Advertisement

Analysing the Resilience of Hospitals’ Surge Procedures Using the Functional Resonance Analysis Method

  • Farhad Mahmoudi
  • Sherif MohamedEmail author
  • Fahim Tonmoy
Conference paper
  • 77 Downloads
Part of the Lecture Notes in Mechanical Engineering book series (LNME)

Abstract

Hospitals are a critical element of the healthcare system and their continuous function is highly important to the wellbeing of communities. In accordance with the criticality of their functional performance during disruptive events, several modelling and analysis approaches have been developed to investigate the extent of various aspects of hospitals’ vulnerability and resilience. However, these approaches fall short in addressing either the degree of absorption, adaptation and, in some cases, degradation of the hospital as a system before its fundamental breakdown or fail to differentiate their performance in normal conditions versus surge circumstances and protocols. In this paper, these issues were addressed via deployment of the Functional Resonance Analysis Method (FRAM) and a macro analysis of the interactions among hospital system functions under surge conditions. The use of FRAM as the modelling technique helps to address the extent of system adaptability to changes and explore the hidden impact of different functions on overall system performance. The modelling involved identification of surge functions and fulfilment of conditions for the functions generating the outcomes. The study identifies the limitations existing in hospital surge procedures and highlights the difference between work-as-imagined and work-as-done regarding hospital surge procedures.

Keywords

FRAM Hospital functional performance Resilience 

References

  1. Alm H, Woltjer R (2010) Patient safety investigation through the lens of FRAM. Human factors: a system view of human, technology and organisation. Maastricht, The Netherlands: Shaker Publishing, pp 53–65Google Scholar
  2. Clay-Williams R, Hounsgaard J, Hollnagel E (2015) Where the rubber meets the road: using FRAM to align work-as-imagined with work-as-done when implementing clinical guidelines. Implement Sci 10(1):125CrossRefGoogle Scholar
  3. Damen NL, de Vos MS, Moesker MJ, Braithwaite J, de Lind van Wijngaarden RAF, Kaplan J, Clay-Williams R (2018) Preoperative anticoagulation management in everyday clinical practice: an international comparative analysis of work-as-done using the functional resonance analysis method. J Patient SafGoogle Scholar
  4. Das P, Benneyan J, Powers L, Carmody M, Kerwin J, Singer S (2018) Engineering safer care coordination from hospital to home: lessons from the USA. Futur Hosp J 5(3):164–170CrossRefGoogle Scholar
  5. Furniss D, Curzon P, Blandford A (2016) Using FRAM beyond safety: a case study to explore how sociotechnical systems can flourish or stall. Theor Issue Ergon Sci 17(5–6):507–532 Google Scholar
  6. Hollnagel E (2004) Barriers and accident prevention. RoutledgeGoogle Scholar
  7. Hollnagel E (2012) An application of the functional resonance analysis method (FRAM) to risk assessment of organisational change (No. SSM–2013–09). Swedish Radiation Safety AuthorityGoogle Scholar
  8. Laugaland K, Aase K, Waring J (2014) Hospital discharge of the elderly-an observational case study of functions, variability and performance-shaping factors. BMC Health Serv Res 14(1):365CrossRefGoogle Scholar
  9. Macchi L (2010) A Resilience Engineering approach for the evaluation of performance variability: development and application of the functional resonance analysis method for air traffic management safety assessment. (Doctoral dissertation, École Nationale Supérieure des Mines de Paris)Google Scholar
  10. Morton MJ, DeAugustinis ML, Velasquez CA, Singh S, Kelen GD (2015) Developments in surge research priorities: a systematic review of the literature following the academic emergency medicine consensus conference, 2007–2015. Acad Emerg Med 22(11):1235–1252CrossRefGoogle Scholar
  11. Pickup L, Atkinson S, Hollnagel E, Bowie P, Gray S, Rawlinson S, Forrester K (2017) Blood sampling-two sides to the story. Appl Ergon 59:234–242CrossRefGoogle Scholar
  12. Raben DC, Bogh SB, Viskum B, Mikkelsen KL, Hollnagel E (2017) Proposing leading indicators for blood sampling: application of a method based on the principles of resilient healthcare. Cogn Technol Work 19(4):809–817CrossRefGoogle Scholar
  13. Raben DC, Viskum B, Mikkelsen KL, Hounsgaard J, Bogh SB, Hollnagel E (2018) Application of a non-linear model to understand healthcare processes: using the functional resonance analysis method on a case study of the early detection of sepsis. Reliab Eng Syst Saf 177:1–11CrossRefGoogle Scholar
  14. Ross A, Sherriff A, Kidd J, Gnich W, Anderson J, Deas L, Macpherson L (2018) A systems approach using the functional resonance analysis method to support fluoride varnish application for children attending general dental practice. Appl Ergon 68:294–303CrossRefGoogle Scholar
  15. Saurin TA, Rosso CB, Colligan L (2017). Towards a resilient and lean health care. In: Resilient health care (Vol 3, No. 17). Routledge in association with GSE Research, pp 3–17Google Scholar
  16. Saurin TA, Werle NJB (2017) A framework for the analysis of slack in socio-technical systems. Reliab Eng Syst Saf 167:439–451CrossRefGoogle Scholar
  17. Shimada M, Tanabe A, Gunshin M, Riffenburgh RH, Tanen DA (2012) Resource utilization in the emergency department of a tertiary care university-based hospital in Tokyo before and after the 2011 Great East Japan earthquake and tsunami. Prehospital Disaster Med 27(6):515–518CrossRefGoogle Scholar
  18. Travers J, Milgram S (1977) An experimental study of the small world problem. In: social networks. Academic Press, pp 179–197Google Scholar
  19. US Department of Homeland Security (2007) Target capabilities list: a companion to the national preparedness guidelinesGoogle Scholar
  20. Woltjer R, Hollnagel E (2008) Functional modeling for risk assessment of automation in a changing air traffic management environment. In: Proceedings of the 4th international conference working on safety, vol 30Google Scholar
  21. Wachs P,  Saurin TA (2018) Modelling interactions between procedures and resilience skills. Appl Ergon 68:328–337 Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.School of Engineering and Built EnvironmentGriffith UniversityGold CoastAustralia

Personalised recommendations