Properly performing health care systems require concepts and methods that match their complexity. Resilience engineering provides that capability. It focuses on a system’s overall ability to sustain required operations under both expected and unexpected conditions rather than on individual features or qualities. This book contains contributions from international experts in health care, organisational studies and patient safety, as well as resilience engineering. Whereas current safety approaches primarily aim to reduce the number of things that go wrong, Resilient Health Care aims to increase the number of things that go right.
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.
In the devastation that follows a major disaster, there is a need for multiple sectors to unite and devote new resources to support the rebuilding of infrastructure, the provision of health and social services, the restoration of care delivery systems, and other critical recovery needs. In some cases, billions of dollars from public, private and charitable sources are invested to help communities recover. National rhetoric often characterizes these efforts as a "return to normal." But for many American communities, pre-disaster conditions are far from optimal. Large segments of the U.S. population suffer from preventable health problems, experience inequitable access to services, and rely on overburdened health systems. A return to pre-event conditions in such cases may be short-sighted given the high costs - both economic and social - of poor health. Instead, it is important to understand that the disaster recovery process offers a series of unique and valuable opportunities to improve on the status quo. Capitalizing on these opportunities can advance the long-term health, resilience, and sustainability of communities - thereby better preparing them for future challenges. Healthy, Resilient, and Sustainable Communities After Disasters identifies and recommends recovery practices and novel programs most likely to impact overall community public health and contribute to resiliency for future incidents. This book makes the case that disaster recovery should be guided by a healthy community vision, where health considerations are integrated into all aspects of recovery planning before and after a disaster, and funding streams are leveraged in a coordinated manner and applied to health improvement priorities in order to meet human recovery needs and create healthy built and natural environments. The conceptual framework presented in Healthy, Resilient, and Sustainable Communities After Disasters lays the groundwork to achieve this goal and provides operational guidance for multiple sectors involved in community planning and disaster recovery. Healthy, Resilient, and Sustainable Communities After Disasters calls for actions at multiple levels to facilitate recovery strategies that optimize community health. With a shared healthy community vision, strategic planning that prioritizes health, and coordinated implementation, disaster recovery can result in a communities that are healthier, more livable places for current and future generations to grow and thrive - communities that are better prepared for future adversities.
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
This accessible textbook introduces a wide spectrum of ideas, approaches, and examples that make up the emerging field of implementation science, including implementation theory, processes and methods, data collection and analysis, brokering interest on the ground, and sustainable implementation. Containing over 60 concise essays, each addressing the thorny problem of how we can make care more evidence-informed, this book looks at how implementation science should be defined, how it can be conducted, and how it is assessed. It offers vital insight into how research findings that are derived from healthcare contexts can help make sense of service delivery and patient encounters. Each entry concentrates on an important concept and examines the idea’s evidence base, root causes and effects, ideas and applications, and methodologies and methods. Revealing a very human side to caregiving, but also tackling its more complex and technological aspects, the contributors draw on real-life healthcare examples to look both at why things go right in introducing a new intervention and at what can go wrong. Implementation Science: The Key Concepts provides a toolbox of rich, contemporary thought from leading international thinkers, clearly and succinctly delivered. This comprehensive and enlightening range of ideas and examples brought together in one place is essential reading for all students, researchers, and practitioners with an interest in translating knowledge into practice in healthcare.
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.
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
Forced migration has yet to be sufficiently addressed from the perspective of health policy and systems research, resulting in limited knowledge on system‐level interventions and policies to improve the health of forced migrants. The contributions within this edited volume seek to rectify this gap in the literature by compiling the existing knowledge on health systems and health policy responses to forced migration with a focus on asylum seekers, refugees, and internally displaced people. It also brings together the work of research communities from the fields of political science, epidemiology, health sciences, economics, psychology, and sociology to push the knowledge frontier of health research in the area of forced migration towards health policy and systems-level interventions, while also framing potential routes for further research in this area. Among the analyses within the chapters: The political economy of health and forced migration in Europe Innovative humanitarian health financing for refugees Understanding the resilience of health systems Health security in the context of forced migration Discrimination as a health systems response to forced migration Health Policy and Systems Responses to Forced Migration offers unique and interdisciplinary theoretical, empirical, and literature-based perspectives that apply a health policy and systems approach to health and healthcare challenges among forced migrants. It will find an engaged audience among policy makers and analysts, international organizations, scholars in academia, think tanks, and students in undergraduate programs or at the graduate level, for policy, practice, and educational purposes.
This document presents the World Health Organization (WHO) operational framework for building climate resilient health systems. The framework responds to the demand from Member States and partners for guidance on how the health sector and its operational basis and health systems can systematically and effectively address the challenges increasingly presented by climate variability and change. This framework has been designed in light of the increasing evidence of climate change and its associated health risks; global, regional and national policy mandates to protect population health; and a rapidly emerging body of practical experience in building health resilience to climate change. Primarily intended for public health professionals and health managers, this framework would also help guide decision-makers in other health-determining sectors, such as nutrition, water and sanitation, and emergency management. International development agencies could use this framework to focus investments and country support for public health, health system strengthening and climate change adaptation. The objective of this framework is to provide guidance for health systems and public health programming to increase their capacity for protecting health in an unstable and changing climate. By implementing the 10 key components laid out in this framework, health organizations, authorities and programs will be better able to anticipate, prevent, prepare for and manage climate-related health risks. Least developed countries and countries in the process of developing the health components of National Adaptation Plans (NAPs) under the UN Framework Convention on Climate Change (UNFCCC) (4) may find this document particularly useful in their efforts to design a comprehensive response to the risks presented by short-term climate variability and long-term climate change.
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.
