Qualitative findings from a pilot stage implementation of a novel organizational learning tool toward operationalizing the Safety-II paradigm in health care

Hegde, Sudeep; Hettinger, A. Zachary; Fairbanks, Rollin J.; Wreathall, John; Krevat, Seth; Jackson, C. Loring; Bisantz, Ann M.

doi:10.1016/j.apergo.2019.102913

Cited by 30 publications

(35 citation statements)

References 23 publications

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“…The tool was validated and revised based on feedback from clinicians, resulting in a version customised for anaesthesia residents. RETIPS has been developed to operationalise the Safety-II paradigm by learning how things go well in everyday clinical work [80].…”

Section: Conceptualisation Of Rhcmentioning

confidence: 99%

Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience

Iflaifel

Lim

Ryan

et al. 2020

BMC Health Serv Res

126

124

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Background: Traditional approaches to safety management in health care have focused primarily on counting errors and understanding how things go wrong. Resilient Health Care (RHC) provides an alternative complementary perspective of learning from incidents and understanding how, most of the time, work is safe. The aim of this review was to identify how RHC is conceptualised, described and interpreted in the published literature, to describe the methods used to study RHC, and to identify factors that develop RHC. Methods: Electronic searches of PubMed, Scopus and Cochrane databases were performed to identify relevant peer-reviewed studies, and a hand search undertaken for studies published in books that explained how RHC as a concept has been interpreted, what methods have been used to study it, and what factors have been important to its development. Studies were evaluated independently by two researchers. Data was synthesised using a thematic approach. Results: Thirty-six studies were included; they shared similar descriptions of RHC which was the ability to adjust its functioning prior to, during, or following events and thereby sustain required operations under both expected and unexpected conditions. Qualitative methods were mainly used to study RHC. Two types of data sources have been used: direct (e.g. focus groups and surveys) and indirect (e.g. observations and simulations) data sources. Most of the tools for studying RHC were developed based on predefined resilient constructs and have been categorised into three categories: performance variability and Work As Done, cornerstone capabilities for resilience, and integration with other safety management paradigms. Tools for studying RHC currently exist but have yet to be fully implemented. Effective team relationships, trade-offs and health care 'resilience' training of health care professionals were factors used to develop RHC. Conclusions: Although there was consistency in the conceptualisation of RHC, methods used to study and the factors used to develop it, several questions remain to be answered before a gold standard strategy for studying RHC can confidently be identified. These include operationalising RHC assessment methods in multi-level and diverse settings and developing, testing and evaluating interventions to address the wider safety implications of RHC amidst organisational and institutional change.

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Section: Conceptualisation Of Rhcmentioning

confidence: 99%

Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience

Iflaifel

Lim

Ryan

et al. 2020

BMC Health Serv Res

126

124

View full text Add to dashboard Cite

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“… 25 The government could contribute to this shift in focus by instructing the CGs to actively reflect on and communicate positive experiences from and smart adaptations in hospital practice. We therefore recommend further research to investigate how resources, success factors, and challenges 48 could be included in supervision reports to better inform hospital improvement work in a resilience perspective.…”

Section: Discussionmentioning

confidence: 99%

Investigating Hospital Supervision: A Case Study of Regulatory Inspectors’ Roles as Potential Co-creators of Resilience

et al. 2021

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Objectives The aim of this study was to explore if, and in what ways, there has been changes in the supervisory approach toward Norwegian hospitals due to the implementation of a new management and quality improvement regulation (Regulation on Management and Quality Improvement in the Healthcare Services, hereinafter referred to as “Quality Improvement Regulation”). Moreover, we aimed to understand how inspectors’ work promotes or hampers resilience potentials of adaptive capacity and learning in hospitals. Methods The study design is a case study of implementation and impact of the Quality Improvement Regulation. We performed a document analysis, and conducted and analyzed 3 focus groups and 2 individual interviews with regulatory inspectors, recruited from 3 county governor offices who are responsible for implementation and supervision of the Quality Improvement Regulation in Norwegian regions. Results Data analysis resulted in 5 themes. Informants described no substantial change in their approach owing to the Quality Improvement Regulation. Regardless, data pointed to a development in their practices and expectations. Although the Norwegian Board of Health Supervision, at the national level, occasionally provides guidance, supervision is adapted to specific contexts and inspectors balance trade-offs. Informants expressed concern about the impact of supervision on hospital performance. Benefits and disadvantage with positive feedback from inspectors were debated. Inspectors could nurture learning by improving their follow-up and add more hospital self-assessment. Conclusions A nondetailed regulatory framework such as the Quality Improvement Regulation provides hospitals with room to maneuver, and self-assessment might reduce resource demands. The impact of supervision is scarce with an unfulfilled potential to learn from supervision. The Government could contribute to a shift in focus by instructing the county governors to actively reflect on and communicate positive experiences from, and smart adaptations in, hospital practice.

show abstract

Section: Discussionmentioning

confidence: 99%

Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience.

Iflaifel

Lim

Ryan

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Traditional approaches to safety management in health care have focused primarily on counting errors and understanding how things go wrong. Resilient Health Care (RHC) provides an alternative complementary perspective of learning from incidents and understanding how, most of the time, work is safe. The aim of this review was to identify how RHC is conceptualised, described and interpreted in the published literature, to describe the methods used to study RHC, and to identify factors that develop RHC.Methods Electronic searches of PubMed, Scopus and Cochrane databases were performed to identify relevant peer-reviewed studies, and a hand search undertaken for studies published in books that explained how RHC as a concept has been interpreted, what methods have been used to study it, and what factors have been important to its development. Studies were evaluated independently by two researchers. Data was synthesised using a thematic approach.Results Thirty-six studies were included; they shared similar descriptions of RHC which was the ability to adjust its functioning prior to, during, or following events and thereby sustain required operations under both expected and unexpected conditions. Qualitative methods were mainly used to study RHC. Two types of data sources have been used: direct (e.g. focus groups and surveys) and indirect (e.g. observations and simulations) data sources. Most of the tools for studying RHC were developed based on predefined resilient constructs and have been categorised into three categories: performance variability and Work As Done, cornerstone capabilities for resilience, and integration with other safety management paradigms. Tools for studying RHC currently exist but have yet to be fully implemented. Effective team relationships, trade-offs and health care ‘resilience’ training of health care professionals were factors used to develop RHC. Conclusions Although there was consistency in the conceptualisation of RHC, methods used to study and the factors used to develop it, several questions remain to be answered before a gold standard strategy for studying RHC can confidently be identified. These include operationalising RHC assessment methods in multi-level and diverse settings and developing, testing and evaluating interventions to address the wider safety implications of RHC amidst organisational and institutional change.

show abstract

Qualitative findings from a pilot stage implementation of a novel organizational learning tool toward operationalizing the Safety-II paradigm in health care

Cited by 30 publications

References 23 publications

Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience

Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience

Investigating Hospital Supervision: A Case Study of Regulatory Inspectors’ Roles as Potential Co-creators of Resilience

Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience.

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