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Resilient Health Care

Author: Erik Hollnagel

Publisher: CRC Press

Published: 2019-07-23

Total Pages: 254

ISBN-13: 1317065166

Health care is everywhere under tremendous pressure with regard to efficiency, safety, and economic viability - to say nothing of having to meet various political agendas - and has responded by eagerly adopting techniques that have been useful in other industries, such as quality management, lean production, and high reliability. This has on the whole been met with limited success because health care as a non-trivial and multifaceted system differs significantly from most traditional industries. In order to allow health care systems to perform as expected and required, it is necessary to have concepts and methods that are able to cope with this complexity. Resilience engineering provides that capacity because its focus is on a system’s overall ability to sustain required operations under both expected and unexpected conditions rather than on individual features or qualities. Resilience engineering’s unique approach emphasises the usefulness of performance variability, and that successes and failures have the same aetiology. This book contains contributions from acknowledged international experts in health care, organisational studies and patient safety, as well as resilience engineering. Whereas current safety approaches primarily aim to reduce or eliminate the number of things that go wrong, Resilient Health Care aims to increase and improve the number of things that go right. Just as the WHO argues that health is more than the absence of illness, so does Resilient Health Care argue that safety is more than the absence of risk and accidents. This can be achieved by making use of the concrete experiences of resilience engineering, both conceptually (ways of thinking) and practically (ways of acting).

Resilient Health Care, Volume 2

Author: Robert L. Wears

Publisher: CRC Press

Published: 2017-03-02

Total Pages: 349

ISBN-13: 1317065131

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Health systems everywhere are expected to meet increasing public and political demands for accessible, high-quality care. Policy-makers, managers, and clinicians use their best efforts to improve efficiency, safety, quality, and economic viability. One solution has been to mimic approaches that have been shown to work in other domains, such as quality management, lean production, and high reliability. In the enthusiasm for such solutions, scant attention has been paid to the fact that health care as a multifaceted system differs significantly from most traditional industries. Solutions based on linear thinking in engineered systems do not work well in complicated, multi-stakeholder non-engineered systems, of which health care is a leading example. A prerequisite for improving health care and making it more resilient is that the nature of everyday clinical work be well understood. Yet the focus of the majority of policy or management solutions, as well as that of accreditation and regulation, is work as it ought to be (also known as ’work-as-imagined’). The aim of policy-makers and managers, whether the priority is safety, quality, or efficiency, is therefore to make everyday clinical work - or work-as-done - comply with work-as-imagined. This fails to recognise that this normative conception of work is often oversimplified, incomplete, and outdated. There is therefore an urgent need to better understand everyday clinical work as it is done. Despite the common focus on deviations and failures, it is undeniable that clinical work goes right far more often than it goes wrong, and that we only can make it better if we understand how this happens. This second volume of Resilient Health Care continues the line of thinking of the first book, but takes it further through a range of chapters from leading international thinkers on resilience and health care. Where the first book provided the rationale and basic concepts of RHC, the Resilience of Everyday Clinical Work b

Working Across Boundaries

Author: Jeffrey Braithwaite

Publisher: CRC Press

Published: 2019-06-03

Total Pages: 178

ISBN-13: 1000007340

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The book demonstrates how Resilient Health Care principles can enable those on the frontline to work more effectively towards interdisciplinary care by gaining a deeper understanding of the boundaries that exist in everyday clinical settings. This is done by presenting a set of case studies, theoretical chapters and applications that relate experiences, bring forth ideas and illustrate practical solutions. The chapters address many different issues such as resolving conflict, overcoming barriers to patient-flow management, and building connections through negotiation. They represent a range of approaches, rather than a single way of solving the practical problems, and have been written to serve both a scientific and an andragogical purpose. Working Across Boundaries is primarily aimed at people who are directly involved in the running and improvement of health care systems, providing them with practical guidance. It will also be of direct interest to health care professionals in clinical and managerial positions as well as researchers. Presents the latest work of the lauded Resilient Health Care Net group, developing applications of Resilience Engineering to health care, furthering safety thinking and generating applicable solutions that will benefit patient safety worldwide Enables health care professionals to become aware of the boundaries that affect their work so that they are able to use their strengths and overcome their weaknesses Written from a Safety-II perspective, where the purpose is to make sure that as much as possible goes well and the focus therefore is on everyday work rather than on failures. There are at present no other books that adopt this perspective nor which go into the practical details Provides a concise presentation of the state of resilient health care as a science, in terms of major theoretical issues and practical methods and techniques on the overarching and important topics of boundary-crossing and integration of care settings

