INTRODUCTION TO DIGITAL COMPUTERS

A computer is a machine that can be programmed to carry out sequences of arithmetic or logical
operations automatically. It can also be defined as an electronic device capable of manipulating number
and symbols, first taking input, processing it, storing and giving out output under a control of set
instructions which is known as a program.

Charles Babbage (1791-1871), computer pioneer, designed the first automatic computing engines. He
invented computers but failed to build them. The first complete Babbage Engine was completed in London
in 2002, 153 years after it was designed.

1.1 CLASSIFICATION OF COMPUTERS

Computers can be categorized into Analog, Digital and Hybrid Computers. Each category is used for its
own purpose and has its own significance.

1.1.1 Analog Computers

Analog computers are mainly based on voltages and current with continuous electrical signals and display
the output continuously. Analog devices are used to measure voltage, pressure, electric current,
temperature.

These quantities vary continuously while measuring the quantity, such as the temperature of a person
which changes consistently.

These computers store the data and perform calculations quite differently than digital computers which
make use of symbolic representation.

Analog computers are equipped to measure things rather than countable or check. They are specially
designed to measure and perform arithmetic calculations of numbers, where numbers are represented in
physical quantities.

In summary, an analog computer is used to measure continuous values. It measures a physical property
like voltage, pressure, speed, time and temperature. An analog computer takes input in analog form and
gives output in analog form.

Its output is usually displayed on a meter or scale. Analog computer has low memory and fewer functions.
Analog computer is mainly used in the field of engineering and medicine.

Examples include: mercury thermometer, speedometer, analog clock. Other examples of analog
computers are planimeter, nomogram, operational amplifiers, mechanical integrators, slide rules, tide
pool predators, electric integrators that solve partial differential equations as well as solves the algebraic
equations.
 1.1.2 Digital Computers

Digital computers are computers that process the data in binary form ie.0’s and 1’s. The main benefit of
digital computers is that they are quick and re-programmable.

A digital computer works with digital data. Digital computer uses binary number system. Binary number
system consists of only two digits 0 and 1. A digital computer represents data in digital signals. A 0
represents OFF and a 1 represents ON. Digital computer performs arithmetic and logical operations on
data. It gives output in digital form.

Digital computers are very fast. These computers can store results. They have large memory (that is data
storing capacity). Today most of the computers used in offices and homes are digital computers.

Some examples of digital computers include smartphones, personal computers, digital scoreboards and
digital watches.

1.1.3 Hybrid Computers

A hybrid computer is a special purpose computer that is a combination of both analog and digital
computer. Hybrid computers can handle both analog and digital data. A hybrid computer combines the
best characteristics of both the analog and digital computer. It can accept data in both analog and digital
form. The hybrid computer accepts analog signals and converts them to digital form. These are generally
used for scientific applications, airplanes, and hospitals.

A hybrid computer is a mix of digital and analog computers that incorporates the best aspects of both. i.e.
Analog computers handle complex mathematical computations (problems), and digital computers handle
logical and numerical operations. It has the speed of analog computer and the memory and accuracy of
digital computer. Hybrid computers are used mainly in specialized applications where both kinds of data
need to be processed.

Hybrid computer is a digital computer that accepts analog signals (analog signals are transmitted using a
continuously changing quantity as a reference. Data transmission consists of sending signals as continuous
waves. An example of an analogue signal is the transmission of radio waves, television waves or sound
waves), converts them to digital and processes them in digital form

Examples of hybrid computers include electrocardiogram machine, ultrasound machine, monitoring

machine.

1.2 DIGITAL VS ANALOG COMPUTER

The basic difference between analog and digital computers is the type of data they process. Analog
computers process analog, i.e., continuously varying, data. Digital computer process data which is binary,
i.e., in the form of 0 and 1.
The advantages of analog computers are that they show the solutions in a simple and graphical manner
in little time. In a digital computer the real time changes require complex programming and graphical
programs. In an analog computer the output can be connected to an oscilloscope and results can be seen.

The disadvantages of analog computers are that they are not versatile and they are not very accurate. The
accuracy of the analog computers is rather limited and dependent on a number for factors like spread in
circuit parameters, inaccurate assembly, wiring problems, external influences like magnetic field, changes
in ambient temperature and pressure, etc. To obtain accuracy in analog computers before a computation
all op-amps must be checked for DC drift.

1.3 DIGITAL COMPUTERS

The digital computer is a digital system that performs various computational tasks. The word digital
implies that the information in the computer is represented by variables that take a limited number of
discrete values. These values are processed internally by components that can maintain a limited number
of discrete states.

A digital computer can be considered as a digital system that performs various computational tasks. The
first electronic digital computer was developed in the late 1940s and was used primarily for numerical
computations.

In practice, digital computers function more reliably if only two states are used. Because of the physical
restriction of components, and because human logic tends to be binary (i.e., true or false, yes or no
statements), digital components that are constrained to take discrete values are further constrained to
take only two values and are said to be binary.

Digital computers use the binary number system, which has two digits: 0 and 1. A binary digit is called a
bit. Information is represented in digital computers in groups of bits. By using various coding techniques,
groups of bits can be made to represent not only binary numbers but also other discrete symbols, such as
decimal digits or letters of the alphabet.

The operations that are conducted internally in the device happens using the binary number system since
the computer understands only digits i.e., 0’s and 1’s. All the content that is written in English will be
converted to binary language and thus computers and humans communicate with each other.

