Collaborative Decision Research Articles

Trends in Patient Characteristics and Cardiothoracic Surgeries over 14 Years (2010–2023): A Single Center Experience

Background: as transcatheter technologies have advanced, the patient population that is referred to open heart surgeries has shifted. This study’s objective was to evaluate recent trends in the characteristics of patients undergo surgical valvular interventions and coronary revascularizations (CABG) in our center over a period of 14 years. Methods: this is a retrospective analysis of ecological trends in the age, sex, and risk profile (Charlson comorbidity index—CCI) of patients who, from January 2010 to December 2023, underwent CABG, aortic valve replacement (AVR), or mitral valve repair or replacement (with or without tricuspid valve intervention). The data were extracted from electronic clinical files using MD-Clone software. Results: for the CABG procedures, the respective data for 2010 and 2023 were: mean ages 68.0 and 64.6 years; 79.7% and 83.1% males; and mean CCI scores 3.16 and 2.51. The p-values for the cumulative differences over the study period were 0.001, 0.005, and 0.013, respectively. The respective data for isolated AVR were mean ages of 69.2 and 62.9 years; 64.1% and 59.1% males; mean CCI 3.64 and 2.32; p-values: <0.001, 0.229, and 0.019. The respective data for mitral valve procedures were mean ages of 63.6 and 59.8 years, 71.4% and 65.5% males; mean CCI 2.90 and 1.79; p-values: 0.84, 0.422, and 0.318. Conclusions: over a 14-year period, changes were evident in the age, sex distribution, and CCI for operations performed in our center. These changes most likely resulted from accumulated data regarding the advantages and detriments of treatment strategies, mostly of CABG vs. percutaneous coronary intervention; major advancements in transcatheter technologies, mostly in transcatheter AVR; and clinical guidelines facilitating a more collaborative decision-making, open-minded, and personalized approach.

Meta-Heart Team: enhancing multidisciplinary heart teams through virtual reality in the metaverse

Abstract Introduction Cardiovascular Multidisciplinary Heart Teams (MDHTs) are integral for patient management, but persistent challenges, including limited subspecialty expertise and time constraints, necessitate innovative approaches. This study explores the viability of conducting international Meta-Heart Team sessions utilizing virtual reality (VR) within the metaverse, aiming to address these challenges. Methods The Meta-Heart Team, comprising participants from diverse medical specialties and countries, engaged in VR sessions facilitated by VR headsets and web browsers. The immersive Aimedis metaverse platform recreated a three-dimensional hospital setting, complete with a dedicated Meta-Heart Team room featuring large screens displaying patient data such as coronary angiograms and echocardiograms. A 0-10 scale questionnaire evaluated participant experiences, covering technical quality, immersion, willingness to participate again, and overall satisfaction. Results The virtual environment effectively facilitated discussions on valvular heart disease cases among 10 participants, dedicating 15 minutes to each case. Technical stability was robust (90%), with only one participant experiencing internet disconnection. Positive participant feedback highlighted high ratings for technical quality (8.0±1.8) and engagement, a good immersive experience (8.0±1.3), willingness to participate again (9.2±0.8), and confidence in treatment decisions (80%). Despite a sense of digital fatigue reported by a few participants, the majority expressed that the VR session saved time compared to traditional meetings. Privacy concerns were acknowledged by 80% of participants. Discussion The virtual environment demonstrated potential in augmenting MDHT collaboration, providing advantages in global accessibility, multidimensional analysis, and adaptability. Participants recognized limitations in non-verbal communication and interpersonal connections but underscored the adaptability and effectiveness of the virtual setting. Technical challenges, including a single internet disconnection, emphasized the importance of a robust technical infrastructure. Privacy issues, digital fatigue, and potential exclusions were highlighted, prompting consideration of ethical guidelines and ongoing technological advancements. Conclusion Leveraging VR in the metaverse for MDHT sessions is feasible and offers substantial benefits. Despite challenges such as technical issues and privacy concerns, the Meta-Heart Team complements traditional interactions, ushering in a new era in collaborative decision-making while demanding ongoing attention to technological and ethical considerations.Two presenters explaining the processThe Metaverse-based Heart Team room

