Erik Hollnagel – författare

First published in 1999, this volume examined how increasing cockpit automation in commercial fleets across the world has had a profound impact on the cognitive work that is carried out on the flight deck. Pilots have largely been transformed into supervisory controllers, managing a suite of human and automated resources. Operational and training requirements have changed, and the potential for human error and system breakdown has shifted. This compelling book critically examines how airlines, regulators, educators and manufacturers cope with these and other consequences of advanced aircraft automation.

First published in 1999, this volume examined how increasing cockpit automation in commercial fleets across the world has had a profound impact on the cognitive work that is carried out on the flight deck. Pilots have largely been transformed into supervisory controllers, managing a suite of human and automated resources. Operational and training requirements have changed, and the potential for human error and system breakdown has shifted. This compelling book critically examines how airlines, regulators, educators and manufacturers cope with these and other consequences of advanced aircraft automation.

Health care is under tremendous pressure regarding efficiency, safety, and economic viability. It has responded by adopting techniques that have been useful in other industries, such as quality management, lean production, and high reliability – although with limited, and all-too-often disappointing, results. The Resilient Health Care Network (RHCN) has worked since 2011 to facilitate the interaction and collaboration among practitioners and researchers interested in applying concepts from resilience engineering to health care and patient safety. This has met with considerable success, not least because the focus from the start was on developing concrete ways to complement a Safety-I perspective with a Safety-II perspective.

Building on previous volumes, Delivering Resilient Health Care presents documented experiences and practical guidance on how to bring Resilient Health Care into practice. It provides concrete advice on how to prepare a study, how to choose the right data, how to collect it, how to analyse the data, and how to interpret the results. This fourth book in the Resilient Healthcare series contains contributions from international experts in health care, organisational studies and patient safety, as well as resilience engineering.

This book provides a practical guide for delivering resilient healthcare, particularly for clinicians on the frontline of care unsure how to incorporate resilience into their everyday work, managers coordinating care, and for policymakers hoping to steer the system in the right direction. Other groups – patients, the media, and researchers – will also find much of interest here.

Health care is under tremendous pressure regarding efficiency, safety, and economic viability. It has responded by adopting techniques that have been useful in other industries, such as quality management, lean production, and high reliability – although with limited, and all-too-often disappointing, results. The Resilient Health Care Network (RHCN) has worked since 2011 to facilitate the interaction and collaboration among practitioners and researchers interested in applying concepts from resilience engineering to health care and patient safety. This has met with considerable success, not least because the focus from the start was on developing concrete ways to complement a Safety-I perspective with a Safety-II perspective.

Building on previous volumes, Delivering Resilient Health Care presents documented experiences and practical guidance on how to bring Resilient Health Care into practice. It provides concrete advice on how to prepare a study, how to choose the right data, how to collect it, how to analyse the data, and how to interpret the results. This fourth book in the Resilient Healthcare series contains contributions from international experts in health care, organisational studies and patient safety, as well as resilience engineering.

This book provides a practical guide for delivering resilient healthcare, particularly for clinicians on the frontline of care unsure how to incorporate resilience into their everyday work, managers coordinating care, and for policymakers hoping to steer the system in the right direction. Other groups – patients, the media, and researchers – will also find much of interest here.

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.

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.

The complexity of today’s large organisations, businesses, and social institutions defeats management approaches based on monolithic thinking. Most industry and service organisations look at their performance either from a single perspective – productivity, quality, safety, etc. – or from different but separate perspectives that reside in organisational silos. Quality is treated separately from safety, which, again, is treated separately from productivity, and so on. While siloed thinking may be convenient in the short term, it fails to recognise that any specific perspective reveals only a part of what goes on. Yet it is essential to have a unified view of how an organisation functions effectively to manage changes and to ensure the organisation excels in what it does.

Synesis represents the mutually dependent set of priorities, perspectives, and practices that an organisation needs to carry out its activities as intended. It shows how to overcome the fragmentation in foci, scope, and time that characterises the dominant change management paradigms. This book is consequently not about productivity or quality or safety or reliability but about all of these together. It is about why it is necessary to think of them as a whole. And it is about how this can be done in practice.

The complexity of today’s large organisations, businesses, and social institutions defeats management approaches based on monolithic thinking. Most industry and service organisations look at their performance either from a single perspective – productivity, quality, safety, etc. – or from different but separate perspectives that reside in organisational silos. Quality is treated separately from safety, which, again, is treated separately from productivity, and so on. While siloed thinking may be convenient in the short term, it fails to recognise that any specific perspective reveals only a part of what goes on. Yet it is essential to have a unified view of how an organisation functions effectively to manage changes and to ensure the organisation excels in what it does.

Synesis represents the mutually dependent set of priorities, perspectives, and practices that an organisation needs to carry out its activities as intended. It shows how to overcome the fragmentation in foci, scope, and time that characterises the dominant change management paradigms. This book is consequently not about productivity or quality or safety or reliability but about all of these together. It is about why it is necessary to think of them as a whole. And it is about how this can be done in practice.

This book promotes an understanding of the purposeful muddling that health care workers rely on to be better able to function and operate in the multitude of complex ecosystems we call "health care."

The book argues the case for the importance of recognising and understanding muddling behaviours, practices and activities in order to create resilient care. The book demonstrates how resilient health care principles can enable managers as well as those on the frontlines to work more effectively towards interdisciplinary care by gaining a deeper understanding of real-world practices that manifest 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.

Primarily aimed at people who are directly involved in the running and improvement of health care systems, it provides practical guidance. It is also of direct interest to health care professionals in clinical and managerial positions as well as researchers.

Jeffrey Braithwaite is Founding Director of the Australian Institute of Health Innovation, Professor of Health Systems Research and Director of the Centre for Healthcare Resilience and Implementation Science, Macquarie University (Australia). His research examines the changing nature of complex health systems and he has received over 50 different national and international awards for his teaching and research.

Erik Hollnagel is Senior Professor of Patient Safety at Jönköping University (Sweden). He is a highly regarded international expert with significant contributions to a variety of fields ranging from nuclear power generation, aerospace and aviation to industry, transportation and, most notably, health care.

Garthe Hunte is a Clinical Professor and Emergency Physician holding multiple academic and clinical leadership appointments across Canada. His research programme centres around how safety is created in complex socio-technical systems, and in the application of resilience engineering in health care.