EXAMPLES OF DIGITAL COMPUTERS

• Digital Clock.
• Weighing Machine.
• Smart Phones.
• Laptop/Personal Computer. ...
• ATM.

As digital computers are mainly used to store data it is almost used everywhere to store photos, music,
documents, and files.
Students use it for mathematical calculations, computations. It is used by spacecraft, health domains,
schools, colleges, large or small organizations, factories.

FEATURES OF DIGITAL COMPUTER

• Good Memory – Digital computers can store a large number of data and can retrieve data in a
fraction of second. The data can be stored for any duration and retrieved anytime.
• Very Flexible – These computers can perform multi-tasking without any human interference and
hence they are very flexible and versatile.
• Automatic – These devices once started are automatic. They do not need any intervention until
required by the task specifically.
• Good Speed – Digital computers are high in speed and carry out all the operations with very fast
speed.
• Accurate – These devices help in storing all the information which helps in retrieving accurate
data at any point in a given time.

Digital computers are very vastly used in the current era and it is helpful in day-to-day activities. In addition
to scientific and engineering use, it is also used in automated industrial processes, transportation systems
and to analyse other statistical data.
BRIEF HISTORY OF COMPUTERS,
GENERATION OF COMPUTERS, STRUCTURE
OF GENERAL-PURPOSE COMPUTER
As stated earlier, a computer is an electronic device capable of manipulating number and symbols, first
taking input, processing it, storing and giving out output under a control of set instructions which is known
as a program.

A general-purpose computer requires the following hardware components: memory, storage device (hard
disk drive), input device (keyboard, mouse etc.), output device (screen, printer etc.) and central processing
unit (CPU). Many other components are involved in addition to the listed components to work together
efficiently.

2.1 COMPONENTS

A digital computer has the following basic components –

• Input device
• CPU
• Output device

Input Device

The Input device is basically the devices that are attached to the system such as a mouse, keyboard, and
scanner.

These input devices take the input from the user and convert it to binary language which is
understandable by the computer making it easy to understand.

Central Processing Unit (CPU)

CPU is the Central Processing Unit which is known as the brain of the computer as it controls the entire
computer system. Once the user provides input through the input device such as a keyboard or mouse,
the same is processed in the Central processing unit.

This first get the instructions from the memory and then decides what needs to be done. Hence CPU
performs all the computation parts and sends it to the output device.

CPU has different components within, which has different responsibilities.

Arithmetic Logic Unit (ALU) – The main function of ALU is that it performs all the arithmetic and
mathematical calculations which include addition, subtraction, multiplication, and division.

Control Unit – The task of the Control unit is that it mainly allows the data to move from and to CPU and
manages the operations performed by ALU. All the instructions that are sent are picked, decoded, and
analysed. It then sends the instruction to input/output devices accordingly.

Memory – This part is mainly used to store the data and is named as “Internal memory”. The internal
memory has been divided into multiple locations which store the instructions. Each of these locations has
a unique address and has the same size. With this unique address, the computer will read the data stored
in the memory without having to search the entire memory location. Whenever a program is run, the data
will be stored in the internal memory and it would remain till the end of the execution. This internal
memory is named RAM i.e., Random Access Memory.
Output Devices

Output Devices are the devices that are attached to the computer which converts the binary data from
the computer to language which humans understand.

Some of the common output devices are Monitor, plotter, and printer.

Figure 2.1: Block diagram of the digital computer

2.2 HARDWARE AND SOFTWARE

A computer system is subdivided into two functional entities: Hardware and Software.

The hardware consists of all the electronic components and electromechanical devices that comprise the
physical entity of the device.

The software of the computer consists of the instructions and data that the computer manipulates to
perform various data-processing tasks.

2.3 CLASSIFICATION

Computers can be classified by size and power as follows:

• Personal computer: Personal computers are small computers based on a microprocessor. A

personal computer has a keyboard for inputting data, a monitor for output and a storage device
for saving data.
• Workstation: workstations are usually powerful than a personal computer. It has more powerful
microprocessor and a higher-quality monitor.
• Minicomputer: Mini computers are multi-user computer capable of supporting from 10 to
hundreds of users simultaneously.
• Mainframe computer: Mainframe computers are powerful multi-user computer capable of
supporting many hundreds or thousands of users simultaneously.
• Super computer: Super computers are extremely fast computers that can perform hundreds of
millions of instructions per second.
2.4 BRIEF HISTORY AND EVOLUTION OF THE DIGITAL COMPUTERS

The computer as we know it today had its beginning with a 19th century English mathematics professor
name Charles Babbage. He designed the Analytical Engine and it was this design that the basic framework
of the computers of today are based on.

FIRST GENERATION OF COMPUTERS

In the early years of the computing era, the first generation of computers was evolved in 1940 – 1956
which was named Vacuum Tubes. Using this system, it would take weeks to execute the problem and get
the results. Earlier then the input used to be punch cards and output would be printouts. An example of
first-generation computers is the ENIAC computer.

SECOND GENERATION COMPUTERS

The second generation of computers were transistors that replaced the vacuum tubes in the year 1956 -
1963. Transistors were faster, cheaper, efficient and smaller compared to an earlier generation. The
output remained the same as the first generation (punch cards and printout).

THIRD GENERATION OF COMPUTERS

The third generation of computers were Integrated circuits that replaced Transistors in the year 1964-
1971. Integrated circuits were miniature of transistors and they were placed above the silicon chips and
named as semiconductors.

