Antibiotic Treatment of Pneumococcal Pneumonia BPMN Example
Borut Jures
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Delayed Duration Constraints?
Delaying an activity duration means that duration is measured only after a certain condition is met. For example the duration of the activity is started from some milestone event that occurs after the activity initiation.
As an example, let us consider the treatment of uncomplicated pneumococcal pneumonia, a common lung infection leading to hospitalization. Antibiotic therapy must be initiated immediately after the onset of the infection. Then, depending on the extent of the infection and the patient clinical response, antibiotic administration is continued for 5–7 days after defervescence. The overall duration of therapy should not exceed 10 days. If the patient does not defervesce within 3–5 days, antibiotic susceptibility must be reviewed.?
Antibiotic therapy begins, but its duration of 5-7 days is measured starting from milestone event (no fever). If the latter does not occur within 5 days (the maximum time allowed for defervescence), an alternative activity (Review Susceptibility) is triggered.
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Patient discharge from hospital?
We can also specify a delayed duration with reset. The milestone event captures the beginning of a certain condition that must hold for the whole period of the delayed duration. When such condition is not valid anymore, we must capture the change and reset the delayed duration.?
For example, let us consider patient discharge from hospital. Discharge criteria require patients to have been afebrile for at least 24 hours to be safely dismissed. This means that, whenever fever (re-)appears the patient must wait for temperature to lower within normal ranges and, from that moment, stay in hospital for 24 fever-free additional hours. To specify the delayed duration of activity “hospitalization”, which should be of at least 24 hours after “fever disappears”, our milestone event should consider reset condition “fever comes back”, which requires physicians to wait until fever disappears again before recounting 24 hours.