Building Resilient Healthcare Teams: Insights from Analogy to the Social Biology of Ants, Honey Bees and Other Social Insects

Abstract

The resilience of a healthcare system hinges on the adaptability of its teams. Thus far, healthcare teams have relied on well-defined scopes of practice to fulfill their safety mandate. While this feature has proven effective when dealing with stable situations, when it comes to disruptive events, healthcare teams find themselves navigating a fine balance between safety and resilience. Therefore, a better understanding of how the safety vs resilience trade-off varies under different circumstances is necessary if we are to promote and better train for resilience in modern healthcare teams. In this paper, we aim to bring awareness to the sociobiology analogy that healthcare teams might find useful during moments when safety and adaptability have the potential to conflict. Three principles underpin the sociobiology analogy: communication, decentralization, and plasticity. Of particular interest in this paper is plasticity whereby swapping roles or tasks becomes an adaptive, rather than a maladaptive, response teams could embrace when facing disruptive situations. While plasticity has naturally evolved in social insects, infusing plasticity in healthcare teams requires intentional training. Inspired by the sociobiology analogy, such training must value the ability: a) to read each other's cues and miscues, b) to step aside when others had the necessary skills, even if outside their scope, c) to deviate from protocols, and d) to foster cross-training. If the goal is to increase a team's behavioural flexibility and boost their resilience, this training mindset should become second nature.

Safety on the ground: using critical incident technique to explore the factors influencing medical registrars’ provision of safe care

“…Adaptability and plasticity within teams when working towards a common goal is thought to enhance resilience within healthcare systems. 38 39 However, healthcare organisations often value standardisation, stability and the control of risk, which must be balanced with the adaptive flexibility that is essential when navigating the complexity intrinsic to healthcare. 40 41 Rigidity within teams is promoted by professional silos, hierarchy, externalisation of responsibility or fixation on incidents.…”