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Lampi, M., Junker, J., Tabu, J. S., Berggren, P., Jonson, C.-O. & Wladis, A. (2018). Potential benefits of triage for the trauma patient in a Kenyan emergency department. BMC Emergency Medicine, 18(49), 1-7
Open this publication in new window or tab >>Potential benefits of triage for the trauma patient in a Kenyan emergency department
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2018 (English)In: BMC Emergency Medicine, ISSN 1471-227X, E-ISSN 1471-227X, Vol. 18, no 49, p. 1-7Article in journal (Refereed) Submitted
Abstract [en]

Background

Improved trauma management can reduce the time between injury and medical interventions, thus decreasing morbidity and mortality. Triage at the emergency department is essential to ensure prioritization and timely assessment of injured patients. The aim of the present study was to investigate how a lack of formal triage system impacts timely intervention and mortality in a sub-Saharan referral hospital. Further, the study attempts to assess potential benefits of triage towards efficient management of trauma patients in one middle income country.

Methods

A prospective descriptive study was conducted. Adult trauma patients admitted to the emergency department during an 8-month period at Moi Teaching and Referral Hospital in Eldoret, Kenya, were included. Mode of arrival and vital parameters were registered. Variables included in the analysis were Injury Severity Score, time before physician’s assessment, length of hospital stay, and mortality. The patients were retrospectively categorized according to the Rapid Emergency Triage and Treatment System (RETTS) from patient records.

Results

A total of 571 patients were analyzed, with a mean Injury Severity Score of 12.2 (SD 7.7) with a mean length of stay of 11.6 (SD 18.3) days. The mortality rate was 1.8%. The results obtained in this study illustrate that trauma patients admitted to the emergency department at Eldoret are not assessed in a timely fashion, and the time frame recommendations postulated by RETTS are not adhered to. Assessment of patients according to the triage algorithm used revealed a significantly higher average Injury Severity Score in the red category than in the other color categories.

Conclusion

The results from this study clearly illustrate a lack of correct prioritization of patients in relation to the need for timely assessment. This is further demonstrated by the retrospective triage classification of patients, which identified patients with high ISS as in urgent need of care. Since no significant difference in to time to assessment regardless of injury severity was observed, the need for a well-functioning triage system is apparent.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Triage, Trauma, Emergency department
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-153305 (URN)10.1186/s12873-018-0200-7 (DOI)30497397 (PubMedID)2-s2.0-85057551142 (Scopus ID)
Note

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2018-12-18Bibliographically approved
van Laere, J., Berggren, P., Larsson, A., Olsson, L., Johansson, B. & Gustavsson, P. (2017). Analyzing the implications of design choices in existing simulation-games for critical infrastructure resilience. In: International Simulation and Gaming Association’s conference (ISAGA) 2017: . Paper presented at International Simulation and Gaming Association’s conference (ISAGA), Delft, Netherlands, 10-14 July 2017.
Open this publication in new window or tab >>Analyzing the implications of design choices in existing simulation-games for critical infrastructure resilience
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2017 (English)In: International Simulation and Gaming Association’s conference (ISAGA) 2017, 2017Conference paper, Published paper (Refereed)
National Category
Other Engineering and Technologies not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-141855 (URN)
Conference
International Simulation and Gaming Association’s conference (ISAGA), Delft, Netherlands, 10-14 July 2017
Available from: 2017-10-10 Created: 2017-10-10 Last updated: 2017-11-07Bibliographically approved
Berggren, P., Johansson, B. & Baroutsi, N. (2017). Assessing the quality of Shared Priorities in teams using content analysis in a microworld experiment. Theoretical Issues in Ergonomics Science, 18(2), 128-146
Open this publication in new window or tab >>Assessing the quality of Shared Priorities in teams using content analysis in a microworld experiment
2017 (English)In: Theoretical Issues in Ergonomics Science, ISSN 1463-922X, E-ISSN 1464-536X, Vol. 18, no 2, p. 128-146Article in journal (Refereed) Published
Abstract [en]