3.X.2. Integrating trust as a key component of pandemic preparedness and resilience

Abstract Trust is a key component of pandemic preparedness, which impacts the success of response measures during the public health emergency. Trust is built during preparedness, however the drivers and dimensions of trust are complex and context-specific. What is required is a collaborative, inclusive approach that provides a platform for communities to express their questions and concerns. The proposed workshop will begin with a presentation from a global expert on trust in the content of epidemics and pandemics and the current knowledge about how trust can be built during preparedness. This will be followed by interactive group-work, designed to encourage collaborative discussions and decision-making. Finally, introducing the WHO Hive digital platform that provides a safe space for public health communities to share information and ask questions. Attendees will then reconvene in plenary to discuss these approaches and interventions that can be implemented to build and maintain trust prior to and during an epidemic or pandemic. This workshop has the following objectives: 1. To demonstrate how trust is an important determinant of successful pandemic response; 2. To enable attendees to explore how the implementation of public health and social measures, infodemic management and digital community partnerships and engagement can build trust during pandemic preparedness for both online and offline communities; 3. To provide opportunity for attendees to workshop how the different features of the Hive digital space can enhance trust building, and to develop actionable strategies for health emergency preparedness, response and resilience. The workshop will deliver these objectives through an interactive simulation activity. Attendees will be placed into small groups to work through a scenario, having to decide on the actions that need to be taken, considering budget constraints, other health priorities, and the current local context. The teams will co-create actionable strategies for building and maintaining trust. While there is not a one size fits all approach to trust building, this workshop will aim to increase understanding of the drivers and determinants of trust to encourage participants to consider how they can be applied in their local context. It will be interactive and hands-on requiring active participation from participants. Key messages • Trust as a construct is an important component of pandemic preparedness and readiness that impacts on response. • A multidimensional approach to building and sustaining trust needs to considered across a range of drivers and determinants, where actionable strategies are vital.

Analysis of Airport Operation Control Center (AOCC) Unit Services at Adi Soemarmo Boyolali International Airport

Airport Operation Control Center (AOCC) is the front line in supervising and controlling all problems and is the control center of Adi Soemarmo Solo International Airport operations in serving Airport Service Users. AOCC involves all stakeholders at the Airport by integrating the systems owned by each stakeholder so that they can operate effectively and efficiently. This study aims to determine how the AOCC unit service system is at Adi Soemarmo Boyolali International Airport and what factors can cause problems and solutions to AOCC unit service problems. This study uses a descriptive qualitative approach. The data used are primary and secondary data. Primary data is obtained from observation and interviews, while secondary data comes from literature studies and photographs related to the problems studied. The data analysis techniques used are data reduction, data presentation and drawing conclusions. To test the validity of the data, triangulation techniques are used. The research time is in August - September 2023. The results of this study indicate that a good service system was found by the Airport Operation Control Center (AOCC) Unit to service users starting from coordination with all parties, namely Airlines and Ground Handling, Air Traffic Control (ATC), Apron Movement Control (AMC), Information Unit, Aviation Security, Airport Operation Landside And Terminal (AOLT), Traffic Administration Office and Central Flight Schedule Office (CFSO) and the Airport Mechanical Unit. The service system uses the ACDM (Airport Collaborative Decision Making) system, namely with collaboration between stakeholders to share information between related parties in real time and make joint decisions in a win-solution manner. Factors that can cause problems are related to coordination between one and another so that it can harm several parties. The solution to various problems is to implement ACDM (Airport Collaborative Decision Making), where related units in airport operations synergize with each other, receive and share information from each unit, make proactive and appropriate joint decisions, anticipate unexpected events and provide the best quality of service, cohesiveness and unity of vision and mission.

