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08:00-08:15 Session 1: Start of the day: Resilience Engineering and Naturalistic Decision Making contributions - Trends and opportunities

Start - Day 1

Location: Main Room
Resilience Engineering and Desicion Making Contributions, Trends and Opportunities
PRESENTER: Ivonne Herrera

ABSTRACT. This work explores in a systematic way the contributions to the symposium looking where these perspective complement or diverge. Topics includes managemen of trade-offs, learning, monitoring performance, readiness to respond across diverse critical infrastructures.

08:15-09:00 Session 2: “So what should we do?” Challenges and opportunities for Resilience Engineering and Safety-II in practice

Steven Shorrock

Resilience engineering and Safety-II have emerged as credible perspectives and approaches to tackle some of the fundamental problems faced by societies, organisations and teams. Building on complexity science, systems theory, human factors engineering, and other established disciplines, the approaches have both strong theoretical and practical validity. But - as with prior disciplines - both come with particular challenges for practitioners, who act in a milieu that is not always conducive to straightforward practical application. This talk will explore some of these challenges - and opportunities - with experiences from practitioners in aviation, healthcare and WebOps, at different levels, from intergovernmental organisations to team activity.

Location: Main Room
09:00-09:45 Session 3: Societal resilience, preparedness and reconfiguration

Lightning talk and fishbowl discussion

Location: Main Room
Rethinking mass casualty distribution – Embedding a resilient hospital selection algorithm into a mass casualty distribution simulation model
PRESENTER: Sheuwen Chuang

ABSTRACT. Considering hospitals’ resilience potential in addition to the shortest-distance and medical-care adequacy policy to distribute mass casualties (MC) is an imperative practice for mass casualty distribution decision making. This study developed a novel hospital selection algorithm composed of driving time from the disaster site to hospital, care adequacy, and mobilization ability to determine the best hospital choice for MC distribution. Next, we developed an MC distribution simulation model embedding the algorithm to generate optimized distribution decisions for various MC incident scenarios. The simulation model was tested by using the Formosa Fun Coast Dust Explosion. Regarding super overload on some responsible emergency hospitals in the FFCDE event, the model with mobilization ability shows a better-balanced distribution of mass casualties to the initial receiving hospitals than without the ability. The study findings can contribute to surge capacity planning and resource assessment of emergency medical services for future disasters.

How Nursing Care Stations and Care Facilities in Japan Coped with COVID-19 Pandemic: A Survey of Challenges, Preparations, and Responses

ABSTRACT. This study presents a questionnaire survey, designed by a resource-centric framework, about how Japanese home-visit nursing stations and nursing care facilities prepared and coped with the COVID-19 pandemic. We analyzed the answers using qualitative analysis to develop categories of good and typical practices to cope with pandemic situations. Based on the analysis results and discussions, we developed five categories of preparedness and countermeasures for resource management: protection, utilization, stockpiling, procuring, and repairs. Furthermore, we provided the categories with practice examples for human resources, which can be used as a reference when preparing new business continuity plans (BCPs).

Citizen Audits for Resilience and Preparedness (CARP)

ABSTRACT. When facing shocks and stresses we aim for communities to not just bounce-back and survive, but bounce-forward and thrive. The principle in place has been to enable ‘preparedness’ to facilitate effective planning and response and ‘resilience’ to support anticipation, monitoring, response and learning. However, the coronavirus pandemic has exposed deep problems in how we approach resilience and preparedness at a community level.

Deliberative democratic processes have risen in popularity across the world in the form of citizen assemblies. Such assemblies have been successful and have been applied in areas such as abortion and gay marriage legislation (the classic Irish example) but also issues in transport, social policy, political appointments, and electoral reform. These assemblies work in parallel to formal governance mechanisms and act as guidance for decision making that is based on consensus among a large group of citizens drawn at random from the community.

Social audits are a form of citizen participation that looks at government performance and accountability. The objective of a social audit is to monitor and evaluate government performance - making public officials accountable for their actions and decisions. A social audit exercise is a mechanism of oversight: that is, the control that citizens can exert on their government officials to ensure that they act transparently, responsibly, and effectively.

This paper outlines a study of citizen assemblies and social audits and explores an application called a citizen audit for resilience and preparedness (CARP). This evaluates the capabilities and capacities of a community to respond to stresses and shocks, the process overseen and performed by a randomly selected group of citizens. Resilience and preparedness are characteristics that should emerge from a community rather than something imposed on it, a citizen audit could go some way towards building an active relationship between government bodies and its community.

Also discussed is a means of measuring success of the initiative, based on the regular reviewing of individual well-being, which can be run before and after a disruption.

