Team Awareness Research Articles

TeamWATCH: Visualizing development activities using a 3-D city metaphor to improve conflict detection and team awareness.

The awareness of others’ activities has been widely recognized as essential in facilitating coordination in a team among Computer-Supported Cooperative Work communities. Several field studies of software developers in large software companies such as Microsoft have shown that coworker and artifact awareness are the most common information needs for software developers; however, they are also two of the seven most frequently unsatisfied information needs. To address this problem, we built a workspace awareness tool named TeamWATCH to visualize developer activities using a 3-D city metaphor. In this paper, we discuss the importance of awareness in software development, review existing workspace awareness tools, present the design and implementation of TeamWATCH, and evaluate how it could help detect and resolve conflicts earlier and better maintain group awareness via a controlled experiment. The experimental results showed that the subjects using TeamWATCH performed significantly better with respect to early conflict detection and resolution.

Radioprotection Measures during the Learning Curve with Hybrid Operating Rooms

Endovascular procedures come with a potential risk of radiation hazards both to patients and to the vascular staff. Classically, most endovascular interventions took place in regular operating rooms (ORs) using a fluoroscopy C-arm unit controlled by a third party. Hybrid operating rooms (HORs) provide an optimal surgical suit with all the qualities of a fixed C-arm device, while allowing the device to be controlled by the surgical team. The latest studies suggest that an operator-controlled system may reduce the radiation dose. The purpose of the present study is to determine the amount of absorbed radiation using an HOR in comparison with a portable C-arm unit and to assess whether the radioprotection awareness of the surgical team influences the radiation exposure. The primary end point was the effective dose in milliSievert (mSv) for the surgical team and the average dose-area product (ADAP) in Gray-meters squared (Gym2) for patients. The values of absorbed radiation of the surgical team's dosimeters were collected from January 2015 to May 2016. The HOR was installed in June 2015, and a radioprotection seminar was given in October 2015. The HOR-issued radiation, measured by the maximum dose-area product, ADAP, average dose (AD) per procedure, maximum dose per procedure per month, maximum fluoroscopy time, average fluoroscopic time, peak skin dose, and average skin dose (ASD), was collected monthly from September 2015 to July 2016. The timeline was divided into 3 periods: 5months pre-HOR (Pre-HOR), 5months after the HOR installation (PreS-HOR), and 5months after a radioprotection seminar (PostS-HOR). The average number of procedures per month was 22.55 (±4.9), including endovascular aneurysm repair/thoracic endovascular aneurysm repair, carotid, visceral, and upper and lower limb endovascular revascularization. The average amount of absorbed radiation by the surgeons during PreS-HOR was 1.07±0.4mSv, which was higher than the other periods (Pre-HOR 0.06±0.03mSv, P=0.002; PostS-HOR 0.14±0.09mSv, P=0.000, respectively). The ADAP during PreS-HOR was 0.016±0.01 Gym2, which was lower than the PostS-HOR (0.001±0.002 Gym2) (P=0.034). The AD during PreS-HOR was 0.78±0.3Gy and 0.39±0.3Gy during PostS-HOR (P=0.098). The ASD during PreS-HOR was 0.40±0.2Gy and 0.20±0.1Gy during PostS-HOR (P=0.099). In our experience, the HOR increases the amount of absorbed radiation for both patients and surgeons. The radioprotection seminars are of utmost importance to provide a continued training and optimize the use of ionizing radiation while using an HOR. Despite the awareness of the surgical team in the radioprotection field, the amount of absorbed radiation using an HOR is higher than the one using a C-Arm unit.