Evaluating Layout Dimensionalities in PC+VR Asymmetric Collaborative Decision Making

With the commercialization of virtual/augmented reality (VR/AR) devices, there is an increasing interest in combining immersive and non-immersive devices (e.g., desktop computers) for asymmetric collaborations. While such asymmetric settings have been examined in social platforms, significant questions around layout dimensionality in data-driven decision-making remain underexplored. A crucial inquiry arises: although presenting a consistent 3D virtual world on both immersive and non-immersive platforms has been a common practice in social applications, does the same guideline apply to lay out data? Or should data placement be optimized locally according to each device's display capacity? This study aims to provide empirical insights into the user experience of asymmetric collaboration in data-driven decision-making. We tested practical dimensionality combinations between PC and VR, resulting in three conditions: PC2D+VR2D, PC2D+VR3D, and PC3D+VR3D. The results revealed a preference for PC2D+VR3D, and PC2D+VR2D led to the quickest task completion. Our investigation facilitates an in-depth discussion of the trade-offs associated with different layout dimensionalities in asymmetric collaborations.

A game-based decision-making method for multi-ship collaborative collision avoidance reflecting risk attitudes in open waters

To accurately reflect risk attitudes towards ship intentions in multi-ship encounters, this paper develops a novel two-stage collaborative collision avoidance decision-making (CADM) model by incorporating intention prediction and real-time decision-making. We acquire prior knowledge of risk attitudes by analyzing Automatic Identification System (AIS) data and further estimate the probability distributions of encountering ship's risk attitude using Bayesian reasoning. By treating collision avoidance procedure as a static game with incomplete information, a predictive model for collision avoidance intentions is developed by taking account into risk attitude probabilities. Real-time decisions are then implemented according to different stages, and a collaborative CADM model is established by a game-decision cycle. Finally, a multi-ship encounter scenario is simulated under all combinations of risk attitudes, and the results are compared with those obtained under complete information. The results demonstrate that the proposed model can formulate avoidance actions that meet safety requirements under all combinations of risk attitudes. Further comparison with complete information proves the effectiveness of the risk attitude probability model, which is conducive to improving the decision-making flexibility and reducing complexity. The research findings enhance the collaborative decision-making, contributing to the development of autonomous navigation in open waters.

‘Give us the numbers!’: sovereign capture and the undermining of shared situational awareness in the UK’s COVID-19 response

ABSTRACT Shared situational awareness is advanced as a solution to the problem of collaborative decision-making in multi-agency emergency responses. By harnessing information and communication technologies to construct and distribute a common understanding of the event, shared situational awareness promises to optimise, distribute and devolve decision-making, thus improving the overall speed and efficiency of emergency responses. However, in the context of actual emergencies shared situational awareness is found to routinely breakdown. This paper draws upon 41 interviews conducted with emergency responders on their experience of using ResilienceDirect to manage shared situational awareness in the UK COVID-19 response. We argue that while shared situational awareness attempts to technologise the problem of sovereign decision-making in emergencies, UK emergency response frameworks contain a latent potential for sovereign capture. As the COVID-19 response demonstrates, an atmosphere of distrust; desire for secrecy and control; and the ubiquity of hierarchies throughout UK Civil Contingencies permitted the reactualisation of sovereign modes of control to frustrate and displace bottom-up modes of emergency organisation meant to guide UK emergency responses. Elucidating the impediments to achieving shared situational awareness within actual response raises urgent questions regarding the robustness of shared situational awareness to political interference within major emergency events.

