Resilience and Resilience Engineering in Health Care

Learning from incidents in health care: Critique from a Safety-II perspective

“…As a result, clinicians and health care professionals create success on a daily basis through performance adjustments , Hollnagel, 2009) and dynamic trade-offs (Sujan et al, 2015a, Sujan et al, 2015b based on their experience and expertise, and depending on the specific characteristics of the situation. Such necessary performance adjustments contribute to organisational resilience as well as to organisational failures (Fairbanks et al, 2014, Hollnagel, 2012. From a WAI perspective, on the other hand, performance variability is often regarded as unnecessary detrimental deviations from or violations of an imaginary ideal practice (Hollnagel, 2015).…”

“…incidents), but rather as the presence of something -the ability to make dynamic trade-offs and to adjust performance in order to meet changing demands and deal with disturbances and surprises (Fairbanks et al, 2014, Hollnagel, 2014b, Hollnagel, 2014a, Sujan et al, 2015c, Sujan et al, 2015a.…”

“…The paper aims to make suggestions for the policy and practice of learning from incidents in health care by offering a critique based on a Safety-II perspective. In Safety-II thinking safety is defined as an ability -to make dynamic trade-offs and to adjust performance in order to meet changing demands and to deal with disturbances and surprises (Fairbanks et al, 2014, Hollnagel, 2014b, Hollnagel, 2014a, Sujan et al, 2015c, Sujan et al, 2015a. The paper argues that health care organisations might improve their ability to learn from past experience by studying not only what goes wrong (i.e.…”

Implementing Healthcare Improvement

“…This is because healthcare professionals are able to make dynamic trade-offs and to adjust their performance in order to meet changing demands and deal with disturbances and surprises [18,24,43,46,50]. Empirical studies of everyday clinical work provide a diverse range of examples of such performance adjustments in practice [51][52][53].…”

“…Such necessary performance adjustments contribute to organisational resilience [50] by adding the adaptive capacity that is required to operate successfully in complex environments. From a WAI perspective, on the other hand, performance variability is often regarded as detrimental deviations or violations [54].…”