Resilience: The Calming Power of Proactive Care
How can hospital units organize themselves to outpace the tempo of deteriorating patient condition (or deteriorating patient experience)?
The answer is resilience. What makes a hospital unit resilient is being able to stay ahead of issues as they arise. In the illustration below that foresight corresponds to the flatter part of the slope.
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Hospital unit resilience comes from having a teamwork routine that (a) uses a quality-safety checklist to prevent predictable complications and (b) creates team accountability moments to help recognize and respond as early in the time-opportunity continuum as possible.
Most hospital units are brittle. If you’re working in a resilient hospital unit, you’d be able to recognize three complementary modes (see image) that create a proactive rather than a reactive care environment: (1) Foresight, (2) Coping, and (3) Recovery (Jeffcott et al 2009).
|Mode||Definition||How Great Teams Make it Happen|
|Foresight||Predicting and preventing adverse outcomes before they happen||Identify and mitigate risk-states using a quality-safety checklist which triggers best-practice protocols|
|Coping||Detecting and averting evolving adverse events before they become worse||– Collaborative cross-checks during rounds and face-to-face updates as condition changes|
– Revisions to diagnostic or treatment plan
– Transfers to a high level of care
|Recovery||Overcoming an adverse event once it has happened||– Call a Code MET or Raid-Response Team|
– Call a Code Blue
To learn more about resilience in healthcare, while earning CME and CE credits, please view the section “An Engineered System” in the Better Together masterclass (coming summer 2019).
- Jeffcott, S.A., Ibrahim, J.E. & Cameron, P.A., 2009. Resilience in healthcare and clinical handover. Quality and Safety in Health Care, 18, 256-260.