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Resilience and precarious success

Published on Sep 1, 2015in Reliability Engineering & System Safety4.04
· DOI :10.1016/j.ress.2015.03.014
Mary Patterson9
Estimated H-index: 9
(NEOMED: Northeast Ohio Medical University),
Robert L. Wears48
Estimated H-index: 48
(UF: University of Florida)
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Abstract
Abstract This paper presents an empirical case study to illustrate, corroborate, and perhaps extend some key generalizations about resilient performance in complex adaptive systems. The setting is a pediatric hematology/oncology pharmacy, a complex system embedded in the larger complex of the hospital, which provides chemotherapy and other high risk medications to children with cancer, sickle cell disease and autoimmune disorders. Recently the demands placed on this system have dramatically intensified while the resources allocated to the system have remained static. We describe the adaptations of this system in response to this additional stress. In addition, we discuss the risks associated with miscalibration about the system׳s adaptive capacity, and the tradeoff between the need to invest in adaptive capacity (to sustain performance when the system is stressed) versus the need to invest in efficient production (to sustain performance under normal circumstances and economic pressures).
  • References (17)
  • Citations (14)
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References17
Newest
Published on Mar 1, 2014in Annals of Emergency Medicine5.21
Robert L. Wears48
Estimated H-index: 48
(Imperial College London),
A. Zachary Hettinger9
Estimated H-index: 9
(Georgetown University)
Published on Dec 1, 2013in BMJ Quality & Safety7.04
Michael W. Smith10
Estimated H-index: 10
,
Traber Davis Giardina13
Estimated H-index: 13
+ 2 AuthorsHardeep Singh41
Estimated H-index: 41
Objectives Systemic issues can adversely affect the diagnostic process. Many system-related barriers can be masked by ‘resilient’ actions of frontline providers (ie, actions supporting the safe delivery of care in the presence of pressures that the system cannot readily adapt to). We explored system barriers and resilient actions of primary care providers (PCPs) in the diagnostic evaluation of cancer. Methods We conducted a secondary data analysis of interviews of PCPs involved in diagnostic eva...
Published on Dec 1, 2013
Robert L. Wears48
Estimated H-index: 48
,
Charles Vincent73
Estimated H-index: 73
Published on Nov 1, 2011in IEEE Intelligent Systems4.46
Robert R. Hoffman24
Estimated H-index: 24
,
David Woods61
Estimated H-index: 61
(OSU: Ohio State University)
Articulating the laws of cognitive work has been a continuing theme in this department. A number of the articles represent an effort to move toward a unified theory of "macrocognitive work systems." These are complex adaptive systems designed to support near-continuous interdependencies among humans and intelligent machines to carry out functions such as sensemaking, replanning, mental projection to the future, and coordination. The effort to identify empirical generalizations and use them to co...
Published on Feb 28, 2011
Meir Finkel1
Estimated H-index: 1
This book addresses one of the basic questions in military studies: How can armies cope effectively with technological and doctrinal surprises-ones that leave them vulnerable to new weapons systems and/or combat doctrines? Author Meir Finkel contends that the current paradigm-with its over-dependence on intelligence and an all-out effort to predict the nature of the future battlefield and the enemy's capabilities-generally doesn't work. Based on historical case analysis of successful "under-fire...
Published on Feb 28, 2011
Sidney Dekker34
Estimated H-index: 34
What does the collapse of sub-prime lending have in common with a broken jackscrew in an airliner's tailplane? Or the oil spill disaster in the Gulf of Mexico with the burn-up of Space Shuttle Columbia? These were systems that drifted into failure. While pursuing success in a dynamic, complex environment with limited resources and multiple goal conflicts, a succession of small, everyday decisions eventually produced breakdowns on a massive scale. We have trouble grasping the complexity and norma...
Published on Nov 1, 2010in Annals of Emergency Medicine5.21
Robert L. Wears48
Estimated H-index: 48
(Imperial College London),
Richard I. Cook24
Estimated H-index: 24
(U of C: University of Chicago)
Published on Jul 1, 2010 in SMC (Systems, Man and Cybernetics)
David L. Alderson20
Estimated H-index: 20
,
John C. Doyle80
Estimated H-index: 80
(California Institute of Technology)
There exists a widely recognized need to better understand and manage complex “systems of systems,” ranging from biology, ecology, and medicine to network-centric technologies. This is motivating the search for universal laws of highly evolved systems and driving demand for new mathematics and methods that are consistent, integrative, and predictive. However, the theoretical frameworks available today are not merely fragmented but sometimes contradictory and incompatible. We argue that complexit...
Published on Jun 24, 2008
Paul R. Schulman13
Estimated H-index: 13
,
Emery Roe13
Estimated H-index: 13
Contents Acknowledgments 1. The Stakes Part One The Case Study: California Independent System Operator, 20012007 2. CAISO in 2001: The Electricity Crisis from Inside the Control Room 3. A Framework for High Reliability Management 4. Working in Practice but Not in Theory 5. CAISO in 2004: Control Room Reliability Endangered 6. CAISO in 20042006: New Challenges and Responses Part Two High Reliability Management: Key Concepts, Topics, and Issues 7. Error, Risk, and Bandwidth Management 8. Anticipat...
Published on Mar 27, 2006
David Woods61
Estimated H-index: 61
,
Erik Hollnagel41
Estimated H-index: 41
Preface CORE ACTIVITIES AND VALUES Adaptability versus Limits Complementarity Core Values of CSE in Practice On Systems in CSE Patterns Discovering Patterns in Joint Cognitive Systems at Work A JCS at Work: JOINT COGNITIVE SYSTEMS ADAPT TO COPE WITH COMPLEXITY Adaptation in Joint Cognitive Systems at work BEING BUMPABLE The Story: A Delay The Intensive Care Unit the Scene, the Cast, and BackDrop Coping with Complexity: Parceling out beds by the Bedmeister Artifacts as Tools: The Bed Book Prepari...