Resilient Health Care

Author: Professor Erik Hollnagel

Publisher: Ashgate Publishing, Ltd.

Published: 2013-09-02

Total Pages: 297

ISBN-13: 1409469808

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Resilience in Healthcare Leadership

Author: Alan Belasen, PhD

Publisher: CRC Press

Published: 2022-01-20

Total Pages: 208

ISBN-13: 1000520633

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The COVID-19 Pandemic has been an ultimate challenge for leadership resiliency. Resilient leaders are thoughtful and deliberate. They balance logic and emotion, ego and humility. They lead through compassionate empathy by focusing on the ‘how’, not only the ‘what’. They use their influence to drive positive change, diversity and inclusion, and create an equitable community. Most books on resilient leadership appear to focus on spirituality and tools to grow an “unshakable core of calm, strength, and happiness” or “bounce back without getting stuck in the toxic emotions of guilt, false guilt, anger, and bitterness”. These books are very similar to handbooks focusing on mental toughness and providing guides for overcoming adversity and managing negative emotions. This book, however, defines resilience as a critical competency of high-performing leaders. Leaders must cultivate resilience in themselves and foster it throughout their organizations and multidisciplinary teams in order to adapt and succeed. Resilience in Healthcare Leadership is differentiated by offering practical strategies and self-assessment instruments for identifying strengths and weaknesses and for developing and sustaining the performance of resilient leaders. The book will also focus on best practices to help build a talent pipeline and develop resilient care team leaders to effectively manage the challenges of disruptive environments. Whether senior or mid-level manager the reader will learn to apply knowledge and skills to initiate cultural change, assess strengths and weaknesses, align leadership roles with organizational goals, and position themselves to become a resilient leader. The reader will also learn how to identify message strategies consistent with stakeholders’ needs, resolve conflicts, lead multidisciplinary teams, and realize the impact of resilient leadership in influencing outcomes. Takeaways and tools are included to guide progressive learning and leadership development and build a strong succession pipeline, to help organizations become more prepared to respond to challenges facing healthcare leaders in the future.

Resilient Health Care, Volume 3

Author: Jeffrey Braithwaite

Publisher: CRC Press

Published: 2016-10-03

Total Pages: 210

ISBN-13: 1498780571

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This book is the 3rd volume in the Resilient Health Care series. Resilient health care is a product of both the policy and managerial efforts to organize, fund and improve services, and the clinical care which is delivered directly to patients. This volume continues the lines of thought in the first two books. Where the first volume provided the rationale and basic concepts of RHC and the second teased out the everyday clinical activities which adjust and vary to create safe care, this book will look more closely at the connections between the sharp and blunt ends. Doing so will break new ground, since the systematic study in patient safety to date with few exceptions has been limited.

