A Retained Foreign Object (RFO) is a fairly infrequent but serious adverse event. An accurate rate of RFOs is difficult to establish due to underreporting but it has been estimated that incidences range between 1/1000 and 1/19,000 procedures. The cost of a RFO incident may be substantial and three-fold: (i) the cost to the patient of physical and/or psychological harm; (ii) the reputational cost to an institution and/or healthcare provider; and (iii) the financial cost to the taxpayer in the event of a legal claim. This Health Research Board-funded project aims to analyse and understand the problem of RFOs in surgical and maternity settings in Ireland and develop hospital-specific foreign object management processes and implementation roadmaps. This project will deploy an integrated evidence-based assessment methodology for social-technical modelling (Supply, Context, Organising, Process & Effects/ SCOPE Analysis Cube) and bow tie methodologies that focuses on managing the risks in effectively implementing and sustaining change. It comprises a multi-phase research approach that involves active and ongoing collaboration with clinical and other healthcare staff through each phase of the research. The specific objective of this paper is to present the methodological approach and outline the potential to produce generalisable results which could be applied to other health-related issues.

Background/Objectives: This study addresses the gap in methodological guidelines for neuroergonomic attention assessment in safety-critical tasks, focusing on validating EEG indices, including the engagement index (EI) and beta/alpha ratio, alongside subjective ratings. Methods: A novel task-embedded reaction time paradigm was developed to evaluate the sensitivity of these metrics to dynamic attentional demands in a more naturalistic multitasking context. By manipulating attention levels through varying secondary tasks in the NASA MATB-II task while maintaining a consistent primary reaction-time task, this study successfully demonstrated the effectiveness of the paradigm. Results: Results indicate that both the beta/alpha ratio and EI are sensitive to changes in attentional demands, with beta/alpha being more responsive to dynamic variations in attention, and EI reflecting more the overall effort required to sustain performance, especially in conditions where maintaining attention is challenging. Conclusions: The potential for predicting the attention lapses through integration of performance metrics, EEG measures, and subjective assessments was demonstrated, providing a more nuanced understanding of dynamic fluctuations of attention in multitasking scenarios, mimicking those in real-world safety-critical tasks. These findings provide a foundation for advancing methods to monitor attention fluctuations accurately and mitigate risks in critical scenarios, such as train-driving or automated vehicle operation, where maintaining a high attention level is crucial.

Mobility is associated with driving a vehicle. Age-related declines in the abilities of older persons present certain obstacles to safe driving. The negative effects of driving cessation on older adults’ physical, mental, cognitive, and social functioning are well reported. Automated driving solutions represent a potential solution to promoting driver persistence and the management of fitness to drive issues in older adults. Technology innovation influences societal values and raises ethical questions. The advancement of new driving solutions raises overarching questions in relation to the values of society and how we design technology (a) to promote positive values around ageing, (b) to enhance ageing experience, (c) to protect human rights, (d) to ensure human benefit and (e) to prioritise human well-being. To this end, this chapter reviews the relevant ethical considerations in relation to assisted driving solutions. Further, it presents a new ethically aligned system concept for assisted driving. It is argued that human benefit, well-being and respect for human identity and rights are important goals for new automated driving technologies. Enabling driver persistence is an issue for all of society and not just older adult.