Sewage Treatment Equipment Supply Chain Collaboration and Resilience Improvement Path Analysis: Collaborative Decision-Making, Information Sharing, Risk Management

Since the dawn of the 21st century, supply chains (SCs) have faced an array of unprecedented challenges, encompassing economic volatility, escalating geopolitical conflicts, intensified trade disputes, and persistent environmental degradation. These challenges have imposed immense pressures on SCs, amplifying both the risks and occurrences of disruptions. In response to these critical demands, there has been a substantial increase in academic, industrial, and governmental focus on the resilience and recovery capabilities of SCs. In this context, the supply chain (SC) for sewage treatment equipment has been significantly affected. This study aims to systematically investigate collaborative strategies and mechanisms for bolstering the resilience of manufacturing SCs within the sewage treatment sector, with particular attention to collaborative decision-making, information sharing, and risk mitigation throughout the SC lifecycle. Following a comparative analysis of various methodologies, this paper employed the structural equation model (SEM) and subsequently conducted a comprehensive survey of manufacturers specializing in glass fiber sewage treatment systems, yielding 385 valid responses. Through this data, a structural equation model was developed to analyze pathways for resilience enhancement. A thorough analysis of the results indicates that Supply Chain Collaboration (SCC) and collaborative decision-making are instrumental in strengthening Glass Fiber Sewage Treatment Supply Chain Resilience (SCR) through the implementation of effective information sharing and risk management practices. These findings contribute to the theoretical framework of SCC and SCR by clarifying the influence of collaborative practices while also providing practical guidance for the governance and strategic management of sewage treatment equipment enterprises and their associated SCs. The conclusions drawn from this study can guide us in establishing a more resilient and sustainable SC ecosystem, making it more directive and capable of mitigating complex disruptions.

A Qualitative Thematic Analysis Exploring Chinese Young Adults' Experiences in Decision Making on the Management of Low-Risk Papillary Thyroid Cancer.

Background: Thyroid cancer is the most common endocrine neoplasm in China. Questions regarding the extent of patient involvement in shared decision-making (SDM) processes persist; this is particularly pertinent to patients considering treatment options for low-risk papillary thyroid cancer (PTC). In this study, we aimed to explore Chinese young adults' experiences of SDM relating to the choice of treatment for low-risk PTC. Methods: The study used a qualitative descriptive design and semistructured interviews. Interviews were conducted with 24 patients (ages ranging from 18 to 38 years; 4 men and 20 women) diagnosed with low-risk (PTC) between March 2023 and May 2024. Twenty-two of 24 patients' tumor size measured 1 cm or smaller; the largest tumor size measured 1.47 cm. Reflexive thematic analysis was used to identify key themes from the transcribed interviews. Results: The analysis revealed that the SDM experiences of young patients with low-risk PTC involve four themes: challenges in information sharing; reasons for information seeking; factors influencing decision making; and self-positioning in treatment decision making. Three self-positions relating to treatment decision making were identified. These included dependent positioning, which reflects a "paternalistic" decision-making pattern; collaborative positioning, reflecting a "sharing" of decision making; and autonomous positioning, reflecting an increased sense of personal responsibility for both managing their health and engagement in decision making. Limited treatment options being offered, overuse of medical terminology, and communication gaps between clinicians and patients were the main challenges described during the information-sharing process. Information that needs persisting after physician-patient consultations resulted in active information-seeking behavior. The key variables identified in this study that potentially affected the decision-making process were future personal considerations, language used to discuss cancer, and negative emotions. Conclusions: These results highlight the necessity of adopting flexible strategies when supporting collaborative treatment decision making in the context of the doctor-patient interaction for low-risk PTC. Based on these findings, clinicians can take measures to enhance the quality of SDM by inquiring about patients' role preferences, providing details of the full range of treatment options, and encouraging patients to share their preferences and concerns relating to possible treatment options.