They proved to be very efficient compared to previous versions in terms of speed and size. Here input and
output changed to keyboards and monitors.

FOURTH GENERATION OF COMPUTERS

The fourth generation of computers was Microprocessors that replaces Integrated circuits in the year
1971- present.

Thousands of integrated circuits started to be built on the single silicon chip and this brought the fourth
generation of the computer into life.

These were small, efficient, smart computers which became more powerful. It could be connected to a
different input and output devices. Eventually, they were able to connect to networks and led to internet
development.

FIFTH GENERATION OF COMPUTERS

The fifth generation of computers is Artificial Intelligence (AI). These are computing devices based on
artificial intelligence which are still getting developed with a lot of progress day by day. These include
applications such as voice recognition and parallel processing.
The idea of fifth-generation computing is to create new devices that understand human language input
and are capable of learning and giving output independently.

REFERENCES

https://www.classmate4u.com/digital-computer/

https://www.javatpoint.com/digital-computers
PRACTICAL EXPERIENCE OPERATING
COMPUTERS AND PERIPHERAL EQUIPMENT
A computer is not fully functional without various peripheral devices. These are typically connected to a
computer through cables, although some may be built into the same unit with the CPU.

These include devices for the input of data, such as keyboards, mice, trackballs, scanners, light pens,
modems, magnetic strip card readers, and microphones, as well as items for the output of data, such as
monitors, printers, plotters, loudspeakers, earphones, and modems.

In addition to these input/output devices, other types of peripherals include computer data storage
devices for auxiliary memory storage, where data is saved even when the computer is turned off. These
devices most often are magnetic tape drives, magnetic disk drives, or optical disk drives.

3.1 COMPUTERS AND PERIPHERAL EQUIPMENT

A peripheral is a device that is used to put information into or get information out of the computer.

There are three different types of peripherals:

1. Input: Input devices are used to interact with, or send data to the computer (mouse, keyboards,
etc.)
2. Output: Output devices provide output to the user from the computer (monitors, printers, etc.)
3. Storage: Storage devices store data processed by the computer (hard drives, flash drives, etc.)

A computer system, therefore, is a computer combined with peripheral equipment and software so that
it can perform desired functions. Often the terms "computer" and "computer system" are used
interchangeably, especially when peripheral devices are built into the same unit as the computer or when
a system is sold and installed as a package.

The term "computer system," however, may also refer to a configuration of hardware and software
designed for a specific purpose, such as a manufacturing control system, a library automation system, or
an accounting system. Or it may refer to a network of multiple computers linked together so that they can
share software, data, and peripheral equipment.

According to the most technical definition, the only pieces of a computer not considered to be peripherals
are the central processing unit, power supply, motherboard, and computer case. Usually, the word
peripheral is used to refer to a device external to the computer case, like a scanner, but the devices located
inside the computer case are also technically peripherals.

Devices that exist outside the computer case are called external peripherals, or auxiliary components.
Devices that are inside the case such as internal hard drives or CD-ROM drives are also peripherals in
technical terms and are called internal peripherals, but may not be recognized as peripherals by laypeople.

In a system on a chip, peripherals are incorporated into the same integrated circuit as the central
processing unit. They are still referred to as “peripherals” despite being permanently attached to (and in
some sense part of) their host processor.
Figure 3.1 Human Machine Interface (HMI) peripherals.

3.2 LIST OF COMMON PERIPHERALS

• Input
o Keyboard
o Computer mouse
o Graphic tablet
o Touchscreen
o Barcode reader
o Image scanner
o Microphone
o Webcam
o Game controller
o Light pen
o Scanner
o Digital camera
• Output
o Computer display
o Printer
 o Projector
o Speaker
• Storage devices
o Floppy disk drive
o Flash drive
o Disk drive
o Smartphone or Tablet computer storage interface
o CD/DVD drive

3.2.1 INPUT DEVICES

In computing, an input device is a peripheral (piece of computer hardware equipment) used to provide
data and control signals to an information processing system such as a computer or other information
appliance. Examples of input devices include keyboards, mice, scanners, digital cameras and joysticks.

Many input devices can be classified according to:

➢ Modality of input (e.g. mechanical motion, audio, visual, etc.)

➢ The input is discrete (e.g. key presses) or continuous (e.g. a mouse’s position, though digitized
into a discrete quantity, is fast enough to be considered continuous)

Pointing devices, which are input devices used to specify a position in space, can further be classified
according into:

➢ Whether the input is direct or indirect. With direct input, the input space coincides with the
display space, i.e. pointing is done in the space where visual feedback or the pointer appears.
Touchscreens and light pens involve direct input. Examples involving indirect input include the
mouse and trackball.
➢ Whether the positional information is absolute (e.g. on a touch screen) or relative (e.g. with a
mouse that can be lifted and repositioned)

Direct input is almost necessarily absolute, but indirect input may be either absolute or relative. For
example, digitizing graphics tablets that do not have an embedded screen involve indirect input and sense
absolute positions and are often run in an absolute input mode, but they may also be set up to simulate
a relative input mode like that of a touchpad, where the stylus or puck can be lifted and repositioned.