Objective, easy to use, and easy to comprehend assessment methods for measuring shared understanding in teams are hard to find. This paper describes an experiment where a measure called Shared Priorities, which is based on ranking of self-generated strategic items, is assessed. Trained teams were compared to non-trained teams in a dynamic problem-solving task. The maturity of the participating teams was also assessed using a content analysis measure. The Shared Priorities measure was used alongside other well-documented measures of team awareness based on self-rating. Results show that the Shared Priorities measure correlates with task performance and could also distinguish between trained and non-trained teams. However, the Shared Priorities measure did not correlate with the other team measures (cf. CARS – Crew Awareness Rating Scale – and DATMA – Distributed Assessment of Team Mutual Awareness), suggesting that it captures a different quality of teamwork than the self-rating measures. Further, the Shared Priorities measure was found to be easily administered.

Place, publisher, year, edition, pages
Taylor & Francis, 2017
Keywords
Shared Priorities, CARS, team, microworld, DATMA, shared understanding, mixed design MANOVA
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:liu:diva-141761 (URN)10.1080/1463922X.2016.1159354 (DOI)2-s2.0-84961210979 (Scopus ID)
Available from: 2017-10-05 Created: 2017-10-05 Last updated: 2019-01-09Bibliographically approved
van Laere, J., Berggren, P., Gustavsson, P., Ibrahim, O., Johansson, B., Larsson, A., . . . Wiberg, C. (2017). Challenges for critical infrastructure reslience: cascading effects of payment system disruptions. In: Tina Comes, Frederick Benaben, Chihab Hamachi, Matthieu Lauras and Auriel Montarna (Ed.), Proceedings May 21-24, 2017 ISCRAM 2017: Agility is comming Mines Albi.. Paper presented at 14th International Conference on Information Systems for Crisis Respons And Management, May 21-24, (pp. 281-292). Albi: ISCRAM SOCIETY, 14
Open this publication in new window or tab >>Challenges for critical infrastructure reslience: cascading effects of payment system disruptions
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2017 (English)In: Proceedings May 21-24, 2017 ISCRAM 2017: Agility is comming Mines Albi. / [ed] Tina Comes, Frederick Benaben, Chihab Hamachi, Matthieu Lauras and Auriel Montarna, Albi: ISCRAM SOCIETY , 2017, Vol. 14, p. 281-292Conference paper, Published paper (Refereed)
Abstract [en]

Critical infrastructures become more and more entangled and rely extensively on information technology. A deeper insight into the relationships between critical infrastructures enables the actors involved to more quickly understand the severity of information technology disruptions and to identify robust cross-functional mitigating actions. This study illustrates how and why disruptions in the payment system in Sweden could create cascading effects in other critical infrastructures with potentially severe consequences for many citizens, government institutions and companies. Data from document studies, interviews and workshops with field experts reveal seven challenges for collective cross-functional critical infrastructure resilience that need to be dealt with: 1) Shortage of food, fuel, cash, medicine; 2) Limited capacity of alternative payment solutions; 3) Cities are more vulnerable than the countryside; 4) Economically vulnerable groups in society are more severely affected; 5) Trust maintenance needs; 6) Crisis communication needs; 7) Fragmentation of responsibility for critical infrastructures across many actors. 

Place, publisher, year, edition, pages
Albi: ISCRAM SOCIETY, 2017
Series
Proceedings of the International Conference on Information Systems for Crisis Response and Management, ISSN 2411-3387 ; 14
Keywords
Critical infrastructures, resilience, collective resilience, payment system.
National Category
Civil Engineering Other Civil Engineering
Identifiers
urn:nbn:se:liu:diva-141767 (URN)
Conference
14th International Conference on Information Systems for Crisis Respons And Management, May 21-24,
Available from: 2017-10-05 Created: 2017-10-05 Last updated: 2017-10-10Bibliographically approved
Berggren, P. (2016). Assessing Shared Strategic Understanding. (Doctoral dissertation). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Assessing Shared Strategic Understanding
2016 (English)Doctoral thesis, monograph (Other academic)
Abstract [en]