The patient’s perspectives of safe and routine proactive deprescribing in primary care for older people living with polypharmacy: a qualitative study

BackgroundThe process of identifying and discontinuing medicines in instances in which harms outweigh benefits (deprescribing) can mitigate the negative consequences of problematic polypharmacy. This process should be conducted with a focus on the patient and involve collaborative decision-making. Evidence is needed regarding patients’ views on how deprescribing should be safely and routinely implemented in English primary care to improve its application. This study aimed to identify optimal methods of introducing and actioning deprescribing from the patient’s perspective.MethodsParticipants in England aged 65 and above who were taking five or more medicines and residing in their own homes were recruited through social media and service user groups. An interview guide was created from deprescribing literature and input from patients and the public, guided by the Normalisation Process Theory (NPT). The interviews were held online using Microsoft Teams® or via phone, recorded, and then transcribed. The data was analysed using the Framework analysis.ResultsTwenty patients (mean age of 74.5, SD = 6.93), with 75% being female, were enrolled in the study. Three main themes emerged: (1) ‘Why deprescribe now?’ emphasised the significance of explaining the reasons behind deprescribing; (2) ‘Monitoring and follow-up’ underscored the necessity of safety measures during deprescribing and patients’ willingness to self-monitor post-intervention; (3) ‘Roles and relationships’ explored patient perceptions of various healthcare professionals involved in deprescribing and the essential interpersonal skills for fostering therapeutic relationships.ConclusionOptimal methods of introducing deprescribing included communicating a convincing rationale for stopping medicines and preparing patients for deprescribing conversations. Patients required support from a range of healthcare professionals with whom they had an existing therapeutic relationship. Whilst patients were motivated to self-monitor unwanted/unexpected effects post-deprescribing, timely support was required. The nature of such bolstered collective action and cognitive participation within NPT enhances the normalisation potential of deprescribing. These findings highlight the significance of considering the content and process of deprescribing consultations to enhance normalisation and tackle problematic polypharmacy. This provides a deeper understanding of patients’ needs for implementing safe and routine deprescribing in primary care, which should be considered when designing medication review and deprescribing services.

A novel collaborative collision avoidance decision method for multi-ship encounters in complex waterways

With the continuous growth of maritime traffic volume, multi-ship collision avoidance has gradually become one of the most crucial issues in ensuring the safety of ship navigation. This study proposes a multi-ship collaborative collision avoidance decision model (MCCA) to address the issue of multi-ship encounters in complex waterways. The model takes into account the ship spatio-temporal collision risk, relative motion trends, as well as the safety and economic considerations of ship navigation. A comprehensive collision avoidance method is designed based on the velocity obstacle method, enabling simultaneous adjustments both course and speed, with the aim of minimizing economic losses incurred by ships due to avoidance operations while ensuring ship navigation safety. Meanwhile, the NSGA-II algorithm, which has faster convergence and better effect, is used to calculate the optimal collaborative collision avoidance decision of multiple ships. Besides, both simulation and example validation are used to test the validity of the model. The results indicate that the proposed model can effectively achieve multi-ship collaborative collision avoidance in the region. Simultaneously, it holds significant reference value for guaranteeing the safety of ship navigation, enhancing supervision efficiency, and promoting the development of intelligent ship navigation systems.

Transformative Local Governments: Addressing Social Urban Challenges by Bringing People and Politics Together

As the tier of government closest to people, local government plays a key role in answering local needs and aspirations. However, local governments are often under-resourced, leaving them inadequately responsive to many of these critical local demands. Moreover, accountability to their citizens, which is the core of a well-functioning local democracy, is often lacking because the necessary formal laws and informal norms do not enable citizens to influence the decision-making process in a collaborative, creative, and evidence-based process that promotes collective learning. Through innovative case study analyses from around the world, the 12 contributions in this thematic issue delve into the multifaceted ways in which local governments can bridge the gap between people and politics, offering innovative perspectives on participatory governance, co-creation, and collaborative decision-making for inclusive, safe, resilient, and sustainable cities. The cases showcase innovations and challenges in the urban environment, capturing different ways to bring people and politics together in an attempt to co-create solutions for a sustainable and resilient urban future. The insights provided by this plethora of cases provides lessons that can help revolutionise international, national, and local urban policy to empower local authorities and their local communities to address the increasingly urgent challenges faced by municipalities around the world, ensuring an inclusive, safe, resilient, and sustainable future for the generations to come.

Multi-level barriers and facilitators to implementing evidence-based antipsychotics in the treatment of early-phase schizophrenia.

