse column’s elements on the rest of the elements, and the set is matrix of (I − N). denoted as C: C (C1,C2,C3, ... , Cn), (4) 3.3. Calculation of Relation between Human Factors. �e impact degree D and the degree of being impacted C are where C tij, (i 1, 2, 3, · · ·,n). j1 calculated, according to the value of t in the comprehensive ij inŽuence matrix T and the comprehensive inŽuence degree of factor i on factor j, as shown in equations (3) and (4) [26]. 3.4. Calculation of Centrality and Causality. Centrality and �e degree of impact reŽects the comprehensive inŽu- causality are calculated based on the impact degree and ence of elements of each row in the matrix T on all other the degree of being impacted, as shown in equations (5) elements. �e sum of the values of each row of the matrix Tis and (6) [18]. In addition, identiˆcation of factors’ 4 Journal of Electrical and Computer Engineering Key factors Minor factors Impact in the system Minor dependent factors Dependent factors Figure 2: Interactions and importance of factors in the system. 000030 0000000202 0200000 001144 0000300400 2400000 000000 0000040000 0000000 100003 0000000000 2000000 330004 0000000000 3000000 130030 2003200400 0300200 002001 0001100010 0000000 0 000000 0000442410 000000 0000000 000344211 0000000 0000000 000230300 2240440 0200000 000000400 0000000 M = 0000000 000000440 0000000 0000000 440000000 0000000 0000000 000000003 0000000 0000000 000000002 0000000 0000000 000000000 0002000 0000030 003000000 0240000 0200000 000000000 4000000 0000000 003000000 0002000 0000000 000020000 0040400 0000000 000000000 0043000 0000000 000000000 0040000 0000000 000000000 0030000 Figure 3: Relation matrix M. interaction and importance based on centrality and the factor is called the cause factor, and the higher the causality is shown in Figure 2. causality value, the stronger the inŽuence of the factor on Centrality, also known as prominence in related studies, other factors. When the causality of a factor is negative, the factor is referred to as the result factor, and the higher the indicates the force of the factor’s impact in the system and is a quantitative indicator of the factor’s importance. �e absolute value of the causality, the stronger the impact of greater the relevance of a factor in the system, the higher the other factors on the factor. �e causality of factor i is ob- centrality of the factor. �e greater the centrality value, the tained by subtracting the degree of impact and the degree of greater the inŽuence of the factor on the overall system. �e being impacted, which is denoted as Ri: centrality of factor i is obtained by adding the degree of Ri Di − Ci. (6) impact and the degree of being impacted, which is denoted as Mi: 3.5. DEMATEL Model Results. Based on the results of expert Mi Di + Ci. (5) evaluation, the degree of interaction between human factors Causality reŽects the degree of the causal attribute of a in fever clinics is quantiˆed, and the relationship matrix N is factor in the system, and there are positive and negative established according to the coding order of the 23 factors, as values of causality. When the causality of a factor is positive, shown in Figure 3. Impact received None Impact given Journal of Electrical and Computer Engineering 5 Table 3: Impact degree, degree of being impacted, centrality degree, causality degree, and weights. Codes Impact degree Degree of being impacted Centrality Causality Weights F1 0.601 0.343 0.944 0.258 0.032 F2 1.744 0.775 2.519 0.969 0.085 F3 0.229 0.171 0.4 0.058 0.013 F4 0.576 0.074 0.65 0.502 0.022 F5 1.251 0.715 1.965 0.536 0.066 F6 1.735 1.006 2.742 0.729 0.092 F7 0.422 0.167 0.589 0.255 0.02 F8 0.823 0.235 1.058 0.588 0.036 F9 0.863 0.235 1.098 0.628 0.037 F10 1.416 0.857 2.273 0.559 0.076 F11 0.419 0.747 1.166 −0.328 0.039 F12 0.373 0.97 1.343 −0.597 0.045 F13 0.614 0.412 1.026 0.202 0.034 F14 0.142 1.8 1.941 −1.658 0.065 F15 0.094 0.634 0.729 −0.54 0.024 F16 0.133 0.701 0.834 −0.568 0.028 F17 1.013 0.936 1.949 0.077 0.065 F18 0.564 0.975 1.539 −0.411 0.052 F19 0.435 1.527 1.961 −1.092 0.066 F20 0.593 0.57 1.163 0.023 0.039 F21 0.438 0.738 1.177 −0.3 0.039 F22 0.239 0.31 0.549 −0.071 0.018 F23 0.179 0 0.179 0.179 0.006 2.0 1.0 F2 1.8 F14 F6 F9 1.6 F8 F10 F5 0.5 F4 F19 1.4 F7 F1 F13 F23 F3 F17 0.0 F20 1.2 F22 1.0 F6 F11 F21 F18 F12 R F17 F18 -0.5 F10 F15 F16 0.8 F12 F11 F2 F21 F5 F16 0.6 F15 F20 -1.0 F19 0.4 F13 F1 F22 F8 F9 0.2 -1.5 F3 F7 F14 F4 0.0 F23 -2.0 -0.2 0.0 0.5 1.0 1.5 2.0 2.5 3.0 0.0 0.2 0.4 0.6 0.8 1.0 1.2 1.4 1.6 1.8 Figure 5: Centrality-causality diagram. Figure 4: Diagram of impact degree and degree of being impacted. �e direct matrix M is normalized to obtain the inte- disinfection and isolation design F6, induction training F10, grated impact matrix T. Based on the matrix T, the impact ventilation equipment F5, and environmental cleaning and degree D, degree of being impacted C, centrality M, causality disinfection F17. �e top ˆve factors with highest degree of R, and centrality weights of fever clinic human factors are being impacted are closed-loop management of patients F14, calculated, as shown in Table 3. standard prevention F19, disinfection and isolation design F6, waste disposal F18, and close inspection of patients F12. With the degree of impact as the horizontal coordinate and the degree of being impacted as the vertical coordinate, a As can be seen in Figure 4, three factors, disinfection and diagram of impact on and from other factors can be ob- isolation design F6, zoning and layout F2, and induction tained, as shown in Figure 4. training F10 have the highest centrality, while four factors, With centrality as the horizontal coordinate and cau- ventilation