This thesis describes the development of an instrument for assessing shared understanding in teams. The purpose was to develop an instrument that would be usable, understandable, objective, flexible and self-explanatory. Teams working in naturalistic settings are expected to have a shared understanding concerning common goals and how to achieve these. The problem investigated in this thesis is that current techniques and instruments for assessing shared understanding in teams generally suffer from one or more of the following drawbacks, namely that they are expensive, difficult to use, time-consuming, requiring expertise, and are often based on subjective perceptions. Departing from existing theory in team cognition techniques and theories, the research questions posed in this thesis are: 1) How can shared understanding be measured without the disadvantages of existing methods? 2) How can shared understanding be assessed without the bias of self-ratings and/or assessments by experts/observers? 3) Can team performance be better understood by the outcomes of an instrument that measures shared understanding?

These research questions are answered through six studies that are presented in this thesis. Over the six studies an instrument was iterated and subsequently developed, called the “shared priorities instrument”. When using this instrument, team members are instructed to generate items and rank these in order of importance. By comparing these rank orders from different participants, a team measure of shared understanding can be calculated. The advantages of this instrument compared to earlier measures are that it is less expensive, easier to use, less time-consuming, does not require subject matter expertise, and that the instrument is distanced from subjective perceptions. Furthermore, the final study provides results where outcomes from the shared priorities instrument correlate with performance, supporting earlier research connecting shared understanding in teams with team performance. A structural equation model, a result of the final study, shows that the instrument is both valid and reliable.

Abstract [sv]

Denna avhandling beskriver utvecklingen av ett mätinstrument för att värdera delad förståelse hos team. Syftet har varit att utveckla ett mätinstrument som är användbart, förståeligt, objektivt, flexibelt och självförklarande. Team som arbetar i naturalistiska miljöer förväntas ha en delad förståelse för gemensamma mål och hur dessa ska uppnås. Befintliga tekniker och mätinstrument för värdering av delad förståelse hos team är att de ofta lider av ett eller flera av följande problem: de är dyra, svåra att använda, tidskrävande, kräver expertis, och bygger många gånger på subjektiva bedömningar. Genom att utgå från teoribildningen inom teamkognition ställs följande forskningsfrågor: 1) Hur kan delad förståelse i team mätas utan nackdelarna hos befintliga metoder? 2) Hur kan delad förståelse i team mätas utan att riskera att färgas av partiskheten hos egenbedömningar och/eller experters värderingar? 3) Kan teamprestation förstås bättre med hjälp av ett instrument som mäter delad förståelse?

Dessa frågeställningar besvaras i de sex delstudier som presenteras i denna avhandling där ett instrument (som kallas shared priorities) utvecklats för att mäta delad förståelse. Tillämpningen innebär att medlemmarna i ett team individuellt får generera och rangordna faktorer som de anser vara viktiga för att teamet ska nå sitt/sina gemensamma mål och därefter rangordna varandras faktorer. Genom att beräkna överensstämmelsen i dessa rangordningar erhålls ett mått på teamets delade förståelse. Fördelen med detta instrument, i jämförelse med tidigare mått, är att det kostar mindre, är lättare att använda, tar mindre tid, inte kräver någon domänexpertis, och att mätmetoden inte bygger på rent subjektiva bedömningar. I den sista delstudien erhålls resultat där instrumentet shared priorities korrelerar med prestation, vilket stöder tidigare forskning om delad förståelse. En statistisk modell (SEM) visar på instrumentets validitet och reliabilitet.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2016. p. 150
Series
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 677
Keywords
Team, team cognition, shared understanding, method development
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:liu:diva-126346 (URN)10.3384/diss.diva-126346 (DOI)978-91-7685-786-1 (ISBN)
Public defence
2016-05-11, Key 1, Hus Key, Campus Valla, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2016-04-14 Created: 2016-03-22 Last updated: 2018-01-10Bibliographically approved
Berggren, P., Nählinder, S. & Svensson, E. (Eds.). (2014). Assessing Command and Control Effectiveness: Dealing with a changing world. Farnham: Ashgate
Open this publication in new window or tab >>Assessing Command and Control Effectiveness: Dealing with a changing world
2014 (English)Collection (editor) (Other academic)
Abstract [en]

