<p>Hospitals are complex socio-technical systems where health professionals from varied backgrounds interact with each other and technology for the wellbeing of patients. Effective communication among the members of the care team is vital for optimal care; poor communication can result in suboptimal care and in many cases, lead to adverse events (AEs) and even death. More than a decade after the US Institute of Medicine report which catalyzed patient safety improvement measures, patient safety remains a major concern. Two-thirds of AEs in hospitals are still linked to communication errors. Hospitals are trying to improve communication by introducing new communication devices like smart phones and tablet computers for professional use. However, they are being deployed without adequate study of the mechanics of communication in hospitals or their use affects inter-professional communication. High risk organizations such as nuclear power plants, aviation and the military have achieved better safety records than healthcare. This is likely because they have studied their communication challenges and based their assessments on a firm theoretical foundation before implementing customized solutions. This approach in healthcare is lacking. Therefore a scoping review was conducted to collect communication theories, models, frameworks, and methods applicable to new information and communication technology used in hospitals. Literature from basic and applied science domains such as cognitive psychology, human factors engineering, organizational behavior, sociology, communication sciences and from high risk organizations like aviation, nuclear power generation and defense was reviewed. 14 theories, 12 models and 12 communication analysis methods were identified. One of the selected methods was employed to conduct a case study of a case of faulty communication reported in the AHRQ web M&M. It is not known how well those theories, models and analysis methods can be adapted to medicine. Future research may be able to address the issue and adopt theories and models to hospital communication research, modifying existing theories and models to suit the unique requirements of hospitals or by developing a strategy to design them de-novo.</p> / Master of Science (MSc)

Random hole optical fibers (RHOF) offer advantages over other types of microstructured optical fibers (MOFs). They are inexpensive and easy-to-make when compared to the high cost of ordered hole MOFs. They also have unique characteristics since they contain open and closed holes. The open holes contain ambient air under normal conditions and the closed holes contain residual gases from the fabrication process at certain pressure. The objective of this research work was to investigate the radiation resistance of Random Hole Optical Fibers (RHOF) for possible use as both sensing element and data transmission medium in nuclear reactor instrumentation and control applications. This work is motivated by the demand for efficient, cost effective, and safe operation of nuclear power plants, which accounts for more than 14% of the world's electricity production. This work has studied the effect of gamma irradiation on RHOF fibers by comparing their performance to that of standard solid telecommunication fibers and commercially available specialty solid fiber designed to be radiations hardened fiber. The fibers were evaluated at different absorbed dose levels: 12 mGy(Si), 350 mGy(Si), and 7200 Gy(Si) by measuring their radiation induced absorption (RIA) on-line. In the low dose test, the maximum RIA measured in untreated RHOF was approximately 8 dB while the RIA in the untreated MMF fibers reached a maximum at about 28 dB. In the high dose test, the maximum RIA measured in untreated RHOF was 36 dB while RIA in the methanol washed RHOF was only 9 dB. RHOF also demonstrated superior radiation damage recovery time over all of the other fibers tested. Based on the experimental evaluations, it was deduced that RHOFs used in this work are resistant to gamma radiation. and recover from radiation damage at a faster rate compared to other fibers tested. The radiation induced absorption (RIA) at the 1550 nm window in the RHOF fibers could be attributed to the OH absorption band tail. However, the existence of other mechanisms responsible for RIA is also postulated. Some of these mechanisms include bulk and surface defects which are related to the fabrication process and the influence of the gases confined within the RHOF microstructure. Gamma radiation resistance of RHOFs can be attributed to the lack of dopants and also possibly the inherent OH and nitrogen content. The behavior of thermally annealed RHOF and their fast recovery is in favor of this hypothesis. / Master of Science