For Quality Care

dependability
a measure of the extent to which a system can justifiably be relied on to deliver the services expected from it. Discovering dependability problems in an operational system often indicates that extensive- and expensive-changes to the system are needed.

Six Attributes of Dependability

System Reliability Safety

Service Availability

Dependability Responsivene ss Data Integrity

Confidentiality

ATTRIBUTE System reliability

Service availability

DESCRIPTION system consistently behaves in the same way required services are present and usable when they are needed sensitive information is disclosed only to those authorized to see it

Confidentiality

ATTRIBUTE System reliability

Service availability

DESCRIPTION system consistently behaves in the same way required services are present and usable when they are needed sensitive information is disclosed only to those authorized to see it

Confidentiality

Guidelines for Dependabl e System

 Guideline 1: Architect for Dependability

While these applications provide services that are critical to assuring patients privacy and safety, these services are only as dependable as the system services on which they depend. In particular, operating systems provide system-level security functions that are critical to assuring that individuals can access only those resources for which they are authorized.

 The Health Insurance Portability and Accountability Act (HIPAA) security regulation prescribes administrative, technical and physical safeguards for promoting confidentiality and integrity of health information.

 The following represent important operational practices that clearly will contribute to system dependability:

Eight Required Administrative Safeguards 1. Security management 2. Assigned security responsibility 3. Information Access management 4. Security Awareness and training 5. Security Incident procedures 6. Contingency Planning 7. Evaluation 8. Business associate contracts

 Five specified physical safeguards also contribute to system depemdability: a) Access control, including unique user identification and emergency access procedure b) Audit controls c) Data integrity protection d) Person or entity authentication e) Transmission security

 Guideline 2: Anticipate Failures

As computers are getting faster, systems are getting more complex and design flaws are becoming a problem. In anticipation of failures at the infrastructure level, features that are transparent to software applications should be implemented to detect faults and to recover from failure. Safety-critical systems should be designed and built to fail in a safe state.

 Guideline 3: Anticipate Success

The systems planning process should anticipate business success and the consequential need for larger networks.

Guideline 4: Hire Meticulous Managers

Good system administrators meticulously monitor and manage systems and network performance. They develop, maintain and exercise plans for managing emergencies and recovering from disaster.

 Guideline 5: Dont be Adventurous

For dependability, one should use only proven methods, tools and products that have been in production, under conditions and at a scale similar to the intended environment. The enterprise with a requirement for dependable system should not be the first to adopt a new technology.

Nursing Minimum Data Set System