Assessing Command and Control Effectiveness: Dealing with a Changing World offers a description of the current state of Command and Control (C2) research in imperfect settings, showing how a research process should assess, analyse and communicate results to the development cycle of methods, work, manning and C2-technology. Special attention is given to the development of C2 research methods to meet the current and coming needs. The authors also look forward towards a future where effective assessment of C2 abilities are even more crucial, for instance in agile organisations.

The purpose of the C2 research is to improve the process and make it more effective while still saving time and money. Research methods have to be chosen carefully to be effective and simple, yet provide results of high quality. The methodological concerns are a major consideration when working under such circumstances. Furthermore, there is often a need for a swift iterative development cycle, and thus a demand to quickly deliver results from the research process. This book explains how field research experimentation can be quick, simple and effective, being able to draw valid conclusions even when sample sizes are small and resources are limited, collecting empirical data using measures and procedures that are minimally intrusive.

Place, publisher, year, edition, pages
Farnham: Ashgate, 2014. p. 226
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-117711 (URN)978-1-4724-3696-2 (ISBN)
Note

Contents

Forewords; Preface; Introduction, P. Berggren, S. Nählinder and E. Svensson; Analysing tactical cognitive systems: theories, models and methods, A. Norlander; Designing case studies using a systems analysis approach, P. Wikberg; Dynamic measures of effectiveness in command and control, E. Svensson and S. Nählinder; Organizational agility - an overview, B.J.E. Johansson and P.V. Pearce; Characteristics of command and control in response to emergencies and disasters, J. Trnka and R. Woltjer; Empirical studies of command and control centres at the Swedish Air Force, E. Svensson, C. Rencrantz, J. Marklund and P. Berggren; The advance of a valid and reliable tool for assessing shared understanding, P. Berggren; Evaluating the effectiveness of an armoured brigade staff, P. Thunholm, P. Berggren and P. Wikberg; Organizational effectiveness at the Kosovo Force headquarters: a case study, M. Granåsen and J. Marklund; Agility in command and control - functional models of cognition, B.J.E. Johansson; Conclusions, P. Berggren, S. Nählinder and E. Svensson; Index.

Available from: 2015-05-07 Created: 2015-05-07 Last updated: 2015-12-10Bibliographically approved
Baroutsi, N., Berggren, P., Johansson, B. J., Nählinder, S., Granlund, R., Turcotte, I. & Tremblay, S. (2014). Assessing development of team training in emergency management. In: Proceedings of the 11th ISCRAM: . Paper presented at ISCRAM.
Open this publication in new window or tab >>Assessing development of team training in emergency management
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2014 (English)In: Proceedings of the 11th ISCRAM, 2014Conference paper, Poster (with or without abstract) (Refereed)
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-117703 (URN)
Conference
ISCRAM
Available from: 2015-05-07 Created: 2015-05-07 Last updated: 2015-05-20
Svensson, E., Rencrantz, C., Marklund, J. & Berggren, P. (2014). Empirical studies of command and control centres at the Swedish Air Force. In: Peter Berggren, Staffan Nählinder, Erland Svensson (Ed.), Assessing command and control effectiveness: dealing with a changing world (pp. 103-126). Farnham: Ashgate
Open this publication in new window or tab >>Empirical studies of command and control centres at the Swedish Air Force
2014 (English)In: Assessing command and control effectiveness: dealing with a changing world / [ed] Peter Berggren, Staffan Nählinder, Erland Svensson, Farnham: Ashgate, 2014, p. 103-126Chapter in book (Other academic)
Place, publisher, year, edition, pages
Farnham: Ashgate, 2014
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-117717 (URN)9781472436948 (ISBN)
Available from: 2015-05-07 Created: 2015-05-07 Last updated: 2015-08-25Bibliographically approved
Thunholm, P., Berggren, P. & Wikberg, P. (2014). Evaluating the Effectiveness of an Armoured Brigade Staff. In: Peter Berggren, Staffan Nählinder, Erland Svensson (Ed.), Assessing Command and Control Effectiveness: Dealing with a changing world (pp. 141-160). London: Ashgate
Open this publication in new window or tab >>Evaluating the Effectiveness of an Armoured Brigade Staff
2014 (English)In: Assessing Command and Control Effectiveness: Dealing with a changing world / [ed] Peter Berggren, Staffan Nählinder, Erland Svensson, London: Ashgate, 2014, p. 141-160Chapter in book (Other academic)
Abstract [en]

