Publication Abstract
Multi-Level Strategies to Achieve Resilience for an Organization Operating at Capacity: A Case Study at a Trauma Centre Miller A, Xiao, Y Cognition, Technology, & Work. 9(2):51-66. 2007 Healthcare services are examples of organizations that operate frequently at capacity, as reflected by periods of high demand and hospital overcrowding. Using the safe operating envelope framework (Cook & Rasmussen, 2005), this study identifies the strategies hospital staff use to respond to high patient demand pressures. A surgical unit (SU) in a dedicated trauma hospital provides the context for the study. Results are based on the outcomes of structured, critical decision method and contextual interviews involving six participants selected according to their roles in relation to resource allocation within the SU. The study’s central findings are 1) that temporally nested patterns of emergency patient admissions are the dominant influence on three levels of management decision making in the SU and 2) that compensatory buffers are actively planned at multiple levels of work organisation. These results are discussed in terms of their theoretical implications and implications for technological design. The methodological limitations of the research are also discussed.
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Publication Abstract

Multi-Level Strategies to Achieve Resilience for an Organization Operating at Capacity: A Case Study at a Trauma Centre
Miller A, Xiao, Y
Cognition, Technology, & Work. 9(2):51-66. 2007

Healthcare services are examples of organizations that operate frequently at capacity, as reflected by periods of high demand and hospital overcrowding. Using the safe operating envelope framework (Cook & Rasmussen, 2005), this study identifies the strategies hospital staff use to respond to high patient demand pressures. A surgical unit (SU) in a dedicated trauma hospital provides the context for the study. Results are based on the outcomes of structured, critical decision method and contextual interviews involving six participants selected according to their roles in relation to resource allocation within the SU. The study’s central findings are 1) that temporally nested patterns of emergency patient admissions are the dominant influence on three levels of management decision making in the SU and 2) that compensatory buffers are actively planned at multiple levels of work organisation. These results are discussed in terms of their theoretical implications and implications for technological design. The methodological limitations of the research are also discussed.

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