3:00 PM Abstract No. 141 Interventional radiology patient throughput: application of lean sigma methodology and real-time delay dashboard to improve operations and patient experience

Implementation of large scale EMRs are problematic for optimization of patient experience. A large interventional radiology center performing up to 1000 procedures every month developed a customized, unique, unit-specific patient delay dashboard with real-time feedback to mitigate patient delays. Due to various inefficiencies and limitations, 28% of outpatients are delayed more than 60 minutes past their scheduled procedure start time. The purpose of this project is to achieve a 50% short-term reduction in patient delays greater than 60 minutes and a long-term 50% decrease in delays overall. Additional areas of focus include patient experience e-survey scores, procedure room downtime, reduced PACU capacity, denied insurance days, and financial cost. A multidisciplinary team utilized Lean Sigma methodology for this quality improvement project. A computer application was developed to calculate delays using daily EMR data extracts sent via sftp to our data base. The app supplies a real-time color-coded patient delay dashboard which is prominently displayed on flat screens throughout the department, and alerts staff to individual patient delays in real time with green, yellow, orange, and red lights. A bundled set of interventions targeted preprocedure care coordination and scheduling, outpatient prerounding, reduction of the PT/INR requirement, and the development of an IR bedside service. Patient delays were reduced by 27% in the > 60 minute category (p>0.05) from a baseline 5-month period in January 2016 to a corresponding period in May 2017. Top box scores for timeliness improved 21% on patient e-surveys (n = 802). An anticipated reduction in hospital insurance denied days, due to improved throughput, facilitated funding to open an additional procedure suite and add the bedside services team. Interventions resulted in significant improvement in patient delays, patient experience scores, and denied days. The invention, design, and implementation of a real-time unit-specific dashboard supplied by a data dump from the EMR was invaluable in helping to promote team awareness and transparency regarding delays and throughput.

Non-Uniform Information Access in Collaborative Information Retrieval

Although there has been a great deal of research into Collaborative Information Retrieval/Seeking (CIR/S), the majority has assumed that team members in a collaborative search team always have the same level of unrestricted access to information. However, observations from different domains such as healthcare, business, government, etc. have suggested that collaboration sometimes involves people with differing levels of access to information. This type of scenario has been referred to as Multi-Level Collaborative Information Retrieval (MLCIR). As well as a support for collaboration, MLCIR must consider information flow, security and shareability between collaborators. Therefore, existing CIR/S interface components and concepts (e.g. awareness, division of labour, persistence, etc.) may not be directly applicable to MLCIR. To the best of our knowledge, there has not been any systematic evaluations to investigate the impact of MLCIR on search outcomes and to provide user-centred design recommendations for MLCIR interfaces. To address this gap, a number of studies were conducted using real-world MLCIR examples as scenarios. This thesis highlights four research objectives; these are: 1) to investigate the impact of different collaborative search strategies and MLCIR scenarios on search outcomes using a user simulation approach, 2) to develop a preliminary MLCIR interface and investigate the impact of MLCIR scenarios on search outcomes using a user study, 3) to investigate the impact of existing CIR concepts on MLCIR search outcomes using a user study, and 4) to develop and evaluate a working prototype of an MLCIR interface that supports users for asynchronous collaboration. These investigations followed an iterative approach until a final MLCIR interface could be produced. The first study was a user simulated study which allowed us to test a large number of variables and to pick prominent ones for further user studies. It was found that when relevance feedback search strategies were used, search performance of non-full access (where team members had 90% access to collection) outperformed full access (where team members had 100% access to collection). This simulated study also fulfilled the first research objective. Next, a preliminary user study was conducted using variables selected based on the findings of the simulated study. This study uncovered a number of interface components, and awareness concepts such as query awareness, result awareness and team awareness that could be used to support users in MLCIR scenarios. This user study addressed the second research objective. Based on findings from this user study, two further user studies were conducted where we evaluated a number of interface components implemented to support query awareness, result awareness and team awareness. Results suggested that having access to query properties and result properties in MLCIR scenarios can leverage team members? search performance. These two user studies addressed the third research objective. Finally, a working MLCIR interface was built based on the findings elicited from our previous user studies. The interface was then evaluated using the web and non-uniform information access scenarios. The results showed that blacklisting search terms had a significant negative impact on search outcome than blacklisting documents (f-measure: 0.04 vs 0.197). This study fulfilled the final research objective. All five studies presented in this thesis provided us with an increasing understanding of how to develop an MLCIR interface that is usable and helpful for users. As a final product, a working MLCIR interface was produced which could provide collaborating users with useful awareness information without disclosing any sensitive data. Overall, this thesis provided important new design suggestions and showed reusability of CIR components for MLCIR interfaces, something that has never been demonstrated before. The interfaces, experimental designs and findings including design suggestions that are presented in this thesis serve as novel guidelines for further investigations into MLCIR.

