Page - 134 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners

Resilient Health Care: A Determinant Robyn CLAY-WILLIAMSa,1 and Jeffrey BRAITHWAITE a a Macquarie University, Sydney Australia Abstract. This chapter presents an overview of Resilient Health Care (RHC), introducing two aspects of RHC that are important for designing sustainable digital health systems and for considering implementation outcomes: (1) understanding how normal variation in everyday work can affect implementation of digital health interventions, and (2) the role of information systems in coping with unexpected events. The importance of considering how variation in everyday work can lead to wanted and unwanted outcomes when designing information systems is illustrated through a case study of implementation of a telehealth intervention. We examine how normal variation in everyday work can lead to both safety and error, and discuss how consideration of system resilience when designing and implementing health informatics applications can contribute to improving safety for patients in the future. How health information systems can assist organisations in coping with the unexpected is illustrated through a second case study, of a thunderstorm asthma event in Melbourne, Australia. We briefly present the thunderstorm asthma case, and discuss the role of healthcare informatics in preparing for future unexpected events affecting population health. Keywords. Resilient Health Care, Patient Safety, Complex Adaptive System, Safety-I, Safety-II Learning objectives After reading this chapter the reader will: 1. Understand the background to Resilient Health Care (RHC) and its historical antecedents. 2. Appreciate the main currents and selected underlying concepts in the field, including Safety-I and Safety-II; and Work-as-Imagined and Work-as-Done. 3. Apply knowledge about RHC to current research-based or practice-based problems in health informatics. 4. Analyse health informatics problems in a frame that offers a more positive vision of how safe, effective care can be delivered in complex, dynamic health settings. 5. Consider normal variation in everyday work when designing or implementing health informatics systems. 1 Corresponding Author, Robyn Clay-Williams, E-mail: robyn.clay-williams@mq.edu.au Framework for Understanding Variation in Everyday Work and Designing Sustainable Digital Health Systems Applied Interdisciplinary Theory in Health Informatics P. Scott et al. (Eds.) © 2019 The authors and IOS Press. This article is published online with Open Access by IOS Press and distributed under the terms of the Creative Commons Attribution Non-Commercial License 4.0 (CC BY-NC 4.0). doi:10.3233/SHTI190118 134