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.
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.
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 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.
Drawing on the knowledge and experiences of world-renowned scientists and healthcare professionals, this important book brings together academic, medical and health systems accounts of the impact of applying qualitative research methods to transform healthcare behaviours, systems and services. It demonstrates the translation of tried-and-tested and new interventions into high-quality care delivery, improved patient pathways, and enhanced systems management. It melds social theory, health systems analysis and research methods to address real-life healthcare issues in a rich and realistic fashion. The systems and services examined include those affecting patient care and patient and professional wellbeing, and the roles and responsibilities of people providing and receiving care. Some chapters delve deeply into the human psyche, examining the very private face of health and illness. Others concentrate on public health and how people’s needs can be met through health promotion and new investments. From real-time case studies to narratives on illness to theories of change, there is something here for everybody. Transforming health systems needs ingenuity – and the drive of individuals, the staying power of systems and above all the involvement of patients. Full of novel ideas and innovative solutions from around the world, all underpinned by qualitative methods and methodologies, this book is a key contribution for advanced students, practitioners and academics interested in health services research, research methods and the sociology of health and illness.
Operational Framework for Building Climate Resilient Health Systems
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.
Empowering Resilience addresses a critical area of concern for all individuals, governments, and non-government organizations involved in international peace building and economic development: the rebuilding of health care systems in countries emerging from civil conflict. Professor Aaron G. Buseh sets a broad context for improving health care delivery in war-impacted African countries by presenting a clear and concise historical overview of Liberia, including it's political, economic, and cultural factors that led to social upheaval. Through understanding the organization, financing, and delivery of health care in Liberia, readers will be able to appreciate the analysis of the pre-war root causes of the civil conflict and a poorly functional pre-war health care system that Buseh effectively investigates. With a convincing argument, Buseh offers a strategic vision for reforming and reorganizing Liberia's health care system. A book that breaches many concerns steadily rising in today's society, Empowering Resilience is devoted to contributing to political stability by capitalizing on the resilience of the Liberian people who endured the civil conflict.
Underuse of health systems and a lack of confidence in their quality contribute to high rates of mortality in the developing world. How individuals perceive health systems may be especially critical during epidemics, when they choose whether to cooperate with response efforts and frontline health workers. Can improving the perceived quality of healthcare promote community health and ultimately, help to contain epidemics? We leverage a field experiment to answer this question in the context of Sierra Leone and the 2014 West Africa Ebola crisis. Two years before the outbreak, we randomly assigned two accountability interventions to government-run health clinics –- one focused on community monitoring and the other conferred non-financial awards to clinic staff. These interventions delivered immediate benefits under "normal" conditions. Even prior to the Ebola crisis, both interventions increased clinic utilization and satisfaction with healthcare, and community monitoring additionally improved child health, leading to 38 percent fewer deaths of children under five. Later, during the crisis, the interventions also increased reporting of Ebola cases by 62 percent, and significantly reduced Ebola-related deaths. Evidence on mechanisms suggests that the interventions improved confidence in the health system, encouraging patients to report Ebola symptoms and receive medical care. These results indicate that promoting accountability not only has the power to improve health systems during normal times, but can also make them more resilient to crises that emerge over the longer run.
The Role of Research in the Delivery of Legal Services