Resilient health care (2013)

Hollnagel, E., Braithwaite, J. & Wears, R. L. (Eds.),  (2013). Resilient health care. Farnham, UK: Ashgate.

Japanese translation: レジリエント・ヘルスケア 複雑適応システムを制御する. Tokyo: e-hon. (2016)

Health care is everywhere under tremendous pressure with regard to efficiency, safety, and economic viability – to say nothing of having to meet various political agendas – and has responded by eagerly adopting techniques that have been useful in other industries, such as quality management, lean production, and high reliability. This has on the whole been met with limited success because health care as a non-trivial and multifaceted system differs significantly from most traditional industries. In order to allow health care systems to perform as expected and required, it is necessary to have concepts and methods that are able to cope with this complexity. Resilience engineering provides that capacity because its focus is on a system’s overall ability to sustain required operations under both expected and unexpected conditions rather than on individual features or qualities. Resilience engineering’s unique approach emphasises the usefulness of performance variability, and that successes and failures have the same aetiology.

This book contains contributions from acknowledged international experts in health care, organisational studies and patient safety, as well as resilience engineering. Whereas current safety approaches primarily aim to reduce or eliminate the number of things that go wrong, Resilient Health Care aims to increase and improve the number of things that go right. Just as the WHO argues that health is more than the absence of illness, so does Resilient Health Care argue that safety is more than the absence of risk and accidents. This can be achieved by making use of the concrete experiences of resilience engineering, both conceptually (ways of thinking) and practically (ways of acting).


Preface: on the need for resilience in healthcare;

Section I Healthcare as a Multiple Stakeholder, Multiple System Enterprise:

Making healthcare resilient: from safety I to safety II, Erik Hollnagel;

Resilience, the second story, and progress on patient safety, Richard Cook;

Resilience and safety in healthcare: marriage or divorce?, René Amalberti;

What safety II might learn from the socio-cultural critique of safety I, Justin Waring;

Looking at success vs looking at failure: is quality safety? Is safety quality, Sam Sheps and Karen Cardiff;

Healthcare as a complex adaptive system, Jeffrey Braithwaite, Robyn Clay-Williams, Peter Nugus and Jennifer Plumb.

Section II The Locus of Resilience - Individuals, Groups, Systems:

Resilience in intensive care units: the HUG case, Jean Pariès, Nicolas Lot, Fanny Rome and Didier Tassaux; Investigating expertise, flexibility and resilience in socio-technical environments. A case study in robotic surgery, Anne-Sophie Nyssen and Adelaide Blavier;

Reconciling regulation and resilience in healthcare, Carl Macrae;

Re-structuring and the resilient organisation: implications for health care, Robyn Clay-Williams;

Relying on resilience: too much of a good thing?, Robert L. Wears and Charles A. Vincent;

Mindful organizing and resilient healthcare, Kathleen M. Sutcliffe and Karl E. Weick.

Section III The Nature and Practice of Resilient Health Care:

Separating resilience from success, Rollin J. Fairbanks, Shawna Perry, William Bond and Robert L. Wears;

Adaptation versus standardization in patient safety, Sheuwen Chuang;

The use of PROMS to promote patient empowerment and improve resilience in health care systems, Alessandra Gorini, Ketti Mazzocco and Gabriela Pravettoni;

Resilient health care, Rob Robson;

Safety-II thinking in action: ‘just in time’ information to support everyday activities, Robyn Clay-Williams and Jeffrey Braithwaite;

Mrs Jones can’t breathe: can a resilience framework help?, Patricia H. Strachan;

Epilogue how to make health care resilient, Erik Hollnagel, Jeffrey Braithwaite and Robert L. Wears;