Long-acting injectable (LAI) antipsychotic medications and clozapine are effective yet underutilized medical therapies in early intervention services. The purpose of this study was to conduct a pre-implementation evaluation of contextual determinants of early intervention programs to implement innovations optimizing LAI antipsychotic and clozapine use within a shared decision-making model. Semi-structured interviews explored barriers and facilitators to implementing LAI antipsychotics and clozapine in early intervention services. Participants were: prescribers (n = 2), non-prescribing clinicians (n = 5), administrators (n = 3), clients (n = 3), and caregivers (n = 3). Interviews were structured and analyzed using the Consolidated Framework for Implementation Research (CFIR 2.0). Participants were supportive of using LAI antipsychotics, despite barriers (e.g., transportation, insurance coverage), while most were unfamiliar with clozapine (Innovation). Critical incidents (e.g., COVID-19) did not interfere with implementation, while barriers included lack of performance measures; stigma affecting willingness to take medication; and clozapine considered to be a "last resort" (Outer Setting). Treatment culture was described as client-centered and collaborative, and most participants indicated LAI antipsychotic use was compatible with clinic workflows, but some were in need of resources (e.g., individuals trained to administer LAI antipsychotics; Inner Setting). Participants on the healthcare team expressed confidence in their roles. Family education and collaborative decision-making were recommended to improve client/family engagement (Individuals). Participants related the importance of tracking medication compliance, addressing client concerns, and providing prescribers with updated guidelines on evidence-based treatment (Implementation Process). Results may guide implementation strategy selection for future programs seeking to optimize the use of LAI antipsychotics and clozapine for early-phase schizophrenia, when appropriate.

Project Monitoring Based on View of All Project Partners At Digital Project Management Platforms

In the dynamic landscape of digital project management, effective project monitoring is critical for successful project outcomes. The emergence of digital project management platforms has revolutionized the way projects are monitored, enabling real-time collaboration and data-driven decision-making. Periodic site visits and gathering input from all project stakeholders are crucial for ensuring clear understanding of project progress by states institutional. With digital project management systems, on-site progress should be monitored in real-time and inclusive of all project stakeholders. The research investigates how collaborative monitoring fosters project progress of transparency and active engagement among project partners. By providing real-time visibility into project progress, tasks, and milestones, these platforms empower stakeholders with up-to-date information, enabling agile decision-making and prompt risk mitigation. This study explores how digital project management platforms integrate site monitoring evaluations and reporting tools, providing valuable data-driven insights into project performance. By considering periodic analytics, project partners can improve resource allocation, decision making process against possible bottlenecks at construction stages and boost productivity and inform states institutional to monitor project progress closely. Furthermore, the research examines the influence of these platforms on communication dynamics, promoting communication and efficient information exchange among project partners. Such enhanced communication capabilities result in improved team cohesion and collaboration, driving the project forward with synchronized efforts. In this study, the focus lies on tracking the progress of contractual agreements through digital platforms, enabling all stakeholders to monitor advancements. Specifically, the investigation centers on how the designated contractor responsible for project execution and the consulting firm appointed by the project owner can effectively track project progress on a periodic basis using digital platforms. In the context of transportation projects in Turkey, a digital project tracking system has been developed for the Ministry of Transport and Infrastructure, through which data obtained from on-site visits and consultant opinions regarding project advancements are shared with the Ministry. Subsequently, the responsible contracting authority, guided by the consultant's feedback, can respond and evaluate progress accordingly. This approach ensures that project advancements are accurately monitored by all stakeholders of the project. To do so, this study investigates the utilization of the prepared digital platform to facilitate rapid and precise contract monitoring by all project stakeholders, encompassing the opening information and assessment evaluations based on stakeholders' perspectives.