Introduction of Triggers for Palliative Care Consultation Improve Utilization and Satisfaction within a Level IV NICU (SA508D)

•Identify three key elements that influence successful implementation of triggers for palliative care consultation within a NICU setting.•Recall the four major trigger domains that qualify for pediatric palliative care consultation within a NICU setting. The use of a palliative care guideline, such as a trigger list for palliative care consultation (PCC), remains controversial in the NICU. Despite knowledge that a palliative team is present at our institution, the level of utilization of their services, and the NICU providers’ attitudes and beliefs regarding neonatal palliative care, are unknown. We sought to increase awareness of the palliative care team’s role and the criteria in which a consultation is appropriate, with a SMART aim to increase the number of PCCs within our level four NICU by 20% by the end of December 2016. The setting is in a Level four NICU at an academic urban pediatric hospital. The study design included observational time series with multiple planned sequential interventions, which include but not limited to surveys and education. Medical chart review screened for eligibility for PCC. Statistical process control charts show performance over time. Many providers noted a need for a guideline for PCC. Prior to implementation of the triggers, of those who qualified for PCC, 26% received consultation, which increased to 46% after implementation. There was also an increase in the percentage of survey respondents who understand what the team's role is, know when they should be consulted, and noticed a positive difference since their utilization. Lastly, the time until initial consultation decreased from approximately 1.5 months to one week. We achieved our goal of increasing the number of PCC by 20%, and decreased time to initial consultation. The triggers helped establish prompt and proactive referral. Not only can a written guideline increase awareness of a palliative care team’s role within a NICU, but it also enhances the satisfaction amongst providers of the care they are giving. Early integration of palliative care within the NICU can help guide revision of treatment goals, improve communication, and provide continuity of comprehensive care to families.

An authoring system for VR-based firefighting commanders training

Building a realistic training environment to teach situation awareness and coordination of teams implies more than good graphics and HCI. Plausible and varied behavior of the artificial characters, richness and variety of the stories experienced by the trainee are essential features of an effective training session. This paper discusses an authoring environment for simulations targeted at the training of firefighting commanders. This environment, called PRESTO-FF, currently includes a modelling facility for behaviours of people on the scene, a specific 3D environment, and a visual scripting system that drives the unfolding of the simulation according to the player's actions and real-time choices by a trainer. Models and scripts are reusable in multiple 3D environments thanks to abstractions and semantics provided by underlying AI technologies. Results of the validation of a simulation with domain experts are reported, highlighting both advantages and limitations of the current framework.

A survey of anaphylaxis etiology and treatment.

