Resilience skills as emergent phenomena: A study of emergency departments in Brazil and the United States. (September 2016)

• Record Type: Journal Article
• Authors: Wachs, Priscila; Saurin, Tarcisio Abreu; Righi, Angela Weber; Wears, Robert Lewis
• Is Part Of: Applied ergonomics. Volume 56(2016:Sep.)
• Page Start: 227
• Page End: 237
• Publication Date: 2016-09
• Subjects: Resilience skills -- Resilience engineering -- Complexity -- Emergency department; Human engineering -- Periodicals; 620.82
• DOI: 10.1016/j.apergo.2016.02.012
• Languages: English
• ISSNs: 0003-6870

Abstract

Abstract: Although the use of resilience skills (RSs) by emergency department (ED) front-line staff is ubiquitous, the nature and origin of these skills tend to be taken for granted. This study investigates the research question "where do RSs come from"? Case studies in two EDs were undertaken in order to answer the research question: one in Brazil and the other in the United States. The case studies adopted the same data collection and analysis procedures, involving interviews, questionnaires, observations, and analysis of documents. A model for describing RSs as emergent phenomena is proposed. The model indicates that RSs arise from interactions between: work constraints, hidden curriculum, gaps in standardized operating procedures, organizational support for resilience, and RSs themselves. An instantiation of the model is illustrated by a critical event identified from the American ED. The model allows the identification of leverage points for influencing the development of RSs, instead of leaving their evolution purely to chance. Highlights: Resilience in two EDs is investigated. Origins of resilience skills (RSs). Model of RSs as emergent phenomena. Instantiation of the model. Factors that support or degrade RSs.