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Journal of Healthcare Engineering
Volume 1 (2010), Issue 3, Pages 357-366
Research Article

Inter-Observer Agreement Among Medical Professionals in Critical Care of Neonates and Children

Osnat Tourgeman-Bashkin,1 David Shinar,1 Yisrael Parmet,1 and Ehud Zmora2

1Department of Industrial Engineering & Management, Faculty of Engineering, Ben Gurion University of the Negev, PO Box 653, Beer Sheva, Israel
2Department of Neonatology, Soroka Medical Center, Faculty of Health Sciences, PO Box 653, Beer Sheva, Israel

Copyright © 2010 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Inter-observer agreement is essential to medical staff members and has a major effect on communication. The goal of the study was to examine the way medical professionals evaluate the potential severity of Almost Adverse Events (AAEs) that were observed in two intensive care units (ICUs). One hundred and fourteen AAEs were observed and recorded in both units by engineering students. Each AAE was rated independently by five senior medical staff members from each ICU, chosen by the unit manager, on a three- point severity level scale. Statistical analysis (K statistic and Cohen's Kappa) yielded relatively low levels of agreement among raters in both ICUs (< 0.3), but significantly greater agreement was found among nurses than among physicians in both ICUs. Low levels of agreement are attributed to the nature of work and characteristics of each ICU. Recommendations for improving agreements including forming shared mental models are specified.