Resilience skills as emergent phenomena: A study of emergency departments in Brazil and the United States

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 ans...

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Bibliographic Details
Published in:Applied ergonomics 2016-09, Vol.56, p.227-237
Main Authors: Wachs, Priscila, Saurin, Tarcisio Abreu, Righi, Angela Weber, Wears, Robert Lewis
Format: Article
Language:English
Subjects:
Adaptability
Brazil
Case studies
Complexity
Cooperative Behavior
Emergency department
Emergency Service, Hospital
Emergency services
Health Personnel - psychology
Humans
Interviews as Topic
Models, Psychological
Observation
Resilience engineering
Resilience skills
Resilience, Psychological
Skills
Surveys and Questionnaires
United States
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Summary: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. •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.
ISSN:0003-6870
1872-9126
DOI:10.1016/j.apergo.2016.02.012