Identifying the causes of anaphylaxis which is an acute, potentially fatal systemic reaction is very important in every community. Treatment strategies and pitfalls should also be determined. We sought to determine the most common triggers of anaphylaxis, clinical manifestations and treatment strategies in Mashhad, northeast of Iran. An observational cross-sectional study was conducted to evaluate all patients with a history of anaphylactic reaction who were referred to University Allergy Clinics between 2006 and 2016 in Mashhad Iran. We used a combination of patient’s clinical history and allergy diagnostic testing including radioallergosorbant test and skin prick test in order to determine the etiology of anaphylaxis. We identified 172 anaphylactic reactions in 70 patients. Median age was 15 years with a range from 6 months to 48 years. The triggers included: foods, 61.4%; drugs, 15.7%; hymenoptera venom, 8.6%; idiopathic, 5.7%; immunotherapy, 4.3% and other etiologies: 5.7%. Nuts and seeds were the most important triggers of food induced anaphylaxis, especially in school children, adolescents and young adults, followed by fruits. However, Cow’s milk and hen’s egg were the main triggers of anaphylaxis in children aged under 2 years. The most common symptoms were cutaneous and cardiovascular. Corticosteroids (94.3%) and/or antihistamines (85.7%) were used most frequently for treatment followed by intravenous fluids (54.3%), whereas epinephrine was only used in 17.1% of the cases. Food related anaphylaxis and other typical triggers of anaphylaxis are age dependent and the risks and triggers change with age. Epinephrine injection should be increased by improving the awareness of physician and medical teams. The study was approved by the Ethics Committee of the Faculty of Medicine of Mashhad University of Medical Sciences (approved number: IR.MUMS.REC.1393.960).

How Social Media-Enabled Communication Awareness Enhances Project Team Performance

Project teams increasingly rely on computer-mediated communication. In this paper, we propose that communication within these teams benefits from a communication-awareness feature that summarizes communication at one common place. We argue that such a feature pays out specifically during action episodes, when team members engage in taskwork. We conducted two studies of 51 and 35 project teams to examine how the amount of communication during action episodes relates to team performance under low versus high communication awareness. In both studies, we technologically designed communication awareness as the availability of a feed, known from social media platforms, that displays all team-internal, computer-mediated communication. The results show that the communication-awareness feature makes communication during action episodes more beneficial, both in term of effectiveness and efficiency. Zooming into the temporal patterns of communication during action episodes further reveals that high-performing teams in the high-communication-awareness condition stick out by early and steady communication. Implications for current and future research on team communication and awareness support are discussed.

Mothers and Premature Infants’ Emotional Interactions in a Neonatal Infant Care Unit: Case Studies

The aim of this study was to describe the ways premature infants and their mothers emotionally interact in the first weeks of their lives. In order to understand the intersubjective dyadic interaction between mother and premature infant, a qualitative and descriptive approach to research has been adopted. Four dyads comprised of primiparae women and their newly-born premature infants took part in the study. The babies were born prematurely after 28 to 35 weeks of gestation and admitted to the neonatal intensive care unit (NICU). Data was collected filming the first dyadic interaction with infant in the mother’s arms, lasting between 15 to 30 minutes. After that first registry, dyadic behaviors between mother and baby were described and categorized following the intersubjective categories suggested by Fiamenghi (1999) and Fiamenghi et al. (2010). Results showed that dyads display positive emotions, with infants’ behaviors falling into the categories of negotiation, interaction and emotional curiosity; as well as a low frequency of negative behaviors. The outcome of this research reinforces the need to adopt a humanizing approach to prematurely born infants and their mothers in NICU, as well as training and awareness of the whole multidisciplinary team that deals with them.

Survey of communication and awareness as the most relevant socio‐technical aspects of requirements‐driven collaboration among software development teams

Requirements engineering is a social process and while working together, stakeholders develop socio-technical relationships. Socio-technical aspects such as communication (information exchange among members) and awareness (knowledge of others) were discussed in literature, but little is known with respect to their role in requirements engineering activities. Therefore, requirements-driven collaboration (RDC), particularly on the relevance of socio-technical aspects, warrants further investigation. The authors aim to fill this gap by conducting a systematic literature review on these two aspects. This review covers planning (defining objectives and search strategy), execution (study search and selection), and interpretation of the findings (results and discussions). Findings revealed more studies on communication than on awareness. Two aspects of communication covered for RDC in literature are: (i) preferred communication medium, and (ii) communication patterns of teams. However, for awareness the aspects affecting awareness and vice versa were studied for RDC. Further investigation indicated the interdependence of awareness and communication and that distance does not affect team's awareness. The authors discuss implications for software practitioners in terms of enhancing their performance by considering the role of information brokers, and identifying central and emergent members etc. Researchers can strengthen the domain by providing more empirical results on interdependence of socio-technical aspects.

