Resilient Health Care, Volume 3 : Reconciling Work-as-Imagined and Work-as-Done book cover
1st Edition

Resilient Health Care, Volume 3
Reconciling Work-as-Imagined and Work-as-Done

ISBN 9781498780568
Published August 25, 2016 by CRC Press
236 Pages 11 B/W Illustrations

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Book Description

This book is the 3rd volume in the Resilient Health Care series. Resilient health care is a product of both the policy and managerial efforts to organize, fund and improve services, and the clinical care which is delivered directly to patients. This volume continues the lines of thought in the first two books. Where the first volume provided the rationale and basic concepts of RHC and the second teased out the everyday clinical activities which adjust and vary to create safe care, this book will look more closely at the connections between the sharp and blunt ends. Doing so will break new ground, since the systematic study in patient safety to date with few exceptions has been limited.

Table of Contents

Preface; Editors; Contributors; Prologue: Why Do Our Expectations of How Work Should Be Done; Never Correspond Exactly to How Work Is Done? Towards a Resilient and Lean Health Care; The Jack Spratt Problem: The Potential Downside of Lean Application in Health Care – A Threat to Safety II; Recovery to Resilience: A Patient Perspective; Is System Resilience Maintained at the Expense of Individual Resilience? Challenges in Implementing Resilient Health Care; Exploring Ways to Capture and Facilitate Work-as-Done That Interact with Health Information Technology; Resilience Work-as-Done in Everyday Clinical Work; Understanding Resilient Clinical Practices in Emergency Department Ecosystems; Reporting and Learning: From Extraordinary to Ordinary; Reflections on Resilience: Repertoires and System Features; Power and Resilience in Practice: Fitting a ‘Square Peg in a Round Hole’ in Everyday Clinical Work; Modelling Resilience and Researching the Gap between Work-as-Imagined and Work-as-Done; Simulation: Closing the Gap between Work-as-Imagined and Work-as-Done; Realigning Work-as-Imagined and Work-as-Done: Can Training Help? Resilient Procedures: Oxymoron or Innovation? Conclusion: Pathways Towards Reconciling WAI and WAD; References; Index

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Jeffrey Braithwaite, BA, MIR (Hons), MBA, DipLR, PhD, FAIM, FCHSM,

FFPHRCP (UK), FAcSS (UK), is foundation director, Australian Institute

of Health Innovation; director, Centre for Healthcare Resilience and

Implementation Science; and professor of health systems research, Faculty

of Medicine and Health Sciences, Macquarie University, Australia. His

research examines the changing nature of health systems, attracting funding

of more than AU$85 million (€54 million, £42 million). He has contributed

over 600 total publications and presented at international and national

conferences on more than 800 occasions, including 80 keynote addresses.

His research appears in journals such as the British Medical Journal, The Lancet,

Social Science and Medicine, BMJ Quality and Safety and the International Journal

of Quality in Health Care. He has received numerous national and international

awards for his teaching and research. Further details are available at

his Wikipedia entry: He

blogs at


Robert L. Wears, MD, PhD, MS, is an emergency physician, professor of

emergency medicine at the University of Florida and visiting professor in

the Clinical Safety Research Unit at Imperial College London. His further

training includes a master’s degree in computer science, a 1-year research

sabbatical focused on psychology and human factors in safety at the Imperial

College, followed by a PhD in industrial safety from Mines ParisTech (Ecole

Nationale Supérieure des Mines de Paris). He serves on the board of directors

of the Emergency Medicine Patient Safety Foundation, and multiple

editorial boards, including Annals of Emergency Medicine, Human Factors and


"This book pushes the boundaries of patient safety science and is essential reading for all those interested in creating better, safer, health systems."
—Russell Mannion, University of Birmingham, United Kingdom

"I really like the highly international nature of the chapter authorship and also the way in which chapters blended together both a resilience engineering prism and an organizational behavior perspective, which is unusual and encouraging."
Ewan Ferlie, King’s College London, United Kingdom

"The book justifies an important shift in perspective: from the ‘find-and-fix’ approach that focuses on where the system is not working to a more positive focus on how things do work and how we can learn from models of good practice."
— Trisha Greenhalgh, University of Oxford, United Kingdom

"This book builds a much needed bridge over the gap between our plans for care and the reality of practice. It makes a valuable contribution to the RHC series. As the final installment of the trilogy of books on this topic it offers a range of perspectives and challenges to thinking on this topic that will be of interest to students and practitioners interested in health care improvement and re-design."
Catherine Pope, University of Southampton, United Kingdom

"The change of perspective from Safety I to Safety II is a major breakthrough in thinking about patient safety, emphasizing the complex and dynamic interactions that characterize much healthcare practices. Putting the relation between ‘work-as-imagined’ and ‘work-as-done’ center stage, this book adds to those critical insights by offering tools (and re-analyzing existing ones) that help both scholars and practitioners in researching and designing safer healthcare systems."
— Roland Bal, Erasmus University Rotterdam, Netherlands