Ashgate Studies in Resilience Engineering
2 total works
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 This fails to recognise that this normative conception of work is often oversimplified, incomplete, and outdated.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
Resilience Engineering in Practice, Volume 2
by Christopher P. Nemeth and Erik Hollnagel
Published 5 November 2014
This is the fifth book published within the Ashgate Studies in Resilience Engineering series. The first volume introduced resilience engineering broadly. The second and third volumes established the research foundation for the real-world applications that then were described in the fourth volume: Resilience Engineering in Practice. The current volume continues this development by focusing on the role of resilience in the development of solutions. Since its inception, the development of resilience engineering as a concept and a field of practice has insisted on expanding the scope from a preoccupation with failure to include also the acceptable everyday functioning of a system or an organisation. The preoccupation with failures and adverse outcomes focuses on situations where something goes wrong and the tries to keep the number of such events and their (adverse) outcomes as low as possible. The aim of resilience engineering and of this volume is to describe how safety can change from being protective to become productive and increase the number of things that go right by improving the resilience of the system.