Abstract: Building and maintaining resilience in health care requires psychological and organizational attitudes that could be affected by the lack of worker well-being. Resilience requires the ability to give strong responses to weak signals, but, if well-being is threatened, workers are more committed to defend it, than detecting and monitoring weak signals in foresight. Malaise is a weak signal itself that, as well as leading to accidents due to fatigue, miscommunication, distraction, etc., blocks operators at a resource-saving cognitive level that prevents noticing and reporting further weak signals. We adopted the Skill-Rule-Knowledge model by Rasmussen as a framework to conceive resilience as continuous movement of workers along the three steps of the ladder. According to this model, we describe a research-intervention project carried out in a few Italian hospitals where trainees were enabled to develop a tool for detecting and monitoring malaise and threats to safety. Its potentials for reducing effects like distrust, resignation, cynicism, helplessness are discussed in light of a well-being-based resilience engineering.
Bracco, F., Bruno, A., & Sossai, D. (2011). Improving resilience through practitioners’ well-being: an experience in Italian health-care. In E., Hollnagel, E., Rigaud, & D., Besnard (eds.). Proceedings of the Fourth Symposium on Resilience Engineering, (pp. 43-49). Paris: Presses des Mines. PDF