Reliability versus Resilience: What Does Healthcare Need?

2007 ◽  
Vol 51 (11) ◽  
pp. 621-625 ◽  
Author(s):  
Christopher Nemeth ◽  
Richard Cook
Keyword(s):  
Systems Engineering ◽  
Service Sector ◽  
High Reliability ◽  
Healthcare Systems ◽  
High Variability ◽  
High Reliability Organizations ◽  
Resilience Engineering ◽  
Cognitive Systems Engineering ◽  
Extensive Training ◽  
Healthcare Need

System performance in healthcare pivots on the ability to match demand for care with the resources that are needed to provide it. High reliability is desirable in organizations that perform inherently hazardous, highly technical tasks. However, healthcare's high variability, diversity, partition between workers and managers, and production pressure make it difficult to employ essential aspects of high reliability organizations (HROs) such as redundancy and extensive training. A different approach is needed to understand the nature of healthcare systems and their ability to perform and survive under duress; in other words, to be resilient. The recent evolution of resilience engineering affords the opportunity to configure healthcare systems so that they are adaptable and can foresee challenges that threaten their mission. Information technology (IT) in particular can enable healthcare, as a service sector, to adapt successfully, as long as it is based on cognitive systems engineering approaches to achieve resilient performance.

Manage Everything or Anything? Possible Ways Towards Generic Emergency Management Capabilities

2015 ◽  
Vol 10 (2) ◽  
pp. 246-251 ◽  
Author(s):  
Jonas Borell ◽  
Keyword(s):  
Information Processing ◽  
Emergency Management ◽  
High Reliability ◽  
High Reliability Organizations ◽  
Abstract Concepts ◽  
Resilience Engineering ◽  
Paper Briefly ◽  
Semantic Hierarchies ◽  
High Level ◽  
Management Capabilities

This paper explores two approaches to information processing and learning in societal safety efforts: (1) stressing specifics and (2) aiming at generalities. It discusses how the two approaches are related to each other and to high-level efforts to achieve societal safety. As background, this paper briefly explores the concept of generic capability – what is it? How is it to be understood? How can it be developed? – and relates it to the interplay between specifics and generalities. The paper gives examples of the factors that may contribute to generic capabilities represented in literature related to safety and emergency management. Examples from continuity management, resilience engineering and high reliability organizations are given and discussed concerning their focus on specifics and/or generalities. The paper also discusses scenario-based learning and the perspective of semantic hierarchies, which explains how a move to more abstract concepts, encompassing the main meaning of more concrete instances, may support the development of generic capability. It ends with a summary and suggestions for practice and the need for further research.

Are Public Bureaucracies Supposed to Be High Reliability Organizations?

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Wolfgang Seibel
Keyword(s):  
Child Protection ◽  
Organization Theory ◽  
Goal Attainment ◽  
High Reliability ◽  
Human Action ◽  
High Reliability Organizations ◽  
Fine Grained ◽  
Trade Offs ◽  
Public Bureaucracy ◽  
Account Standard

This article addresses the question of to what extent conventional theories of high reliability organizations and normal accidents theory are applicable to public bureaucracy. Empirical evidence suggests precisely this. Relevant cases are, for instance, collapsing buildings and bridges due to insufficient supervision of engineering by the relevant authorities, infants dying at the hands of their own parents due to misperceptions and neglect on the part of child protection agencies, uninterrupted serial killings due to a lack of coordination among police services, or improper planning and risk assessment in the preparation of mass events such as soccer games or street parades. The basic argument is that conceptualizing distinct and differentiated causal mechanisms is useful for developing more fine-grained variants of both normal accident theory and high reliability organization theory that take into account standard pathologies of public bureaucracies and inevitable trade-offs connected to their political embeddedness in democratic and rule-of-law-based systems to which belong the tensions between responsiveness and responsibility and between goal attainment and system maintenance. This, the article argues, makes it possible to identify distinct points of intervention at which permissive conditions with the potential to trigger risk-generating human action can be neutralized while the threshold that separates risk-generating human action from actual disaster can be raised to a level that makes disastrous outcomes less probable.

scholarly journals Veränderte Kompetenzanforderungen an Mitarbeitende infolge zunehmender Automatisierung – Eine Arbeitsfeldbetrachtung

2021 ◽  
Author(s):  
Michèle Rieth ◽  
Vera Hagemann
Keyword(s):  
High Reliability ◽  
High Reliability Organizations ◽  
High Reliability Organization

ZusammenfassungBasierend auf einer Arbeitsfeldbetrachtung im Bereich der Flugsicherung in Österreich und der Schweiz liefert dieser Artikel der Zeitschrift Gruppe. Interaktion. Organisation. (GIO) einen Überblick über automatisierungsbedingte Veränderungen und die daraus resultierenden neuen Kompetenzanforderungen an die Beschäftigten im Hochverantwortungsbereich. Bestehende Tätigkeitsstrukturen und Arbeitsrollen verändern sich infolge zunehmender Automatisierung grundlegend, sodass Organisationen neuen Herausforderungen gegenüberstehen und sich neue Kompetenzanforderungen an Mitarbeitende ergeben. Auf Grundlage von 9 problemzentrierten Interviews mit Fluglotsen sowie 4 problemzentrierten Interviews mit Piloten werden die Veränderungen infolge zunehmender Automatisierung und die daraus resultierenden neuen Kompetenzanforderungen an die Beschäftigten in einer High Reliability Organization dargestellt. Dieser Organisationskontext blieb bisher in der wissenschaftlichen Debatte um neue Kompetenzen infolge von Automatisierung weitestgehend unberücksichtigt. Die Ergebnisse deuten darauf hin, dass der Mensch in High Reliability Organizations durch Technik zwar entlastet und unterstützt werden kann, aber nicht zu ersetzen ist. Die Rolle des Menschen wird im Sinne eines Systemüberwachenden passiver, wodurch die Gefahr eines Fähigkeitsverlustes resultiert und der eigene Einfluss der Beschäftigten abnimmt. Ferner scheinen die Anforderungen, denen sie sich infolge zunehmender Automatisierung gegenüberstehen sehen, zuzunehmen, was in einem Spannungsfeld zu ihrer passiven Rolle zu stehen scheint. Die Erkenntnisse werden diskutiert und praktische Implikationen für das Kompetenzmanagement und die Arbeitsgestaltung zur Minimierung der identifizierten restriktiven Arbeitsbedingungen abgeleitet.

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