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The controllability classification of safety events and its application to aviation investigation reports

This paper proposes an amendment of the classification of safety events based on their controllability and contemplates the potential of an event to escalate into higher severity classes. It considers (1) whether the end-user had the opportunity to intervene into the course of an event, (2) the level of end-user familiarity with the situation, and (3) the positive or negative effects of end-user intervention against expected outcomes. To examine its potential, we applied the refined classification to 296 aviation safety investigation reports. The results suggested that pilots controlled only three-quarters of the occurrences, more than three-thirds of the controlled cases regarded fairly unfamiliar situations, and the flight crews succeeded to mitigate the possible negative consequences of events in about 71% of the cases. Further statistical tests showed that the controllability-related characteristics of events had not significantly changed over time, and they varied across regions, aircraft, operational and event characteristics, as well as when fatigue had contributed to the occurrences. Overall, the findings demonstrated the value of using the controllability classification before considering the actual outcomes of events as means to support the identification of system resilience and successes. The classification can also be embedded in voluntary reporting systems to allow end-users to express the degree of each of the controllability characteristics so that management can monitor them over time and perform internal and external benchmarking. The mandatory reports concerned, the classification could function as a decision-making parameter for prioritising incident investigations.

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The controllability classification of safety events and its application to aviation investigation reports

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Education and training of nurses in the use of advanced medical technologies in home care related to patient safety: A cross-sectional survey

BackgroundTo use advanced medical technologies (AMTs) correctly and safely requires both specialist knowledge and skills, and an awareness of risks and how those can be minimized. Reporting safety concerns about AMTs in home care can contribute to an improved quality of care. The extent to which a health care organization has integrated the reporting, evaluation and learning from incidents is a key element of that organization's patient safety culture.ObjectivesTo explore nurses' experiences regarding the education followed in the use of AMTs in the home setting, and their organizations' systems of reporting.DesignDescriptive cross-sectional design.Methods209 home care nurses from across the Netherlands who worked with infusion therapy, parenteral nutrition and/or morphine pumps responded to the online questionnaire between July 2018 and February 2019. The analysis of the data was mainly descriptive.ResultsEducational interventions that are most often used to learn how to use AMTs were, as an average over the three AMTs, instruction by a nurse (71%), practical training in the required skills (71%) and acquiring information to increase theoretical knowledge (69%). Considerable attention is paid to patient safety (88%) and the home setting (89%). However, a substantial proportion of the nurses (up to 29%) use AMTs even though they had not been tested on their skills. 95% of the respondents were well acquainted with the incident reporting protocol of their organization, but only 49% received structural or regular feedback on any actions taken as a result of event reporting.ConclusionsThis study revealed aspects of nurses' education that imply risk factors for patient safety. Practical training is not always given, additional or retraining is often voluntary, and the required skills are not always tested. However, the results show that nurses do have a good awareness of patient safety. Incidents are mainly discussed within the team, but less at the organizational level.

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Education and training of nurses in the use of advanced medical technologies in home care related to patient safety: A cross-sectional survey

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Dispensing of psychotropic medication among 400,000 immigrants in The Netherlands

from the repository of Utrecht University: "PURPOSE: Previously, a high prevalence of certain psychiatric disorders was shown among non-Western immigrants. This study explores whether this results in more prescriptions for psychotropic medication. METHODS: Data on dispensing of medication among adults living in the four largest Dutch cities in 2013 were linked to demographic data from Statistics Netherlands. Incident (i.e., following no dispensing in 2010-2012) and prevalent dispensing among immigrants was compared to that among native Dutch (N = 1,043,732) and analyzed using multivariable Poisson and logistic regression. RESULTS: High adjusted Odds Ratios (ORadj) of prevalent and high Incidence Rate Ratios (IRRadj) of incident dispensing of antipsychotics were found among Moroccan (N = 115,455) and Turkish individuals (N = 105,460), especially among young Moroccan males (ORadj = 3.22 [2.99-3.47]). Among Surinamese (N = 147,123) and Antillean individuals (N = 41,430), slightly higher rates of dispensed antipsychotics were found and the estimates decreased after adjustment. The estimates for antipsychotic dispensing among the Moroccan and Turkish increased, following adjustment for household composition. Rates for antidepressant dispensing among Turkish and Moroccan subjects were high (Moroccans: ORadj = 1.74 [1.70-1.78]). Among Surinamese and Antillean subjects, the rates for antidepressant dispensing were low and the ORadjlagged behind the IRRadj(Surinamese: 0.69 [0.67-0.71] vs. 1.06 [1.00-1.13]). Similar results were found for anxiolytics. For ADHD medication, lower dispensing rates were found among all migrant groups. CONCLUSIONS: The findings agree with earlier reports of more mental health problems among Moroccan and Turkish individuals. Surinamese/Antillean individuals did not use psychotropic drugs at excess and discontinued antidepressants and anxiolytics earlier. The data strongly suggest under-treatment for ADHD in all ethnic minority groups."

