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This paper discusses a business process model and notation (BPMN) extension that includes new elements designed to improve its expressiveness. In previous works, different shortcomings concerning the BPMN language were detected. As a result, a set of requirements to overcome these issues was collected and used to guide this work. The proposed extension supports the representation of information commonly used by experts in the hazard analysis and critical control points domain, usually expressed in natural language, in a machine-understandable fashion. To take full advantage of the features introduced in this BPMN extension, tools such as ProM can be easily upgraded with appropriate plugins to support the new elements. In this line, an advanced conformance checking plugin was developed for process mining on BPMN models. A real-world example of use showing the benefits of applying the new elements is also discussed. This proposal paves the way for novel advanced analysis mechanisms for traceability systems. [ABSTRACT FROM AUTHOR]

Objective: To review the scientific literature related to the safe handling of hazardous drugs (HDs). Method: Critical analysis of works retrieved from MEDLINE, the Cochrane Library, Scopus, CINHAL, Web of Science and LILACS using the terms "Hazardous Substances", "Antineoplastic Agents" and "Cytostatic Agents", applying "Humans" and "Guidelines" as filters. Date of search: January 2017. Results: In total, 1100 references were retrieved, and from those, 61 documents were selected based on the inclusion and exclusion criteria: 24 (39.3%) documents related to recommendations about HDs; 27 (44.3%) about antineoplastic agents, and 10 (33.3%) about other types of substances (monoclonal antibodies, gene medicine and other chemical and biological agents). In 14 (23.3%) guides, all the stages in the manipulation process involving a risk due to exposure were considered. Only one guide addressed all stages of the handling process of HDs (including stages with and without the risk of exposure). The most described stages were drug preparation (41 guides, 67.2%), staff training and/or patient education (38 guides, 62.3%), and administration (37 guides, 60.7%). No standardized informatics system was found that ensured quality management, traceability and minimization of the risks associated with these drugs. Conclusions: Most of the analysed guidelines limit their recommendations to the manipulation of antineoplastics. The most frequently described activities were preparation, training, and administration. It would be convenient to apply ICTs (Information and Communications Technologies) to manage processes involving HDs in a more complete and simpler fashion. [ABSTRACT FROM AUTHOR]

Flowcharts used for hospital protocols have a series of ambiguities and limitations in order to express some types of information. In this article, a notation proposal for flowcharts that partially avoids these problems is presented. This new notation is an adaptation of BPMNE2, an extension of the Business Process Model and Notation (BPMN), which allows direct modelling of procedures that follow the Hazard Analysis and Critical Control Points (HACCP) model. The new notation has been validated in the hospital context, specifically in the field of hazardous drugs (HDs). To measure usability from the perspective of the health staff and auditors, the System Usability Scale (SUS) was used. A total of 47 experts took part in the assessment, resulting in a SUS score of 71, that corresponds to an acceptable level of usability. The feedback provided by these participants allows us to discover benefits and drawbacks of the proposal. Also, it is noteworthy that 76.6% of professionals prefer to migrate to the new notation from the ISO 5807:1985 notation, the most commonly used model. In addition to the direct benefits of this notation from the human point of view, its machine-understandable nature provides the required support for its integration into software tools for intelligent monitoring and auditing. [ABSTRACT FROM AUTHOR]

Business process model and notation (BPMN) is a popular notation used for process modelling mainly due to its high expressiveness. However, BPMN has shortcomings when dealing with specific domains (namely Hazard Analysis and Critical Control Points systems), struggling to model activity duration, quality control points, activity effects and monitoring nature. To tackle these limitations, the business process model and notation extended expressiveness (BPMN-E2) was proposed. In this paper, a multiperspective conformance checking algorithm is developed focusing on detecting non-conformity between an event log and a process model, regarding the information provided by the new elements within BPMN-E2. The proposed algorithm follows a two-step approach that starts by converting the model into a directly follows model (annotated with conformance rules), which is then used in a second phase to perform conformance checking effectively. This modular approach allows to apply the proposed algorithm to other process model notations than BPMN-E2. An event log clustering technique was also developed to downsize large-event logs without compromising data relevance. In this way, both the multiperspective algorithm and the log-downsize clustering technique here proposed are a key contribution to improve conformance checking in process modelling, as evinced in the proof-of-concept provided. [ABSTRACT FROM AUTHOR]