Catálogo de publicaciones - libros

Resilience has become an important topic on the safety research agenda and in organizational practice. In this chapter we give an introduction to the research area and some of the current challenges, before we present the aim of the book.

This chapter contributes to current research on resilience by considering two aspects of this topic. The first describes the popularity of resilience as a product of a shift of era which creates a degree of uncertainty about the future in several domains of concern in a globalised context, and how this notion has also travelled in the field of safety. The second part addresses the cognitive, institutional, methodological, empirical and theoretical challenges of interdisciplinary multilevel safety research.

When and where does resilience happen? This is one of the most fundamental issues in the theory and practice of resilience in complex systems. Is resilience primarily a reactive or a proactive organisational property? Does it emerge locally and rapidly, or over longer time periods and at larger scales? This chapter develops a framework that seeks to characterise how resilience unfolds at three different scales of organisational activity: situated, structural and systemic. This analysis highlights the importance of understanding how locally situated activities of adjustment and recovery can trigger more generalised structural reforms, and how these might support wide-ranging systemic reconfigurations across entire industries. This analysis draws on practical examples from aviation, healthcare and finance.

Current approaches to quality improvement rely on the identification of past problems through incident reporting and audits or the use of Lean principles to eliminate waste, to identify how to improve quality. In contrast, Resilience Engineering (RE) is based on insights from complexity science, and quality results from clinicians’ ability to adapt safely to difficult situations, such as a surge in patient numbers, missing equipment or difficult unforeseen physiological problems. Progress in applying these insights to improve quality has been slow, despite the theoretical developments. In this chapter we describe a study in the Emergency Department of a large hospital in which we used RE principles to identify opportunities for quality improvement interventions. In depth observational fieldwork and interviews with clinicians were used to gather data about the key challenges faced, the misalignments between demand and capacity, adaptations that were required, and the four resilience abilities: responding, monitoring, anticipating and learning. Data were transcribed and used to write extended resilience narratives describing the work system. The narratives were analysed thematically using a combined deductive/inductive approach. A structured process was then used to identify potential interventions to improve quality. We describe one intervention to improve monitoring of patient flow and organisational learning about patient flow interventions. The approach we describe is challenging and requires close collaboration with clinicians to ensure accurate results. We found that using RE principles to improve quality is feasible and results in a focus on strengthening processes and supporting the challenges that clinicians face in their daily work.

This chapter begins with a commentary on resilience as the meta-concept for organizational preparedness for disruptive events, and the factors that influence the implementation of a resilience agenda. This is followed by an analysis of resilience in the special context of essential public infrastructure wherein priority is given to reliability and continuity of service, and interdependencies between infrastructures must be dealt with. The resilience agenda of a major public water supply system is then presented to illustrate the broad range of initiatives needed to ensure its resilience. Finally, policy issues are discussed regarding adaptations of resilience to meet concerns about security and sustainability.

The concept of resilience has spread widely in recent years and is broadly used to examine the dynamic response of critical sectors to disruptions. Resilience is frequently associated with the ability of a system to return to normal operational conditions subsequent to a shock event. Numerous definitions of resilience have been introduced and measures of resilience developed. Yet, the existing literature shows a lack of agreement in operationalising resilience. This chapter expresses resilience in relation to systems performance and levels of service. As people at all levels of an organisation play a significant role on creating (or not) resilience, the human contribution to the resilience of critical infrastructure is discussed. Here, the four resilience cornerstones, i.e., knowing what to do, look for, expect, and has happened, help structure the discussion. This standpoint is found to support a robust operationalisation of resilience.

This chapter looks at resilience from the descriptions of organizational strategies and practices in a regional airline operating regular commercial flights at short runway airports. Like many organizations facing environmental changes and intensive operational demands, the airline faces cascades of disturbances and friction in putting plans into place, requiring the ability to extend performance. This study demonstrates that different types of resilience exist and that precursor resilience is more about the organizational expansion of expectancies than individuals or groups managing the unexpected. This clarification adds depth to the understanding of resilience in aviation and similar organizational contexts, and the chapter takes issue in discussing how resilience varies and is different according to level in organizations or systems, place, time, resources, and competencies. This extends ongoing research efforts identifying specific types of resilience and their requirements based on a closer grounding of the concept in empirical studies.

This chapter focuses on organizations’ ability to change between different modes of operation as a key adaptive capacity that fosters resilience. Four modes are described which represent responses to low versus high demands on stability and flexibility respectively. The operational requirements for leaders both in enacting the different modes of operation and in instigating switches between the modes are detailed. Strategic recommendations are outlined that should help organizations to build the needed leadership abilities and to support organizational change towards better handling fundamental tensions and trade-offs embedded in the requirement to stay in control while facing unexpected uncertainties.

Descriptions of new safety management tools or suggestions for modifying existing tools on the basis of the principles of the Resilience Engineering paradigm are rare. This chapter introduces an evaluation checklist for adaptive safety management that can be used in analyzing the influence of safety management tools on resilience. Three commonly used safety management tools are inspected from the Resilience Engineering perspective to understand how they can be utilized for enhancing resilience in safety-critical organizations. The chapter concludes that the traditional tools of safety management focus heavily on constraining activity, but they do have a positive influence on the system’s general adaptive capacity. This effect is often unintentional, but the tools can also be used intentionally for this purpose, which requires becoming aware of both the direct and the indirect effects of the existing methods.

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 is described as a set of cognitive and behavioral strategies of individuals who enact resilience within an organizational context. The characteristics represented should be seen as examples of how resilience is described in the applied health care research, thus informing possible operationalization of resilience.