About CARe

Who We Are, What We Do...

The Centre is the first dedicated centre for translating emerging theory and practice in organisational resilience into practical steps to improve the quality and safety of care and reduce costs due to low quality care such as inappropriate admissions, avoidable complications and complaints. Organisational resilience can be defined as

“the intrinsic ability of a system or an organisation to adjust its functioning prior to, during, or following changes and disturbances, so that it can sustain required operations under both expected and unexpected conditions” (Hollnagel, 2011, p. xxxvi).

The overall aims of the Centre are to:

  1. Increase the quality and safety of healthcare with organisational resilience interventions
  2. Produce a shift in the NHS cultural approach to safety from reliability (analysing and counting incidents) to organisational resilience
  3. Produce and disseminate evidence about how organisational resilience can be increased
  4. Become a national resource centre for knowledge and learning in resilience

Research will be conducted in two clinical areas: the emergency department and a unit for the care of older people. Exploratory and scoping work using qualitative methods will identify the pressures experienced and how clinicians manage those pressures. This diagnostic work will inform the development of interventions to increase resilience. Interventions will be created in partnership with clinical teams and will be grounded in the realities of everyday clinical work and its demands.

The interventions will be evaluated in terms of quality and cost effectiveness. A range of outcome measures will be used, including Standard Mortality Ratio (SMR), rates of adverse incidents, medication errors, falls, infections, readmissions and complaints. The research will produce evidence about the most effective ways to increase resilience, enabling others to implement this approach. It will also enable the development and testing of theories of organisational resilience.

Hollnagel, E. (2011). Prologue: The scope of resilience engineering. In Hollnagel, E., Pariès, J., & Woods, D. D. (Eds.). Resilience engineering in practice: A guidebook. Surrey, England: Ashgate Publishing Company.


By Janet Anderson