Working Across Boundaries

The book demonstrates how Resilient Health Care principles can enable those on the frontline to work more effectively towards interdisciplinary care by gaining a deeper understanding of the boundaries that exist in everyday clinical settings. This is done by presenting a set of case studies, theoretical chapters and applications that relate experiences, bring forth ideas and illustrate practical solutions. The chapters address many different issues such as resolving conflict, overcoming barriers to patient-flow management, and building connections through negotiation. They represent a range of approaches, rather than a single way of solving the practical problems, and have been written to serve both a scientific and an andragogical purpose. Working Across Boundaries is primarily aimed at people who are directly involved in the running and improvement of health care systems, providing them with practical guidance. It will also be of direct interest to health care professionals in clinical and managerial positions as well as researchers. - Presents the latest work of the lauded Resilient Health Care Net group, developing applications of Resilience Engineering to health care, furthering safety thinking and generating applicable solutions that will benefit patient safety worldwide - Enables health care professionals to become aware of the boundaries that affect their work so that they are able to use their strengths and overcome their weaknesses - Written from a Safety-II perspective, where the purpose is to make sure that as much as possible goes well and the focus therefore is on everyday work rather than on failures. There are at present no other books that adopt this perspective nor which go into the practical details - Provides a concise presentation of the state of resilient health care as a science, in terms of major theoretical issues and practical methods and techniques on the overarching and important topics of boundary-crossing and integration of care settings

Professor Jeffrey Braithwaite, BA, MIR (Hons), MBA, DipLR, PhD, FAIM, FCHSM, FFPHRCP(UK), FAcSS(UK), Hon FRACMA, FAHMS 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. He has appointments at six other Universities internationally, is a board member, and President Elect, of the International Society for Quality in Health Care (ISQua), and consultant to the WHO. His research examines the changing nature of health systems, attracting funding of over AUD$111 million. Professor Braithwaite has contributed over 450 refereed publications, and has presented at international and national conferences on more than 900 occasions, including 90 keynote addresses. His research appears in journals such as the British Medical Journal, The Lancet, Social Science & Medicine, BMJ Quality and Safety, Journal of the American Medical Association, BMC Medicine and International Journal of Quality in Health Care. He has received over 40 different national and international awards for his teaching and research. He is co-series editor of the resilient healthcare series. Erik Hollnagel MSc, PhD is Senior Professor of Patient Safety at Jönköping University (Sweden), Visiting Professor at the Centre for Healthcare Resilience and Implementation Science, Macquarie University Australia, and Professor Emeritus at the Department of Computer Science, University of Linköping, Sweden. He has through his career worked at universities, research centres, and industries in several countries, tackling problems in many domains including nuclear power generation, aerospace and aviation, software engineering, land-based traffic, and healthcare. His professional interests include industrial safety, resilience engineering, patient safety, accident investigation, and modelling large-scale socio-technical systems. He has published widely and is the author or editor of 24 books, including five books on resilience engineering, as well as a large number of papers and book chapters. The latest titles are "Safety-I and Safety-II: The past and future of safety management", "Resilient Health Care Vol 1"; "Resilient Health Care Volume 2: The Resilience of Everyday Clinical Work"; "Resilient Health Care Volume 3: Reconciling Work-as-Imagined and Work-as-Done"; "Resilient Health Care Volume 4: Delivering Resilient Health Care"; and "Safety-II in practice: Developing the resilience potentials.". Garth Hunte, MD, PhD, FCFP is a Clinical Professor and Emergency Physician at St. Paul's Hospital, a scientist at the Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, and the strategic lead for Patient Safety and System Resilience in Emergency Care in the Department of Emergency Medicine, University of British Columbia in Vancouver, Canada. His research program is centred around how safety is created in complex socio-technical systems, and in the application of resilience engineering in healthcare. He is actively involved in the Resilience Engineering Association and the Resilient Health Care Network, and was organizer and host of the 6th Resilient Health Care Meeting in Vancouver in 2017.

Part I: Openings. Introduction: The Journey to Here and What Happens Next. Bon Voyage: Navigating the Boundaries of Resilient Health Care. Part II: Negotiating Across Boundaries. Working Across Boundaries: Creating Value and Producing Safety in Health Care Using Empathetic Negotiation Skills. Untangling Conflict in Health Care. Part III: Theorising About Boundaries. 'Practical' Resilience: Misapplication of Theory?. Creating Resilience in Health Care Organisations through Various Forms of Shared Leadership. Simulation: A Tool to Detect and Traverse Boundaries. Part IV: Empiricising Boundaries. Looking Back Over the Boundaries of our Systems and Knowledge. Understanding Medication Dispensing as Done in Real World Settings - Combining Conceptual Models and an Empirical Approach. Resilient Frontline Management of the Operating Room Floor: The Role of Boundaries and Coordination. Patient Flow Management: Codified and Opportunistic Escalation Actions. Trust and Psychological Safety as Facilitators of Resilient Health Care. Collaborative Use of Slack Resources as a Support to Resilience: Study of a Maternity Ward. Resilient Performance in Acute Health Care: Implementation of an Intervention Across Care Boundaries. Part V: Closure. Discussion, Integration and Concluding Remarks

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