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How does aviation industry measure safety performance?

In this paper we present a review of existing aviation safety metrics and we lay the foundation for our four-years research project entitled “Measuring Safety in Aviation – Developing Metrics for Safety Management Systems”. We reviewed state-of-the-art literature, relevant standards and regulations, and industry practice. We identified that the long-established view on safety as absence of losses has limited the measurement of safety performance to indicators of adverse events (e.g., accident and incident rates). However, taking into account the sparsity of incidents and accidents compared to the amount of aviation operations, and the recent shift from compliance to performance based approach to safety management, the exclusive use of outcomes metrics does not suffice to further improve safety and establish a proactive monitoring of safety performance. Although the academia and aviation industry have recognized the need to use activity indicators for evaluating how safety management processes perform, and various process metrics have been developed, those have not yet become part of safety performance assessment. This is partly attributed to the lack of empirical evidence about the relation between safety proxies and safety outcomes, and the diversity of safety models used to depict safety management processes (i.e. root-cause, epidemiological or systemic models). This, in turn, has resulted to the development of many safety process metrics, which, however, have not been thoroughly tested against the quality criteria referred in literature, such as validity, reliability and practicality.

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How does aviation industry measure safety performance?

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Coping with cybercrime victimization: An exploratory study into impact and change

In order to find out whether victims adequately recover from cybercrime incidents, it is important to gain insight into its effects and impact on users. However, as it stands now, there is not much literature on the impact of cybercrime. We address this gap by qualitatively examining the impact of two types of cybercrime, namely phishing and malware attacks targeting online banking customers. We used the coping approach as a framework to study how victims deal with the negative events they have experienced. In order to study the impact of cybercrime and how victims cope with it, 30 cybercrime victims were interviewed. We observed that, next to financial damage, victims described different forms of psychological and emotional effects. Victims also reported various kinds of secondary impacts, such as time loss and not being treated properly when handling the incident. In addition, the interview data provided insight into cognitive and behavioral change, which potentially offers opportunities for cybercrime prevention. Our study demonstrates that the level of impact varies among cybercrime victims, ranging from little or no impact to severe impact. In addition, while some victims were only affected for a few days, some were still feeling the effects. The effects and impact of these fraudulent schemes on victims should therefore not be underestimated. We conclude that the coping approach provides a useful framework to study the effects and impact of cybercrime victimization and how victims recover from it. The results of our study provide a steppingstone for future studies on this topic. https://www.linkedin.com/in/rutgerleukfeldt/

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Coping with cybercrime victimization: An exploratory study into impact and change

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Handling consumer messages on social networking sites

Firms increasingly use social network sites to reach out to customers and proactively intervene with observed consumer messages. Despite intentions to enhance customer satisfaction by extending customer service, sometimes these interventions are received negatively by consumers. We draw on privacy regulation theory to theorize how proactive customer service interventions with consumer messages on social network sites may evoke feelings of privacy infringement. Subsequently we use privacy calculus theory to propose how these perceptions of privacy infringement, together with the perceived usefulness of the intervention, in turn drive customer satisfaction. In two experiments, we find that feelings of privacy infringement associated with proactive interventions may explain why only reactive interventions enhance customer satisfaction. Moreover, we find that customer satisfaction can be modeled through the calculus of the perceived usefulness and feelings of privacy infringement associated with an intervention. These findings contribute to a better understanding of the impact of privacy concerns on consumer behavior in the context of firm–consumer interactions on social network sites, extend the applicability of privacy calculus theory, and contribute to complaint and compliment management literature. To practitioners, our findings demonstrate that feelings of privacy are an element to consider when handling consumer messages on social media, but also that privacy concerns may be overcome if an intervention is perceived as useful enough.

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Handling consumer messages on social networking sites

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Developing decision support for cybersecurity threat and incident managers

Cybersecurity threat and incident managers in large organizations, especially in the financial sector, are confronted more and more with an increase in volume and complexity of threats and incidents. At the same time, these managers have to deal with many internal processes and criteria, in addition to requirements from external parties, such as regulators that pose an additional challenge to handling threats and incidents. Little research has been carried out to understand to what extent decision support can aid these professionals in managing threats and incidents. The purpose of this research was to develop decision support for cybersecurity threat and incident managers in the financial sector. To this end, we carried out a cognitive task analysis and the first two phases of a cognitive work analysis, based on two rounds of in-depth interviews with ten professionals from three financial institutions. Our results show that decision support should address the problem of balancing the bigger picture with details. That is, being able to simultaneously keep the broader operational context in mind as well as adequately investigating, containing and remediating a cyberattack. In close consultation with the three financial institutions involved, we developed a critical-thinking memory aid that follows typical incident response process steps, but adds big picture elements and critical thinking steps. This should make cybersecurity threat and incident managers more aware of the broader operational implications of threats and incidents while keeping a critical mindset. Although a summative evaluation was beyond the scope of the present research, we conducted iterative formative evaluations of the memory aid that show its potential.

