The purpose of the Resilient Health Care Initiative (RHCN) is to facilitate the interaction and collaboration among people who are interested in applying Resilience Engineering to health care – practitioners and researchers alike. This includes, but is not limited to, discussions (face-to-face, skype, or via other media); establishing a web presence; exchange of views, opinions, and ideas; mutual moral and scientific support; collaboration on papers and projects; exchange visits; and the organisation of various events ranging from local informal workshops to international summer schools.
The developments in safety thinking, in health care and elsewhere, can briefly be characterised by looking at two different interpretations of safety, called Safety-I and Safety-II, respectively.
The goals of Safety-I and Safety-II are in a way the same, namely that there are as few adverse events as possible. But whereas Safety-I tries to achieve this by eliminating what can go wrong, Safety-II tries to achieve it by facilitating everyday work, by improving its resilience and thereby ensure that as much as possible goes right. Another way of saying that is that Safety-I tries to get away from something, namely an unsafe state, while Safety-II tries to approach something, namely a safe state. When you try to get away from something, almost any direction will do. But if you try to approach something, only one direction will bring you closer.
A more detailed discussion of the background can be found in the book 'Resilient Health Care'.
It follows from the description of Safety II that the scope exceeds the traditional safety topics and concerns. The focus is not limited to what goes wrong, but includes what goes right. The focus is not just failures and cause-effect relations but everyday work and the functioning of the health care system as a whole. This means that all aspects of everyday work, as well as all that affects it, must be considered – from safety, productivity and quality to planning, policy, and politics. One good reason for that is that health care consumes a large part of a country’s economy. In 2008, the health care industry consumed an average of 9.0 percent of the gross domestic product (GDP) across the most developed OECD countries. The United States (16.0%), France (11.2%), and Switzerland (10.7%) were the top three spenders.
The ambition of the RHCN is to take a lead in applying resilience engineering to health care worldwide; to become a generally recognised source of expertise, academically as well as practically; and to become an incubator for ideas and methods that can improve the resilience of health care on all levels.
The needs, interests, and energy of the participants in the initiative will determine which concrete activities will be undertaken. The following suggestions can serve as a starting point:
The RHCN constitutes one of the activities in the Patient Safety Agenda of the Region of Southern Denmark. This partnership includes the hospitals in the Region of Southern Denmark, the Centre for Quality Improvement, the Faculty of Health Sciences and the Faculty of Social Sciences at the University of Southern Denmark.
The start-up of the RHCN has been managed by a Core Group.
As stated in the objectives, the purpose of this initiative is to try to make use of the resilience engineering principles in health care – and specifically to try to move from Safety I to Safety II. If you are interested in finding out more about what this entails, or even in helping to do that, you are encouraged to join the initiative. If you do so, we expect that you will not only follow what is going on but also take actively part. Your experience and your motivation will be important in determining how the RHCN is going to develop. In return you will have the opportunity to meet and interact with people who share your concerns, and to use as much time and energy as you want to engage in concrete activities.
What should you do if you want to become part of this?
The first part of the logo is a kanji that has been proposed to represent ‘resilience.’ It can be interpreted as ‘bouncing back’ or ‘ soft, and recoverable rapidly.’ The second part of the logo is, of course, the Rod of Asclepius, which represents medicine and healing.
The Resilient Health Care Net (RHCN) is a non-commercial collaboration of an international group of researchers and practitioners with the aim to apply Resilience Engineering principles in health care. The RHCN has no connection whatsoever with Resilient Healthcare LLC, despite the similarity of the names.
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