Keyboards

A keyboard is a human interface device which is represented as a layout of buttons. Each button, or key,
can be used to either input a linguistic character to a computer, or to call upon a particular function of the
computer. They act as the main text entry interface for most users. Traditional keyboards use spring-based
buttons, though newer variations employ virtual keys, or even projected keyboards. It is typewriter like
device composed of a matrix of switches.
Examples of types of keyboards include:

• Keyer
• Keyboard
• Lighted Program Function Keyboard (LPFK)

Pointing Devices

Fig 3.2: A computer mouse

Pointing devices are the most commonly used input devices today. A pointing device is any human
interface device that allows a user to input spatial data to a computer. In the case of mice and touchpads,
this is usually achieved by detecting movement across a physical surface. Analog devices, such as 3D mice,
joysticks, or pointing sticks, function by reporting their angle of deflection. Movements of the pointing
device are echoed on the screen by movements of the pointer, creating a simple, intuitive way to navigate
a computer’s graphical user interface (GUI).

Composite Devices

Input devices, such as buttons and joysticks, can be combined on a single physical device that could be
thought of as a composite device. Many gaming devices have controllers like this. Technically mice are
composite devices, as they both track movement and provide buttons for clicking, but composite devices
are generally considered to have more than two different forms of input.

• Game controller
• Gamepad (or joypad)
• Paddle (game controller)
• Jog dial/shuttle (or knob)
• Wii Remote
Imaging and Input Devices

Video input devices are used to digitize images or video from the outside world into the computer. The
information can be stored in a multitude of formats depending on the user’s requirement.

• Digital camera
• Digital camcorder
• Portable media player
• Webcam
• Microsoft Kinect Sensor
• Image scanner
• Fingerprint scanner
• Barcode reader
• 3D scanner
• Laser rangefinder
• Eye gaze tracker

Medical Imaging

• Computed tomography (a diagnostic imaging test used to create detailed images of internal
organs, bones, soft tissue and blood vessels).
• Magnetic resonance imaging
• Positron emission tomography
• Medical ultrasonography

Audio Input Devices

Audio input devices are used to capture sound. In some cases, an audio output device can be used as an
input device, in order to capture produced sound.

• Microphones
• MIDI keyboard or another digital musical instrument

3.2.2 OUTPUT DEVICES

An output device is any piece of computer hardware equipment used to communicate the results of data
processing carried out by an information processing system (such as a computer) which converts the
electronically generated information into human-readable form.
Display Devices
A display device is an output device that visually conveys text, graphics, and video information.
Information shown on a display device is called soft copy because the information exists electronically
and is displayed for a temporary period of time. Display devices include CRT monitors, LCD monitors and
displays, gas plasma monitors, and televisions.

Input/Output

Fig 3.3: Inputs are the signals or data received by the system, and outputs are the signals or data sent from
it.

There are many input and output devices such as multifunction printers and computer-based navigation
systems that are used for specialised or unique applications. In computing, input/output refers to the
communication between an information processing system (such as a computer), and the outside world.
Inputs are the signals or data received by the system, and outputs are the signals or data sent from it.

Examples

These examples of output devices also include input/output devices. Printers and visual displays are the
most common type of output device for interfacing to people, but voice is becoming increasingly available.

• Speakers
• Headphones
• Screen (Monitor)
• Printer
• Voice output communication aid
• Automotive navigation system
• Braille embosser
• Projector
• Plotter
3.3 NETWORKING

Computers on a network are physically linked by cables and use network software in conjunction with the
operating system software. Depending on the hardware and software used, different types of computers
may be put on the same network. This may involve computers of different sizes—such as mainframes,
mid-ranges, and microcomputers—or computers and peripherals of different manufacturers, which the
trend toward open systems has facilitated.

Local area networks (LANs) link computers within a limited geographical area, while Wide area networks
(WANs) connect computers in different geographic regions. Networks may have various architectures
which determine whether computers on the network can act independently. A commonly used system
architecture is client-server, whereby a server computer is designated as the one storing and processing
data and is accessed by multiple users each at a client computer.

LANs have transformed how employees within an organization use computers. In organizations where
employees formerly accessed midrange computers through "dumb" terminals, these employees now
typically have more capabilities. These users have their own personal computers at their desks, but are
still able to access needed data from a midrange or other server through the network.

Whereas smaller businesses typically favour LANs, WANs are often used by companies with multiple
facilities located over a wide geographic area. After all, under a WAN system, a company's databases can
be accessed at headquarters in one city, at a manufacturing plant in other city, and at sales offices in other
locations.

3.3 THE FUTURE OF COMPUTER APPLICATIONS IN BIOMEDICINE

See attached material by LAWRENCE M. FAGAN AND EDWARD H. SHORTLIFFE

REFERENCES

https://www.inc.com/encyclopedia/computers-and-computer-systems.html

https://courses.lumenlearning.com/informationliteracy/chapter/computer-devices/
GENERAL PROBLEM SOLVING
4.1 GENERAL PROBLEM SOLVING
Problem solving is the act of defining a problem; determining the cause of the problem; identifying,
prioritizing, and selecting alternatives for a solution; and implementing a solution. Problem-solving skills,
in combination with an understanding of the natural and human-made world, are critical to the design
and optimization of systems and processes.

Most people engage in problem solving every day. It occurs automatically for many of the small decisions
that need to be made on a daily basis.

For example, when making a decision about whether to get up now or sleep in for an extra 10 minutes,
the possible choices and the relative risks and benefits of obeying the alarm clock or sleeping later come
automatically to mind.

Larger problems are addressed in a similar way. For example: “I have tasks that need to be done by the
end of the week. How am I going to get them all done on time?” After considering the possible strategies,
one is chosen and implemented. If it proves to be ineffective, a different strategy is tried.