8463 Navigating Medical Decisions: A Study Of Second Opinions From Both The Physician And Patient Standpoints

Abstract Disclosure: O. Derevyanko: None. Background: In contemporary healthcare, the concept of seeking second opinions has become increasingly prevalent, shaping the dynamics of patient-physician relationships. This study aims to delve into the multifaceted landscape of second opinions, examining the perspectives of both doctors and patients. As medical decision-making becomes more collaborative, understanding the factors influencing the second opinion process is crucial for enhancing patient outcomes and fostering effective communication within the healthcare system. Objectives: • To identify patterns and discrepancies between doctors' and patients' viewpoints on the importance and impact of second opinions.• To provide insights that can contribute to the development of strategies for improving the second opinion experience for both doctors and patients.• To assess how often patients seek for second opinion MethodsA comprehensive survey conducted among 756 doctors endocrinologists in social media Instagram , aiming to explore their attitudes and concerns regarding patients seeking second opinions in medical practice and 787 patients to find out how many of them seek for a second opinion. Results: Out of the surveyed doctors, 51.3% (n=388) expressed a positive and accepting attitude toward patients seeking second opinions. This majority acknowledged the importance of patient autonomy and the right to seek additional perspectives on their medical conditions.A significant portion, 34.5% (n=261) of doctors, voiced concerns related to potential drawbacks associated with second opinions. These concerns primarily revolved around the possibility of patients receiving conflicting advice or experiencing delays in crucial treatment decisions.A noteworthy 14.2% (n=107) of doctors indicated concerns related to the potential impact of second opinions on the trust between doctors and patients. This subset of professionals expressed apprehensions about how seeking additional perspectives might influence the doctor-patient relationship. 554 out of 787 patients reported about seeking for the second opinion most of the time. Conclusion: The insights gleaned from this survey shed light on the complex landscape of doctors' perspectives on second opinions. Recognizing the nuances within these attitudes is imperative for developing strategies that support collaborative decision-making and patient-centered care in the medical community. This research contributes valuable insights to the ongoing discourse surrounding patient autonomy and doctor-patient relationships. Presentation: 6/3/2024

Decision-making strategies for organizational processes

This research aims to explore decision-making strategies in organizational processes and their relevance in today's business environment, using a comprehensive methodology based on a review of the scientific literature. Different approaches and methodologies used for decision making are presented, such as data-driven decision making, multi-criteria decision making, collaborative decision making and decision making based on artificial intelligence and machine learning. In addition, recent applications of these strategies in various organizational contexts, such as manufacturing, logistics and supply chain, project management, and product innovation and development, are discussed.

Unlocking success: Multidisciplinary rounds for effective discharge planning.

341 Background: Multidisciplinary rounds (MDR) streamline collaboration among healthcare professionals across various disciplines to devise patient progress and post-hospitalization transition plans. In our gynecology oncology inpatient unit, coordinating patient care involves multiple teams aiming for discharge objectives. While nurses oversee the care plan, physicians, advanced practice providers, case managers, and other key stakeholders possess essential insights to effective discharge planning. The aim of our study was to evaluate the impact of structured MDR implementation on discharge accuracy, effectiveness, and hospital throughput. Methods: In April 2022, our gynecologic oncology inpatient team implemented structured MDRs to enhance discharge processes, focusing on patient outcomes and hospital throughput. The initiative aimed to identify discharge barriers early, set goals, and address challenges collaboratively through: 1) Interdisciplinary Assessment: Using standardized tools to evaluate patient status and care needs; 2) Review of Clinical Data: Analyzing medical records via EHR systems; 3) Collaborative Decision-Making: Using decision-support tools to set the Estimated Discharge Date (EDD); 4) Patient Engagement: Involving patients and families in shared decision-making; 5) Documentation and Communication: Ensuring clear EDD documentation and effective communication through team huddles, bedside rounds, and discharge planning meetings. EDD reporting, discharge order timing, and patient discharge time were tracked using our Care Team Transformation Dashboard. Results: The implementation of structured MDR led to significant improvements in discharge processes. We observed enhanced accuracy in EDD, with a 2.9% increase, and a notable rise in the completion of discharge orders before 9 am, showing a 60.5% increase (Table). The percentage of patients leaving the hospital before noon increased by 20.4%, highlighting MDRs effectiveness in facilitating timely discharge, enhancing intradisciplinary collaboration, and streamlining discharge efficiency. Conclusions: MDRs play a pivotal role in improving teamwork, quality of care, and patient outcomes. Setting EDDs through structured MDR processes enhances proactive discharge planning, thereby reducing delays and optimizing patient flow, ultimately contributing to the delivery of high-quality, patient-centered healthcare. Measure Preintervention: 1/2023-1/2024 Postintervention02-05/2024 Percentage Increase EDD accuracy 1 day prior 46.9 48.3 2.9% Discharge orders before 9am 33.4 53.6 60.5% Discharges prior to noon 19.1 23.0 20.4%