Assessment of the Awareness and Practice of Health Team Toward Dengue Fever at Al-Hodeidah City –Yemen

Dengue fever represents a major global health challenge and it is one of the most rapidly spreading mosquito-borne viral infections throughout tropical and sub-tropical regions of the world. The study aimed: To assess the awareness and practice of health team about dengue fever at Al-Hodeidah city. Subjects and methods: Descriptive research design was used in the study. Convenient sample was used. The current study included 370 divided into: - 124 physicians, 183 nurses, 33 lab technicians, and 30 midwives. Results: The study revealed that 57% of health team had fair awareness level about dengue fever toward dengue fever. Moreover, 60.1% of nurses & midwives had poor practices, 46.0% of physicians had fair practices, and 63.6% of lab- technicians had good practices. Conclusion: the study concluded that all health team had fair awareness toward dengue fever. While the physicians had fair practices the nurses and midwives had poor practices but the lab technician's practices were good. Recommendations: The current study recommended education programs should be organized for nurses and midwives regarding management and prevention of dengue fever.

Effect of quality control activities on improving compliance and rational diet of elderly patients with coronary heart disease

Objective To explore the effect of quality control activities in the treatment of elderly patients with coronary heart disease and the effect of reasonable diet. Methods From March 2015 to December 2016, the nursing group was divided into two groups: protect heart , and 120 elderly patients with coronary heart disease were systematically managed.The patients were treated with compliance low and without reasonable diet reasons, to develop goals and strategies, the final application of goods tube circle activities to improve patients′ compliance, improve the proportion of reasonable diet. Results After the quality control activities, the patients were investigated, the treatment compliance (75.00%) was significantly higher than before activity (48.33%), and the difference was statistically significant (χ2=19.43, P=0.00). After the event, the patients′ food pass rate increased from 35.00% to 63.33%, the incidence rate of hyperlipidemia decreased from 70.00% to 63.33%, the obesity rate decreased from 65.00% to 55.00%, the food pass rate and quality control activities were significantly improved compared with before treatment (χ2=19.272, P=0.00). After the event of quality control activities, the total cardiovascular adverse events were reduced from 109 cases to 72 cases, and the difference was statistically significant (χ2=30.77, P=0.00). After the activities of the product tube, the self-growth of the health care workers[after the event (4.27±0.80)points, before the event (2.45±0.68)points], the activity participation[after the event (3.39±0.52)points, before activity (1.34±0.42)points], QCC technique[after the event (3.99±0.54)points, before activity (1.35±0.48)points], personal ability[after activity (4.14±0.36)points, before activity (2.69±0.32)points], team spirit[after activity (4.13±0.38)points, before activity (2.26±0.28)points], and the communication skills and expression ability[after activity (4.29±0.39)points, before activity (2.25±0.38)points]had statistically significant differences compared with before activity (t=18.99, 33.60, 32.98, 43.40, 40.03, 41.04, all P=0.000). Conclusion The development of quality control activities can improve patients′ compliance and play a positive role in planning patients' rational diet, thus laying a solid foundation for long-term treatment of coronary heart disease and improving team awareness and self-accreditation of medical staff.So quality control activity is worthy of promoting in the future clinical work. Key words: Quality control; Coronary heart disease; Treatment compliance; Reasonable diet

Individuals Perform Better in Teams but Are Not More Aware - Performance and Situational Awareness in Teams and Individuals

