Resilience engineering in healthcare: Moving from epistemology to theory and practice

Few studies have taken a whole system approach to engineering resilience in healthcare. Doing so involves challenges in operationalising and measuring concepts, developing interventions and assessing their impact at a systems level. In this paper we have outlined a newly funded programme of work to operationalise key resilience concepts, develop and implement interventions to increase resilience, develop metrics to assess their effects and to make recommendations about how the insights of resilience engineering can be harnessed to improve patient safety. The results will provide evidence about the implementation and impact of four complex interventions in the areas of learning, responding, monitoring and anticipating, both singly and in combination, allowing future resilience interventions to be chosen based on knowledge of their effectiveness. The study will also yield an in depth picture of resilience engineering in action to inform the development of theory and the maturation of the approach.