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Developing decision support for cybersecurity threat and incident managers

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Computer Security Incident Response Team Effectiveness: A Needs Assessment

Computer security incident response teams (CSIRTs) respond to a computer security incident when the need arises. Failure of these teams can have far-reaching effects for the economy and national security. CSIRTs often have to work on an ad hoc basis, in close cooperation with other teams, and in time constrained environments. It could be argued that under these working conditions CSIRTs would be likely to encounter problems. A needs assessment was done to see to which extent this argument holds true. We constructed an incident response needs model to assist in identifying areas that require improvement. We envisioned a model consisting of four assessment categories: Organization, Team, Individual and Instrumental. Central to this is the idea that both problems and needs can have an organizational, team, individual, or technical origin or a combination of these levels. To gather data we conducted a literature review. This resulted in a comprehensive list of challenges and needs that could hinder or improve, respectively, the performance of CSIRTs. Then, semi-structured in depth interviews were held with team coordinators and team members of five public and private sector Dutch CSIRTs to ground these findings in practice and to identify gaps between current and desired incident handling practices. This paper presents the findings of our needs assessment and ends with a discussion of potential solutions to problems with performance in incident response. https://doi.org/10.3389/fpsyg.2017.02179 LinkedIn: https://www.linkedin.com/in/rickvanderkleij1/

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Computer Security Incident Response Team Effectiveness: A Needs Assessment

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Cyber incident response decision making

In case of a major cyber incident, organizations usually rely on external providers of Cyber Incident Response (CIR) services. CIR consultants operate in a dynamic and constantly changing environment in which they must actively engage in information management and problem solving while adapting to complex circumstances. In this challenging environment CIR consultants need to make critical decisions about what to advise clients that are impacted by a major cyber incident. Despite its relevance, CIR decision making is an understudied topic. The objective of this preliminary investigation is therefore to understand what decision-making strategies experienced CIR consultants use during challenging incidents and to offer suggestions for training and decision-aiding. A general understanding of operational decision making under pressure, uncertainty, and high stakes was established by reviewing the body of knowledge known as Naturalistic Decision Making (NDM). The general conclusion of NDM research is that experts usually make adequate decisions based on (fast) recognition of the situation and applying the most obvious (default) response pattern that has worked in similar situations in the past. In exceptional situations, however, this way of recognition-primed decision-making results in suboptimal decisions as experts are likely to miss conflicting cues once the situation is quickly recognized under pressure. Understanding the default response pattern and the rare occasions in which this response pattern could be ineffective is therefore key for improving and aiding cyber incident response decision making. Therefore, we interviewed six experienced CIR consultants and used the critical decision method (CDM) to learn how they made decisions under challenging conditions. The main conclusion is that the default response pattern for CIR consultants during cyber breaches is to reduce uncertainty as much as possible by gathering and investigating data and thus delay decision making about eradication until the investigation is completed. According to the respondents, this strategy usually works well and provides the most assurance that the threat actor can be completely removed from the network. However, the majority of respondents could recall at least one case in which this strategy (in hindsight) resulted in unnecessary theft of data or damage. Interestingly, this finding is strikingly different from other operational decision-making domains such as the military, police and fire service in which there is a general tendency to act rapidly instead of searching for more information. The main advice is that training and decision aiding of (novice) cyber incident responders should be aimed at the following: (a) make cyber incident responders aware of how recognition-primed decision making works; (b) discuss the default response strategy that typically works well in several scenarios; (c) explain the exception and how the exception can be recognized; (d) provide alternative response strategies that work better in exceptional situations.

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The controllability classification of safety events and its application to aviation investigation reports

Education and training of nurses in the use of advanced medical technologies in home care related to patient safety: A cross-sectional survey

Dispensing of psychotropic medication among 400,000 immigrants in The Netherlands

How does aviation industry measure safety performance?

Coping with cybercrime victimization: An exploratory study into impact and change

Handling consumer messages on social networking sites

Developing decision support for cybersecurity threat and incident managers

Computer Security Incident Response Team Effectiveness: A Needs Assessment

Cyber incident response decision making

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The controllability classification of safety events and its application to aviation investigation reports

Education and training of nurses in the use of advanced medical technologies in home care related to patient safety: A cross-sectional survey

Dispensing of psychotropic medication among 400,000 immigrants in The Netherlands

How does aviation industry measure safety performance?

Coping with cybercrime victimization: An exploratory study into impact and change

Handling consumer messages on social networking sites

Developing decision support for cybersecurity threat and incident managers

Computer Security Incident Response Team Effectiveness: A Needs Assessment

Cyber incident response decision making