Cited By14
Newest
Published on Jan 1, 2020
Vivek Kant1
Estimated H-index: 1
(IITB: Indian Institute of Technology Bombay)
With the growth in new technologies, disparate sociotechnical systems, ranging from aviation to infrastructure, are rapidly getting interconnected. The scope, level and complexity of these novel sociotechnical systems present a renewed challenge for safety as a discipline. In this regard, in recent times, two major research traditions have emerged for addressing safety—high reliability organizations (HRO) and resilience engineering (RE). Both have emerged from different research traditions, have...
Published on Dec 1, 2019in Safety Science3.62
Jane O'Hara9
Estimated H-index: 9
(University of Leeds),
Carolyn Canfield (UBC: University of British Columbia), Karina Aase13
Estimated H-index: 13
(University of Stavanger)
Abstract Whilst interest in resilient healthcare (RHC) research has increased over the past five years, our understanding of the role of patients, families and carers in supporting system resilience remains limited (Berg et al., 2018; Laugaland and Aase, 2015). The extant empirical evidence for RHC has almost exclusively been undertaken from the perspective of staff. However, evidence is emerging suggesting that patients, families and carers impact on variability and outcomes within complex heal...
Published on Nov 1, 2019in Applied Ergonomics2.61
Dana Womack (OHSU: Oregon Health & Science University), Nancy N. Vuckovic + 3 AuthorsPaul N. Gorman29
Estimated H-index: 29
(OHSU: Oregon Health & Science University)
Abstract Through everyday care experiences, nurses develop expertise in recognition of capacity strain in hospital workplaces. Through qualitative interview, experienced nurses identify common activity changes and adaptive work strategies that may signal an imbalance between patient demand and service supply at the bedside. Activity change examples include nurse helping behaviors across patient assignments, increased volume of nurse calls from patient rooms, and decreased presence of staff at th...
Iacopo Rubbio (University of Palermo), Manfredi Bruccoleri15
Estimated H-index: 15
(University of Palermo)
+ 1 AuthorsBarbara Ragonese (ISMETT)
Purpose In the healthcare management domain, there is a lack of knowledge concerning the role of resilience practices in improving patient safety. The purpose of this paper is to understand the capabilities that enable healthcare resilience and how digital technologies can support these capabilities. Design/methodology/approach Within- and cross-case research methodology was used to study resilience mechanisms and capabilities in healthcare and to understand how digital health technologies impac...
Jiaxin Wu (UIUC: University of Illinois at Urbana–Champaign), Pingfeng Wang18
Estimated H-index: 18
(UIUC: University of Illinois at Urbana–Champaign)
Published on Jan 1, 2019
Siv Hilde Berg1
Estimated H-index: 1
(Stavanger University Hospital),
Karina Aase13
Estimated H-index: 13
(University of Stavanger)
The concept of resilience needs greater empirical clarity. The literature on resilience in health care, published between 2006 and 2016, was reviewed with the aim of describing resilient characteristics in empirical studies. The chapter documents resilient characteristics at the individual, team, management, and organizational level. The characteristics were related to four overall conceptual categories: anticipation, sensemaking, trade-offs and adaptation. Based on empirical accounts resilience...
Published on Dec 1, 2018in Safety Science3.62
Siv Hilde Berg1
Estimated H-index: 1
(Stavanger University Hospital),
Kristin Akerjordet11
Estimated H-index: 11
(University of Stavanger)
+ 1 AuthorsKarina Aase13
Estimated H-index: 13
(University of Stavanger)
Abstract Resilient healthcare research focuses on everyday clinical work and a system’s abilities to adopt or absorb disturbing conditions as opposed to risk management approaches, which are based on retrospective analyses of errors. After more than a decade of theoretical development and a large quantity of empirical work, the field of resilience is beginning to recognize the methodological challenges related to operationalizing and designing studies of complexity. This paper reviews a sample o...
Published on Dec 1, 2018in Environment Systems and Decisions
David Woods61
Estimated H-index: 61
(OSU: Ohio State University)
The paper introduces the theory of graceful extensibility which expresses fundamental characteristics of the adaptive universe that constrain the search for sustained adaptability. The theory explains the contrast between successful and unsuccessful cases of sustained adaptability for systems that serve human purposes. Sustained adaptability refers to the ability to continue to adapt to changing environments, stakeholders, demands, contexts, and constraints (in effect, to adapt how the system in...
Published on Aug 12, 2018in Complexity2.59
Luca Fraccascia6
Estimated H-index: 6
(UT: University of Twente),
Ilaria Giannoccaro15
Estimated H-index: 15
(IPN: Instituto Politécnico Nacional),
Vito Albino24
Estimated H-index: 24
(IPN: Instituto Politécnico Nacional)
This paper reviews the state of the art on the resilience of complex systems by embracing different research areas and using bibliometric tools. The aim is to identify the main intellectual communities and leading scholars and to synthesize key knowledge of each research area. We also carry out a comparison across the research areas, aimed at analyzing how resilience is approached in any field, how the topic evolved starting from the ecological field of study, and the level of cross-fertilizatio...
Ahmed Mebarki9
Estimated H-index: 9
(CNRS: Centre national de la recherche scientifique)
Abstract Resilience of industrial plants is addressed in the case of cylindrical metal tanks. They are considered as demonstrators in order to write explicitly and analytically their bearing capacity drops, their recovery functions by plastic adaptation and their resilience. For illustrative purposes, their behavior and the damages are investigated in the case of lateral loading that corresponds to tsunamis, floods or blasts effects. These key parameters are addressed in order to study the effec...
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