The relation between situational awareness and performance is inconclusive. Although effective performance has been typically associated with higher situational awareness, some studies did not find this trend. This study examined some of the factors that could influence that relationship. Using a firefighting simulator, we asked participants to run through four urban firefighting scenarios, two as individual players and the other two as two-person teams. The findings show better performance in teams as compared to individuals. In contrast, individuals had higher levels of SA when they played alone compared to playing in a team. In other words, even though the team performed better, it was not associated with team members having better situational awareness in the team scenarios. It is possible that team processes, such as communication and coordination, were not effective in the team play in the experiment, resulting in poorer SA, yet not disruptive enough to the performance. This was probably because they could have reached high performance without effective teamwork. There may also be some tacit situational knowledge not measured by SAGAT, that mediates situational awareness and performance.

Implementation of Early Diagnosis and Intervention Guidelines for Cerebral Palsy in a High-Risk Infant Follow-Up Clinic

BackgroundCerebral palsy is the most common physical disability in childhood, and is mostly diagnosed after age 2 years. Delays in diagnosis can have negative long-term consequences for children and parents. New guidelines for early cerebral palsy diagnosis and intervention were recently published, after systematic review of the evidence by international multidisciplinary experts aiming to decrease age at diagnosis. The current study tested the feasibility of implementing these guidelines in an American clinical setting. MethodsWe designed a stepwise implementation process in a neonatal intensive care follow-up clinic. Efficacy was tested by comparing 10-month pre- and post-implementation periods. Clinic visit types, cerebral palsy diagnosis, provider competencies and perspectives, and balancing measures were analyzed. ResultsChanges to infrastructure, assessments, scheduling algorithms, documentation and supports in diagnosis or counseling were successfully implemented. Number of three- to four-month screening visits increased (255 to 499, P < 0.001); mean age at diagnosis decreased (18 to 13 months, P < 0.001). Clinic team awareness of early diagnosis and interventions increased (P < 0.001). There was no decrease in family satisfaction with overall clinic function. Opportunities for improvements included documentation for transitioning patients, generalizabilty across hospital clinics, systematic identification of high-risk status during hospitalization, and need for cerebral palsy care guidelines for infants under age 2 years. ConclusionsWe demonstrated for the first time in a US clinical setting the feasibility of implementation of international early diagnosis and treatment guidelines for cerebral palsy. This process is adaptable to other settings and underscores the necessity of future research on cerebral palsy treatments in infancy.

Lessons Learned: An Effective Approach to Avoid Repeating the Same Old Mistakes

Space missions face major challenges when it comes to improving processes and procedures, making it difficult to guarantee a repeat of good experiences while avoiding bad ones. The core activity to achieve these objectives is a robust method to collect, organize, and disseminate lessons learned. The inherent complications of managing lessons include fear of finger pointing, lack of transparency, and poor team awareness, causing the process to weaken over time. For the Satélite de Aplicaciones Científicas-D/Aquarius mission, a method was implemented allowing any participant in the mission to register quick contributions about suspected anomalies, proposed improvements, or learned lessons into the system. During all project phases, the submitted inputs were periodically classified and refined by a working group and passed on to a board for final analysis and determination. This method allowed for a drastic reduction in the amount of processed items with respect to the quick contributions received. Anomalies, improvements, and lessons were recorded during the Satélite de Aplicaciones Científicas-D/Aquarius operations phase and were continuously used to improve various aspects of the mission. The benefits of using this approach include gaining valuable feedback through direct experiences, contributing to an enhanced work culture, expanding reach to other missions, and pinpointing gaps in the contributions.

Patient positioning during minimally invasive surgery: what is current best practice?