People who can define problems, consider options, make choices, and implement a plan have all the basic
skills required for effective problem solving. Sometimes following a step-by-step procedure for defining
problems, generating solutions, and implementing solutions can make the process of problem solving
seem less overwhelming.

4.2 THE PROBLEM-SOLVING PROCESS

STEP 1: Identify and define the problem

• State the problem as clearly as possible. For example: “I don’t have enough money to pay the
bills.”
• Be specific about the behaviour, situation, timing, and circumstances that make it a problem. For
example: “I need to pay the phone and gas bills, and I don’t have enough money to cover both
this month.”

STEP 2: Generate possible solutions

• List all the possible solutions; don’t worry about the quality of the solutions at this stage.
• Try to list at least 15 solutions, be creative and forget about the quality of the solution.
• If you allow yourself to be creative you may come up with some solutions that you would not
otherwise have thought about.

STEP 3: Evaluate alternatives

• Go through and eliminate less desirable or unreasonable solutions.

 • Order the remaining solutions in order of preference.
• Evaluate the remaining solutions in terms of their advantages and disadvantages.

STEP 4: Decide on a solution

• Specify who will take action.

• Specify how the solution will be implemented.
• Specify when the solution will be implemented. For example: tomorrow morning, phone the gas
company and negotiate to pay the gas bill next month.

STEP 5: Implement the solution

• Implement the solution as planned.

STEP 6: Evaluate the outcome

Evaluate how effective the solution was.

Decide whether the existing plan needs to be revised, or whether a new plan is needed to better address
the problem.

If you are not pleased with the outcome, return to step 2 to select a new solution or revise the existing
solution, and repeat the remaining steps.

Identify &
define
problem

Evaluate the Generate

outcome solutions

Implement Evaluate
the solution alternatives

Decide on a
solution

Fig 4.1: Problem solving chart

4.3 METHOD AND TOOLS IN PROBLEM SOLVING IN HEALTH CARE
Hospitals and other health care providers deal with a host of problems besides treatment of sick patients.
This includes service delivery problems, management and people problems, logistics, maintenance and
resource allocation problems. Unfortunately, very few tools are used by management and the medical
staff in addressing these problems. Problems often recur or remain unsolved because of reliance on
personal styles, subjective approaches, and purely qualitative approaches.

Most of the methods and tools used by manufacturing and service industries to solve quality problems
can be applied in problem solving in health care. These simple tools have proven effective in dramatically
reducing if not eliminating defects, failures, wastes, and customer complaints in these businesses.
Hospitals that have launched a Total Quality Management (TQM) program to improve their services use
these tools on a regular basis.

These tools and methods, most of which are quantitative in nature, can help health care institutions
achieve the following goals:

➢ clearly define, identify, and document a problem

➢ clearly define, identify, and document an opportunity
➢ facilitate problem analysis and problem solving by individuals or groups
➢ enhance and simplify management reporting
➢ facilitate communication, dissemination, and transfer of knowledge or technology by providing a
common language for analysis and presentation
➢ make meetings more organized, productive, and focused
➢ help in developing countermeasures and preventive measures
➢ measure the effectiveness of the solution to the problem and the amount of improvement
➢ help in the formulation of standards and procedures

Among the simple yet effective tools that all health care personnel from management to employees can
adapt and employ are: tables, tally sheets, flowcharts, bar chart, pareto diagram, fishbone diagram. There
are other more sophisticated statistical tools like multivariate analysis that can be used to analyze for
more complex problems. However, these may require computer assistance and extensive training in
statistics.

The tools can be applied in almost any medical and non-medical operation and processes in the hospital
or health care institution like: nursing services, medical services, radiology, laboratories, pharmacy,
admissions, medical records, accounting, dietary, housekeeping and maintenance. Among the problems
that the quality tools can address are: long queuing time or waiting time for the patient, slow response
time to calls, errors in medication and records, cold meals, slow turnover of rooms and slow shift-turnover
of nursing staff.

4.3.1 TABLES AND TALLY SHEETS

Well prepared tables contain critical and often numerical data that are clearly and effectively presented
to highlight problems and opportunities. Tables can also show which problems should be given priority. A
small clinic uses a table to highlight and compare the costs of rework of its major service providers. The
table shows that the administrative staff is the most wasteful and costly for not doing their jobs right the
first time. Training or retraining them may be one way to improve their performance.

Tally sheets can be used to measure, quantify, and locate improvements in quality. A hospital made a two-
year tally of patient comments on all its services, medical and non-medical, using a rating scale from “VP”
(very poor) to “VG” (very good). We may gauge success as the greatest improvement in the "VG"
responses. We can recommend improvement for those units that had high "VP" scores, or had high
increases in "VP" scores during the last two years.

The tally sheet shows the improvement in the number, length, and types of patient calls received by a
nurse station of a hospital after implementing a "kaizen" or work simplification project. For instance,
between October and December, patient calls pertaining to air-con adjustment were reduced from 20 to
7 or by 65% after the hospital improved the air-con knobs and mounted a patient information campaign
on how to adjust and use the air-con thermostat. Tally sheets can thus measure the effectiveness of any
improvement program.

4.3.2 FLOWCHARTS

Flowcharts can be used to clearly show the flow of people, services, and information in a hospital. A
flowchart can show the flow of service in a hospital, starting with admission and ending with satisfied
customers or patients. It also lists the types of services each unit must deliver for the hospital to create
total customer satisfaction.