The purpose with this chapter is to present a study of the effectiveness of an Armoured Brigade Headquarters (HQ) in some specific respects. Important issues were (1) how is the HQ Staff dimensioned in relation to its tasks, (2) how does the three staff processes work (Planning, Execution and Coordination / Decision) and (3) how well does the HQ’s Standard Operating Procedure (SOP) and Battle Rhythm  function in the light of the HQ’s organization and work processes? The study was designed as a survey study and was based on the following four instruments: (1) Military Command Team Effectiveness Instrument (CTEF 2.0; Essence, Vogelaar, Baranski, Berggren, Van Buskirk, Goodwin & Myller, 2008); (2) Measurement of workload according to the Borg scale (Borg, 1998); (3) Subjective assessments of quality of the Brigade HQ’s orders and reports, and (4) verification that the Brigade HQ followed it’s Standard Operating Procedure. Fifty-four staff members of an Armoured Brigade HQ volunteered as participants. In the study, the HQ was challenged with a peace support / peace keeping operation exercise.

The overall result regarding the CTEF and quality measurements on orders and reports indicate that the HQ worked well during the entire exercise and that the SOP and Battle Rhythm worked rather well. However, through the CTEF, four problem areas were identified. These areas regarded (1) the level of uncertainty in the mission, (2) the high complexity of the task, (3) the perceived instability of the objectives that were supposed to be attained in the mission environment, and (4) a high level of workload in some staff sections. Three of these areas are not under the control of the Brigade HQ (high level of uncertainty, high task complexity and unstable objectives of the operation). However, the fourth area, workload, could be influenced. Some staff sections seem to be undermanned in the current organization and that problem needs to be handled, by increasing some staff sections or by moving some duties to other sections.

Place, publisher, year, edition, pages
London: Ashgate, 2014
Keywords
Command team effectiveness, CTEF
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-117719 (URN)978-1-4724-3694-8 (ISBN)
Available from: 2015-05-07 Created: 2015-05-07 Last updated: 2015-05-20Bibliographically approved
Berggren, P., Johansson, B., Svensson, E., Baroutsi, N. & Dahlbäck, N. (2014). Statistical modelling of team training in a microworld study. In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting: . Paper presented at HFES (pp. 894-898). Sage Publications, 58
Open this publication in new window or tab >>Statistical modelling of team training in a microworld study
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2014 (English)In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, Sage Publications, 2014, Vol. 58, p. 894-898Conference paper, Published paper (Refereed)
Abstract [en]

A command and control environment is a dynamic and complex setting with complicated technical systems where teams of operators interact to reach shared goals. This study presents an experiment in which we, by means of Structural Equation Modeling (SEM), explain the relations between basic concepts of command and control environments: mental workload, frustration, situational awareness, and performance. This paper reports a LISREL analysis of the Baroutsi, Berggren, Nählinder, & Johansson (2013) data. From that data, a new latent variable “Frustration” emerges, which now can be included in the model.

Place, publisher, year, edition, pages
Sage Publications, 2014
Series
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, ISSN 1071-1813
National Category
Other Humanities not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-117742 (URN)10.1177/1541931214581188 (DOI)
Conference
HFES
Available from: 2015-05-07 Created: 2015-05-07 Last updated: 2017-02-21
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-2771-2705

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