IntroductionPositioning injuries are a known surgical complication and can result in significant patient morbidity. Studies have shown a small but significant number of neurovascular injuries associated with minimally invasive surgery, due to both patient and case-specific factors. We sought to review the available literature in regards to pathophysiological and practical recommendations.MethodsA literature search was conducted and categorized by level of evidence, with emphasis on prospective studies. The result comprised 14 studies, which were summarized and analyzed with respect to our study objectives.ResultsWhile incidence of positioning injury has been identified in up to one-third of prospective populations, its true prevalence after surgery is likely 2%–5%. The mechanism is thought to be intraneural disruption from stretching or pressure, which results in decreased perfusion. On a larger scale, this vascular compromise can lead to ischemia and rhabdomyolysis. Prevention hinges on addressing patient modifiable factors such as body mass index, judicious positioning with appropriate devices, and intraoperative team awareness consisting of recurrent extremity checks and time management.ConclusionThe risk for positioning injuries is underappreciated. Surgeons who perform minimally invasive surgery should discuss the potential for these complications with their patients, and operative teams should take steps to minimize risk factors.

Application of quality improvement techniques to reduce parenteral nutrition wastage in a national intestinal failure unit

ObjectivesParenteral nutrition (PN) costs approximately £80 per day per bag. Unpredictable changes in patients’ clinical condition, venous access loss or reasons related to the processes involved in administering PN can...

Reducing patient waiting time and length of stay in an Acute Care Pediatric Emergency Department

Prolonged waiting times and length of stay in Pediatric Emergency Department, are the two of the most challenging patient and clinical outcomes of healthcare institution. These emerged due to various...

Using agent transparency to support situation awareness of the Autonomous Squad Member

Agent transparency has been proposed as a solution to the problem of facilitating operators’ situation awareness in human-robot teams. Sixty participants performed a dual monitoring task, monitoring both an intelligent, autonomous robot teammate and performing threat detection in a virtual environment. The robot displayed four different interfaces, corresponding to information from the Situation awareness-based Agent Transparency (SAT) model. Participants’ situation awareness of the robot, confidence in their situation awareness, trust in the robot, workload, cognitive processing, and perceived usability of the robot displays were assessed. Results indicate that participants using interfaces corresponding to higher SAT level had greater situation awareness, cognitive processing, and trust in the robot than when they viewed lower level SAT interfaces. No differences in workload or perceived usability of the display were detected. Based on these findings, we observed that transparency has a significant effect on situation awareness, trust, and cognitive processing.

Prevention of Post-herpetic Neuralgia from Dream to Reality: A Ten-step Model

Herpes zoster (HZ) is a painful, blistering skin eruption in a dermatomal distribution caused by reactivation of a latent varicella zoster virus in the dorsal root ganglia (DRG). Post-herpetic neuralgia (PHN) is the most common complication of acute herpes zoster (AHZ). Severe prodrome, greater acute pain and dermatomal injury, and the density of the eruption are the risk factors and predictors for developing PHN. PHN has a substantial effect on the quality of life; many patients develop severe physical, occupational, social, and psychosocial disabilities as a result of the unceasing pain. The long-term suffering and the limited efficacy of the currently available medications can lead to drug dependency, hopelessness, depression, and even suicide. Family and society are also affected regarding cost and lost productivity. The pathophysiology of PHN remains unclear. Viral reactivation in the dorsal root ganglion and its spread through the affected nerve result in severe ganglionitis and neuritis, which induce a profound sympathetic stimulation and vasoconstriction of the endoneural arterioles, which decreases the blood flow in the intraneural capillary bed resulting in nerve ischemia. Our rationale is based on previous studies which have postulated that the early interventions could reduce repetitive painful stimuli and prevent vasospasm of the endoneural arterioles during the acute phase of HZ. Hence, they might attenuate the central sensitization, prevent the ischemic nerve damage, and finally account for PHN prevention. The author introduces a new Ten-step Model for the prevention of PHN. The idea of this newly suggested approach is to increase the awareness of the health care team and the community about the nature of HZ and its complications, especially in the high-risk groups. Besides, it emphasizes the importance of the prompt antiviral therapy and the early sympathetic blockades for preventing PHN. Key words: Acute herpes zoster, prevention, post-herpetic neuralgia, sympathetic blockade, tenstep model