The flowchart also conveys that message that everybody works towards a common goal. It shows the flow
of services from one hospital unit- the department of laboratories - to the rest of the organization and
eventually to the patients. The flowchart conveys the principle that any one failure in service to any
department or internal customer will result in a dissatisfied external customer or patient.

Flowcharts can show areas of responsibility as well as areas for improvement. A flowchart in a clinic shows
that a client registration process takes up 30 minutes. If the 30-minute registration time were to be
reduced further, the flowchart can help analyze which step or steps to eliminate, combine, or simplify. A
flowchart can show how nurses respond to a patient call. One hospital used flowcharts to indicate the
improvement in charge card approval time of a patient of nuclear medicine from 1 hour to 7 minutes.

Flowcharts and any other problem analysis tool may be supplemented or supported by diagrams or
pictures to clarify the work process or problem.

4.3.3 BAR CHARTS, PARETO DIAGRAM, FISHBONE DIAGRAM

Bar charts can help identify differences, gaps, priorities, and trends. They provide visual representation of
numbers generated by tables and tally sheets. All tables and tallies can be graphed. Use line graphs to
highlight trends, and bars charts to highlight differences among several items or factors. Another popular
form of bar chart is the pareto diagram in which the items graphed are sorted from highest to lowest
resulting in a stair-like shape.
The pareto is used to set priorities or indicate which problem or problems to solve first. It enables us to
have a systematic way of dealing with problems and prevents us from firefighting. The pareto rule is that
80% of problems are due to only 20% of the causes. The pareto will help us identify those vital few (the
20%) causes so that we can improve quality dramatically and quickly.

A hospital made a pareto diagram on the types of patient calls that a nurse station receives. It shows that
the most frequent (around 25%) is call for supplies - linen, blanket, tissue paper, etc. By improving
housekeeping procedures and making sure supplies are always sufficient, the quality improvement team
has almost eliminated this type of call and freed a lot of time for nurses to answer medical calls.

After the pareto has identified the most critical problem to attach, the fishbone or cause and effect
diagram may be used to analyze it. The fishbone diagram looks like a fish. The head represents the
problem to be eliminated, while the bones represent all its possible causes. The fishbone is a result of a
structured brainstorming of all the members of the quality improvement team. It is usually best to have a
cross-functional team to be able to identify all possible causes. A quality improvement team of a hospital
made a fishbone analysis of delayed patient's discharge of a hospital. After constructing the fishbone, the
team how discussed and decided which among the possible causes were the most probable ones, usually
one or two items or factors. These causes were then validated, studied, and eliminated.

4.4 THE MEDICAL PROBLEM-SOLVING PROCESS (DAIGNOSIS AND THERAPY)

Understanding the medical problem-solving process has implications for medical education and the
effectiveness of medical services. Through adaptation to the task at hand the human problem solver is
able to ameliorate the effects of inherent limitations.

In adapting to the medical problem-solving task demands related to diagnosis and therapy, the physician
uses the hypotheticodeductive process. The process draws upon the problem solver's disease centered
and data centered knowledge and can be made more effective through the use of various heuristic rules
and strategies that the physician develops with increasing expertise (Connelly and Johnson, 1980).

4.3.1 MEDICAL ALGORITHM DIAGNOSIS

Making a diagnosis is an art. We humans are not engineering products, and therefore measuring a few
parameters and tweaking a few knobs will not diagnose and cure our diseases.

Part of the art of diagnosis is looking at the whole human being. The way the patient walks, speaks, smells,
or thinks are all important to the final diagnosis. The other part of a correct diagnosis is learning and
gathering whatever information is relevant to the patient’s case. Being a physician entails a commitment
towards life–long learning. Doctors frequently dive into biomedical databases of peer–reviewed papers
to find the information they need. Keeping up to date with the latest literature in their field of interest is
normal routine in the life of a physician.

The first part is what improves with experience and it also requires creativity and instinct. Technology
might never replace that. Wearable devices and home monitoring services can measure a lot of
parameters, but the physician’s impression on meeting a patient is irreplaceable.
The other part is where everybody fails. No doctor in the world can be perfectly up–to–date on recent
medical advances as there are 25 million papers on Pubmed.com. No doctor can be certain they have
found all the pertinent information their case requires. To do so, they do need help from the world of
technology.

In the United Kingdom, computer algorithms are used to assist doctors in making diagnosis. A
supercomputer does big data analysis and acts like a second opinion doctor — telling of drug interactions,
helping to make a diagnosis, making treatment options/suggestions, and even estimating day/time of
death. It helps the UK save millions of dollars a year. Also, the system learns and becomes smarter and
better as time goes on. However, the doctor still remains the primary decision maker.

4.5 CONCLUSION
Problem solving in health care is too important to be left to chance, personal styles, and disorganized
approaches. A thorough and organization-wide application of the tools described above will lead to better
communication, teamwork, and faster solution of problems of any kind in the hospital, whether
administrative or medical.

REFERENCES

https://healthywa.wa.gov.au/Articles/N_R/Problem-solving
Method and tools in problem solving in health care by Rene T. Domingo
Medicalfuturist.com
FLOW DIAGRAMS
5.1 FLOW CHART
A flowchart represents an algorithm or process, showing the steps as boxes of various kinds, and their
order by connecting them with arrows.

Flowcharts (also known as process flowcharts or process flow diagrams) are used in analyzing, designing,
documenting or managing a process or program in various fields. This diagrammatic representation
illustrates a solution to a given problem. Like other types of diagrams, they help visualize what is going on
and thereby help the viewer to understand a process, and perhaps also find flaws, bottlenecks, and other
less-obvious features within it.