Safety-I and Safety-II

Author: Erik Hollnagel

Publisher: CRC Press

Published: 2018-04-17

Total Pages: 167

ISBN-13: 1317059794

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Safety has traditionally been defined as a condition where the number of adverse outcomes was as low as possible (Safety-I). From a Safety-I perspective, the purpose of safety management is to make sure that the number of accidents and incidents is kept as low as possible, or as low as is reasonably practicable. This means that safety management must start from the manifestations of the absence of safety and that - paradoxically - safety is measured by counting the number of cases where it fails rather than by the number of cases where it succeeds. This unavoidably leads to a reactive approach based on responding to what goes wrong or what is identified as a risk - as something that could go wrong. Focusing on what goes right, rather than on what goes wrong, changes the definition of safety from ’avoiding that something goes wrong’ to ’ensuring that everything goes right’. More precisely, Safety-II is the ability to succeed under varying conditions, so that the number of intended and acceptable outcomes is as high as possible. From a Safety-II perspective, the purpose of safety management is to ensure that as much as possible goes right, in the sense that everyday work achieves its objectives. This means that safety is managed by what it achieves (successes, things that go right), and that likewise it is measured by counting the number of cases where things go right. In order to do this, safety management cannot only be reactive, it must also be proactive. But it must be proactive with regard to how actions succeed, to everyday acceptable performance, rather than with regard to how they can fail, as traditional risk analysis does. This book analyses and explains the principles behind both approaches and uses this to consider the past and future of safety management practices. The analysis makes use of common examples and cases from domains such as aviation, nuclear power production, process management and health care. The final chapters explain the theoret

Resilient Health Care, Volume 2

Author: Robert L. Wears

Publisher: CRC Press

Published: 2017-03-02

Total Pages: 328

ISBN-13: 131706514X

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Resilient Health Care, Volume 2

Author: Professor Erik Hollnagel

Publisher: Ashgate Publishing, Ltd.

Published: 2015-03-28

Total Pages: 329

ISBN-13: 1472437829

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Despite the common focus on deviations and failures in health systems, it is an undeniable fact that clinical work goes right far more often than it goes wrong, and that we only can make it better if we understand how this happens. This second volume of Resilient Health Care continues the line of thinking of the first book. It breaks new ground by analyzing everyday work situations in primary, secondary, and tertiary care to identify and describe the fundamental strategies that clinicians everywhere have developed and use with a fluency that belies the demands to be resolved and the dilemmas to be balanced.

Exploring Resilience

Author: Babette Fahlbruch

Publisher:

Published: 2020-10-08

Total Pages: 124

ISBN-13: 9781013272929

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Resilience has become an important topic on the safety research agenda and in organizational practice. Most empirical work on resilience has been descriptive, identifying characteristics of work and organizing activity which allow organizations to cope with unexpected situations. Fewer studies have developed testable models and theories that can be used to support interventions aiming to increase resilience and improve safety. In addition, the absent integration of different system levels from individuals, teams, organizations, regulatory bodies, and policy level in theory and practice imply that mechanisms through which resilience is linked across complex systems are not yet well understood. Scientific efforts have been made to develop constructs and models that present relationships; however, these cannot be characterized as sufficient for theory building. There is a need for taking a broader look at resilience practices as a foundation for developing a theoretical framework that can help improve safety in complex systems. This book does not advocate for one definition or one field of research when talking about resilience; it does not assume that the use of resilience concepts is necessarily positive for safety. We encourage a broad approach, seeking inspiration across different scientific and practical domains for the purpose of further developing resilience at a theoretical and an operational level of relevance for different high-risk industries. The aim of the book is twofold: 1. To explore different approaches for operationalization of resilience across scientific disciplines and system levels. 2. To create a theoretical foundation for a resilience framework across scientific disciplines and system levels. By presenting chapters from leading international authors representing different research disciplines and practical fields we develop suggestions and inspiration for the research community and practitioners in high-risk industries. This book is Open Access under a CC-BY licence.; Explores different approaches for operationalization of resilience across scientific disciplines and system levels Creates a theoretical foundation for a resilience framework across scientific disciplines and system levels Develops suggestions and inspiration for the research community and practitioners in high-risk industries Presents chapters from leading international authors representing different research disciplines and practical fields This work was published by Saint Philip Street Press pursuant to a Creative Commons license permitting commercial use. All rights not granted by the work's license are retained by the author or authors.