A Controlled Adaptive Network Model of a Virtual Coach Supporting Speaking Up by Healthcare Professionals to Optimise Patient Safety

Previous reports show that a substantive proportion of (near) medical errors in the operating theatre is attributable to ineffective communication between healthcare professionals. Speaking up about observed medical errors is a safety behaviour which promotes effective communication between health care professionals, consequently optimising patient care through reducing medical error risk. Speaking up, despite increasing awareness of its importance, by healthcare professionals (e.g., nurses, residents) remain difficult to execute in practice. Therefore, this paper addresses a computational model concerning the mechanisms known from psychological, observational, and medical literature which underlie the speaking up behaviour of a health care professional. It also addresses how a doctor may respond to the communicated message. Through several scenarios, we illustrate what pattern of factors causes a healthcare professional to speak up when witnessing a (near) medical error. We moreover demonstrate how introducing an observant agent can facilitate effective communication and helps to ensure patient safety through speaking up when a nurse cannot.