Flowcharts allow for a step-by-step diagram to be drawn out that help describe complex situations such
as the steps in programming code or troubleshooting a computer.

Elements that may be included in a flowchart are a sequence of actions, materials or services entering or
leaving the process (inputs and outputs), decisions that must be made, people who become involved, time
involved at each step, and/or process measurements.

The program flowchart can be likened to the blueprint of a building. As we know a designer draws a
blueprint before starting construction on a building. Similarly, a programmer prefers to draw a flowchart
prior to writing a computer program. As in the case of the drawing of a blueprint, the flowchart is drawn
according to defined rules and using standard flowchart symbols.

5.2 THE USE OF FLOWCHART IN HEALTHCARE

Hospitals and other healthcare providers deal with many other problems apart from the treatment of sick
patients. Some of these problems include service delivery problems, problems with management and
people, logistics, maintenance and resource allocation problems. Unfortunately, the majority of the time
very little tools are used by staff to resolve these problems.

Most of the methods and tools used by manufacturing and service industries to solve quality problems
can be applied in problem solving in health care. These simple tools have proven effective in dramatically
reducing if not eliminating defects, failures, wastes, and customer complaints in these businesses.

Flowcharts can be used to clearly show the flow of people, services and information in a hospital. It can
show the flow of service in a hospital, beginning with the admission of patients and ending with satisfied
and healthy people.

It also lists the types of services each unit must deliver for the hospital to create total customer
satisfaction. The flowchart also conveys that message that everybody works towards a common goal. It
shows the flow of services from one hospital unit- the department of laboratories – to the rest of the
organization and eventually to the patients. A flowchart shows that if there is any failure in the service to
any department that it will result in a dissatisfied of unhealthy patient.
Flowcharts can show areas of responsibility as well as areas where some improvement may be needed. A
flowchart in a clinic, for example, can show that a client registration process takes up 30 minutes. If the
30-minute registration time were to be reduced further, the flowchart can help analyze which step or
steps to eliminate, combine, or simplify. A flowchart can show how nurses respond to a patient call.

The use of flowcharts within healthcare is extremely useful and ensures that the system is kept in perfect
working order.

5.3 FLOWCHART AND COMPUTER SOLUTIONS

A flowchart is a diagrammatic representation that illustrates the sequence of operations to be performed
to get the solution of a problem. Flowcharts are generally drawn in the early stages of formulating
computer solutions. Flowcharts facilitate communication between programmers and business people.
These flowcharts play a vital role in the programming of a problem and are quite helpful in understanding
the logic of complicated and lengthy problems.

Once the flowchart is drawn, it becomes easy to write the program in any high-level language. Often, we
see how flowcharts are helpful in explaining the program to others. Hence, it is correct to say that a
flowchart is a must for the better documentation of a complex program.

5.4 GUIDELINES FOR DRAWING A FLOWCHART

Flowcharts are usually drawn using some standard symbols; however, some special symbols can also be
developed when required. Some standard symbols, which are frequently required for flowcharting many
computer programs are shown in Fig. 5.1

5.4.1 FLOWCHART NOTATION

Different flow chart symbols have different meanings. The most common flow chart symbols are:

• Terminator: Elongated circles, which signify the start or end of a process.

• Process: A rectangular flow chart shape indicating a normal process flow step (instructions or
actions).

• Decision: A diamond flow chart shape indication a branch in the process flow. Decisions that must
be made

• Connector: A small, labelled, circular flow chart shape used to indicate a jump in the process flow.
(Shown as the circle with the letter “A”, below)

• Data: A parallelogram that indicates data input or output (I/O) for a process.
 • Document: Used to indicate a document or report.

Figure 5.1: Flowchart Notation

The following are some guidelines in flowcharting:

(a) In drawing a proper flowchart, all necessary requirements should be listed out in logical order.

(b) The flowchart should be clear, neat and easy to follow. There should not be any room for ambiguity in
understanding the flowchart.

(c) The usual direction of the flow of a procedure or system is from left to right or top to bottom.

(d) Only one flow line should come out of a process symbol

(e) Only one flow line should enter a decision symbol, but two or three flow lines, one for each possible
answer, should leave the decision symbol.
(f) Only one flow line is used in conjunction with terminal symbol.

(g) Write within standard symbols briefly. As necessary, you can use the annotation symbol to describe
data or computational steps more clearly.

(h) If the flowchart becomes complex, it is better to use connector symbols to reduce the number of flow
lines. Avoid the intersection of flow lines if you want to make it more effective and better way of
communication.

(i) Ensure that the flowchart has a logical start and finish.

(j) It is useful to test the validity of the flowchart by passing through it with a simple test data.

5.5 ADVANTAGES OF USING FLOWCHARTS

1. Communication: Flowcharts are better way of communicating the logic of a system to all concerned.

2. Effective analysis: With the help of flowchart, problem can be analysed in more effective way.

3.Proper documentation: Program flowcharts serve as a good program documentation, which is needed
for various purposes.

4. Efficient Coding: The flowcharts act as a guide or blueprint during the systems analysis and program
development phase.