Human-robot collaborative decision method of hexapod robot based on prior knowledge and negotiation strategy

Against the unstructured terrain environment, human drivers often rely on remote operating patterns to accomplish tasks with robots. With the gradual improvement in robot intelligence, a key problem that urgently requires attention is how to bridge cognitive and perceptual differences between human and robot in collaborative decision-making processes. Particularly effective resolution of differences in decision outcomes is crucial. Therefore, this paper utilizes the decision logic process and prior knowledge model of human drivers to form a robot's decision framework, narrowing the cognitive differences between human and robot. Besides, embedding the human-robot-environment features that affect the decision-making process as prior knowledge into the robot's decision-making system can effectively reduce perceptual gaps. Under the same decision framework, a negotiation strategy is proposed for forming a unified decision outcome between human and robot by finding an optimal concession rate. This study utilizes a hexapod robot simulated driving platform to gather experimental data and develop prior knowledge for robots. It also leverages virtual reality equipment and visual augmentation technologies to establish a remote human-robot collaborative decision-making experimental system. The experimental results conducted in complex obstacle terrain demonstrate the effectiveness of adopting the negotiation strategy for human-robot collaborative decision-making. Compared with the individual human or robot decision, the human-robot collaborative decision method significantly enhances robot stability, reduces energy consumption, and minimizes collisions.

Digital twins for resource optimization in multi-purpose ports: A design approach for data-driven decision making

Abstract Multi-purpose ports’ ef/icient and sustainable operation relies on seamless coordination and decision-making among multiple organizations. This paper underscores the critical importance of forecasting resource and infrastructure utilization for informed operational, tactical, and strategic decision-making. The proposed approach draws on digital twin technology to enable collaborative decision-making by modeling complex port environments to enable shared situational awareness among stakeholders. Illustrated through a collaborative project involving the RISE Research Institutes of Sweden, National University of Singapore, Grieg Connect, Umeå University, Kvarken Ports Umeå, and INAB, we propose a digital twin design to empower the port as a decision-maker in multi-organizational settings to proactively plan and optimize its utilization of present and future resources.

Introduction of Simulation-Based Learning Strategy to Bridge the Theory-Practice Gap in Advanced Concepts in Community Health Nursing Course: Lens from Students' Perspective.

Simulation has proven to be one of the most powerful forms of enactive experience in medical sciences, which enhances the efficacy of both direct and vicarious learning. At the undergraduate level, community health nurses are expected to be inclusively knowledgeable about population-based nursing practices with diverse communities; so, they prepare well to establish partnership skills with stakeholders and make collaborative decisions that promote awareness and understanding of the community's health needs. Problem prioritisation is an essential step of the planning cycle. It is one of the advanced concepts in community health nursing which needs in-depth knowledge and contemplation about the dynamics of the community. This paper highlights the students' perspectives regarding the impeccable effects of simulation pedagogy on students' learning in terms of improving their communication skills and alleviating the fear of dealing with community stakeholders before the actual problem-priority setting exercise for the clinical community project. Key Words: Community health nursing, Simulation-based learning, Problem prioritisation, Stakeholders.