equipment F5, standard prevention F19, envi- sality as the vertical coordinate, a centrality-causality dia- ronmental cleaning and disinfection F17, and closed-loop gram can be obtained, as shown in Figure 5. management of patients F14 are similar in centrality and are As can be seen in Figure 3, the top ˆve factors with signiˆcantly higher compared to the remaining factors. As highest degree of impact are zoning and layout F2, far as causality is concerned, the top ˆve cause factors are 6 Journal of Electrical and Computer Engineering zoning and layout F2, disinfection and isolation design F6, clarify the relation between influencing factors and quantify allocation of nurses F9, allocation of doctors F8, and in- the prominence of factors in system reliability assessment. duction training F10; the top five result factors (absolute (e establishment and application of this research model values)are closed-loop management of patients F14, stan- can provide novel insight into the analysis process and offer dard prevention F19, close inspection of patients F12, references to the prevention and control of the new coronary transfer of suspected or confirmed cases F16, and reporting pneumonia epidemics in hospitals. First, human operations of suspicious cases F15. and allocations involved in epidemic prevention and control can be organized and summarized in the form of multiple factors. (e situation in fever clinics can be clarified into 4. Discussion different elements to reflect the working condition of the overall system. Large-scale operational scenarios are broken Human factors play a vital role in the safe operation of fever into specific factor items to specify the epidemic prevention clinics. (e DEMATEL method is used to analyze human and control program and to systemize the work scientifi- factors in complex environments, and the graph theory and cally. Second, the expert evaluation method can be used to matrix algorithm results quantitatively demonstrate the assess the relation between different factors. Evaluative reliability of human factors in fever clinics. By analyzing the opinions are collected from several experts and are then logical and influential relations between various human aggregated. A multilevel scale is adopted during expert factors, the degree of mutual impact between factors is evaluation to assess factors, which can avoid ambiguity, precisely calculated. Centrality and causality of each factor partialness, and linguistic description lack of directivity and are further clarified based on impact degree and the degree get a unified and clear assessment result. (ird, the of being impacted, so as to examine the risk factors and their DEMATEL method can establish a human factor reliability degree of impact in the safety of the fever clinic system and evaluation model based on the assessment results from provide data support and theoretical basis for the en- expert evaluation, quantitatively show the degree of influ- hancement of the existing medical environment and the ence of each factor in the security system, and measure with establishment of the safety system. precise values the importance of the factor in the system and In this study, 23 main factors involved in epidemic its relation with other factors. Fourth, the results of the prevention are sorted out in the analysis of human reliability DEMATEL model can offer insightful guidance for the in the fever clinic of a level A tertiary hospital in Wenzhou. establishment, improvement, and monitoring of fever In the model, the elements of closed-loop management of clinics. Taking the fever clinic in this study as an example, 23 patients, standard prevention, and close inspection of pa- aspects are involved in and complicate the working envi- tients are most affected by other factors, and all three have ronment. Identifying the core elements with high promi- the least negative values among the result factors so that their nence and the associated risk factors can effectively promote safety reliability is known to be highly reliable on other epidemic prevention and control in an integrated manner, related factors. If there are potential problems in the closed- improve system reliability, and avoid wasting human and loop management of patients, standard prevention, and material resources. close inspection of patients, we need to start with improving In the future, the approach to the analysis of the risks in other factors with high influence, such as zoning and layout, medical safety can be improved. (e extraction and rela- disinfection and isolation design, induction training, ven- tionship assessment of risk factors in the system will be the tilation equipment, and environmental cleaning and dis- next research focus. In addition, multiple analysis methods infection. High-weighted factors have a large impact on the can be introduced to work together with this experimental human-caused reliability of fever clinics and are most critical method to reveal the safety situation in the overall system to the establishment of system safety. (e core of con- more comprehensively. struction and supervision of fever clinics should revolve around three high-weighted core factors, zoning and layout, disinfection and isolation design, and induction training and Data Availability focus on ventilation equipment, standard prevention, en- No data were used to support this study. vironmental cleaning and disinfection, and closed-loop management of patients on this basis. 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Journal of Electrical and Computer Engineering – Hindawi Publishing Corporation
Published: May 5, 2022
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