5. Proper Debugging: The flowchart helps in debugging process.

6. Efficient Program Maintenance: The maintenance of operating program becomes easy with the help of
flowchart. It helps the programmer to put efforts more efficiently on that part

5.6 LIMITATIONS OF USING FLOWCHARTS

1. Complex logic: Sometimes, the program logic is quite complicated. In that case, flowchart becomes
complex and clumsy.

2. Alterations and Modifications: If alterations are required the flowchart may require re-drawing
completely.
3. Reproduction: As the flowchart symbols cannot be typed, reproduction of flowchart becomes a
problem.

4. The essentials of what is done can easily be lost in the technical details of how it is done.

5.7 FLOWCHART EXAMPLES

Flowchart Example One: Should I Bring an Umbrella?

This example shows how a person decides whether he/she should bring an umbrella when living home.
This simple diagram demonstrates the uses decisions and processes.
Flowchart Example Two: Draw a flowchart to find the sum of first 50 natural numbers.
Flowchart Example Three: Medical Services

This flowchart shows the flow of a patient when entering a clinic using processes, decisions and loops.
Flowchart Example Four: Should I cycle to school today?

REFERENCES:

A Comprehensive Guide to Flowchart by Warren Lynch

What is flowchart? (asq.org)
LOGICAL PROCESS ANALYSIS OF
COMPUTATIONAL PROBLEMS
6.1 LOGICAL PROCESS ANALYSIS
A logical level process model is used to model the detailed requirements of an application system. During
analysis, the conceptual process model evolves into the detailed functional requirements, or logical
process model. It describes the behaviour of processes and their interactions.

With a proper approach, solutions to difficult problems can be brought within the reach of the creative
problem solver. When the power of a personal computer is added to the attack, many problems that
otherwise require considerable advanced study often reveal their solutions.

Programming is more than the ability to write loops or make function calls. The real purpose for learning
to program is to span the gap between the mechanics of programming and the generation of solutions to
real problems.

Logical Problem Solving goes far beyond merely presenting problems that have been solved. It augments
programming texts by providing the rules and the logic that lead to programming solutions. Logical
Problem Solving presents the logical processes used by problem solvers for resolving real-world problems
(Lamey, 2001)

6.2 COMPUTATIONAL THINKING AS A PROBLEM-SOLVING PROCESS

Computational thinking is a problem-solving process that includes (but is not limited to) the following
characteristics:

• Formulating problems in a way that enables us to use a computer and other tools to help solve them

• Logically organizing and analyzing data

• Representing data through abstractions, such as models and simulations

• Automating solutions through algorithmic thinking (a series of ordered steps)

• Identifying, analyzing, and implementing possible solutions with the goal of achieving the most efficient
and effective combination of steps and resources

• Generalizing and transferring this problem-solving process to a wide variety of problems.

The first three bullet points highlight the importance of computational modeling as part of the problem-
solving process. General approaches to computational modelling are typically facilitated by programming
languages.

Computational problem-solving should be connected to realistic applications and challenges in science

and humanities. This would link the learning experience and the ensuing creations to relevant real-world
problems. However, realism in this sense can also lead to a “complexity overkill” that obstructs the pure
discovery of important basic building blocks (the nature of which will be elaborated later).

On the other hand, if models are simplified too much, they lose fidelity and ultimately credibility. Many
computer science concepts do not require an application to real complex environment in their basic
version. Interactive game environments, for example, do not necessarily require an accurate modelling of
physics but they can still promote the learning of computational thinking concepts.

6.3 COMPUTATIONAL PROBLEM SOLVING

Problem solving with computers involves several steps:

1. Clearly define the problem.

2. Analyze the problem and formulate a method to solve it (see also “validation”).

3. Describe the solution in the form of an algorithm.

4. Draw a flowchart of the algorithm.

5. Write the computer program.

6. Compile and run the program (debugging).

7. Test the program (debugging) (see also “verification”).

8. Interpretation of results.

6.3.1 VERIFICATION AND VALIDATION

If the program has an important application, for example to calculate student grades or guide a rocket,
then it is important to test the program to make sure it does what the programmer intends it to do and
that it is actually a valid solution to the problem. The tests are commonly divided as follows:

Verification verify that program does what you intended it to do; steps 7(8) above attempt to do
this.

Validation does the program actual solve the original problem i.e. is it valid? This goes back to
steps 1 and 2 - if you get these steps wrong then your program is not a valid solution.

REFERENCES

Logical Problem Solving: Before the Flowchart, with C++ and Visual Basic Applications by Robert
Lamey
Computational Thinking Education by Siu-Cheung Kong and Harold Abelson
ELEMENTARY NUMERICAL ALGORITHMS
7.1 WHAT IS AN ALGORITHM?

An algorithm can be defined as a systematic procedure that produces—in a finite number of steps—the
answer to a question or the solution of a problem.

In the previous classes we discussed about problem solving. When programming a computer to complete
a task or solve a problem, repetitive techniques like iteration and recursion are extremely useful. It is
essential to have a knowledge of these techniques which can also be found in numerical algorithms.

Numerical algorithms are behind designing shapes (e.g., shapes for cars, planes, fonts), computing
intensities for displaying graphics, animating moving objects, studying the spread of diseases, modelling
the orbit of planets and satellites, supporting search engines such as google, and many more practical
problems modelled by mathematics.

Numerical analysis is the area of mathematics and computer science that creates, analyses, and
implements algorithms for solving numerically the problems of continuous mathematics.

REFERENCE

Numerical Analysis by Kendall E. Atkinson

Which numerical computing language is best by Jon Danielsson and Jia Rong Fan
https://www.britannica.com/science/algorithm