Resilience Engineering for quality improvement

Abstract

This chapter describes a study of resilience in the Older Persons' Unit (OPU) of a large London teaching hospital in which they developed practical tools to study resilience and identify potential quality improvement initiatives. It reports initial results from the OPU site to illustrate how the author have used Resilience Engineering (RE) principles to inform quality improvement. Despite increasing interest in the principles of RE there is little guidance available for applying the ideas in practice in health care. The Concepts for Applying RE theoretical model was developed and used to design data collection instruments, analysis methods and interpretation of the data. Concepts from the RE literature were also identified: goal trade-offs, learning from what goes right and the four resilience abilities of responding, monitoring, anticipating and learning. The narratives coded with RE theoretical concepts were analysed to identify opportunities for improvement.