10:00-11:00 Session 4: Emerging technologies and collaborative work - Part A Day 1

Lightning talk and fish bowl discussion

Location: Main Room
A Human-Centred Process Model for Explainable AI

ABSTRACT. With the increase in inscrutable Artificial Intelligence systems being used to support human decision makers, there has been much interest in what it means for these systems to provide ‘explanation’. In this paper, the concern is with applying a simple formalism that can express a minimal set of features that can be used to define an explanation. It is argued that few contemporary AI systems support this minimal set. Advice is provided on how future developments in explainable AI systems could adhere to this minimal set.

Competition and Conflict Between Frames in Using Machine Learning
PRESENTER: Hebah Bubakr

ABSTRACT. Artificial intelligence and Machine learning (AI/ML) systems promise to improve organisational decision making by avoiding bias because the machine ought to remain unaffected by moods, prejudices or personal opinions when interpreting the data. However, this promise rests on the fact that these tools are independent of the biases of their developers.  The purpose of this paper is to investigate what bias means to developers of AI / ML systems, and how they interpret bias through the result of the system. Our concern is with the relationship between developer - algorithm - data - output.  In this paper, we applied the Data/Frame Model (DFM) to understand what decisions are made by developers of AI/ML.  We propose that developers work with three distinct frames. First, they need to define a suitable dataset that will answer specific questions and also be amenable to analysis. We term this the ‘dataset frame’ and it includes factors such as size, representativeness and coverage, type of questions that could be addressed using these data. Second, having selected datasets, participants then explored different algorithms to test the selected datasets. We term this the ‘Algorithm Frame’. Third, once the algorithm produces answers, then these are reviewed. We term this the ‘Interpretation Frame’ which includes both judgement on the performance of the algorithm (so overlaps with the ‘algorithm frame’), plus judgement on the interpretation of the output to the original questions, and also judgement of the implications of this interpretation.  Our conclusions suggest that developers of AI / ML might take a narrow perspective on ‘bias’ (as a statistical problem rather than a social or ethical problem).  This is not because they are unaware of wider, ethical concerns but because the requirements relating to the management of data and the implementation of algorithms might narrow their focus to technical challenges.  Consequently, biased outcomes can be produced unconsciously because developers are simply not attending to these broader concerns. This suggests that the ‘interpretation frame’ ought to be elaborated to encompass the implications arising from possible interpretations of the algorithms’ output.

Interdependency Analysis for collaborative robot applications through FRAM analysis
PRESENTER: Arie Adriaensen

ABSTRACT. Although collaborative robots (cobot) applications are increasingly utilised to physically collaborate in realtime with human operators, current cobot safety mainly focuses on a techno-centric perspective in terms of physical separation and managing the net result of kinetic energy in the cobot system. Human Factors (HF) research or its subcategory Cognitive Systems Engineering (CSE) are largely absent in cobot safety. To complement the current techno-centric approach, this project introduces a socio-technical safety and resilience analysis perspective for human-robot interaction by applying systemic safety analysis methods, with a specific focus on observability, predictability, and directability (OPD) requirements for JCS in relation to cobot operations. For the purpose of this project, cobots are broadly defined by any robot system with the potential for foreseeable or intentional physical contact between robots and humans, not necessarily restricted to system operators. The project sets out a generic cobot safety framework that is based on a FRAM analysis of the work system to assess OPD requirements in JCS.

Development of a Debriefing Tool for Performance Evaluation in Maritime Training Simulations
PRESENTER: Josué França

ABSTRACT. This work presents, based on non-technical skills concepts, BRM (Bridge Resource Management) fundamentals and maritime safety regulations requirements, a proposed design of a debriefing tool for performance evaluation in maritime training simulations. This debriefing tool is formed by a set of questions, comprehending general questions, assessment of the voyage and potential for improvement. It is part of the training simulations and was designed to encourage the discussion regarding the skills, attitudes and interactions that were experienced by the students during the training, aiming to identify and stimulate the development of these and other skills necessary for a productive and safe work on board the vessels.

11:15-12:00 Session 5: Showcase from around the world - Scandinavia

Stian Antonsen; Gesa Praetorius; Ivonne Herrera; Martina Ragosta

A conversation around

  • What happen since last symposium
  • what are your current projects
  • Current questions and possible solutions
  • What industry or other collaborations with end users you have
  • If relevant PhD topics of your students
Location: Main Room
13:00-13:45 Session 6: Organisational resilience

Lightning talk, fishbowl discussion, and workshop

Location: Main Room
Adaptation in Team Performance for Sensemaking: Are We Ready For The Challenge

ABSTRACT. This paper reports an on-going project to explore the challenge of measuring adaptive performance in teams for improved sensemaking. The paper describes an initial rapid review of literature which highlights: (i) the conceptual emphasis of the existing literature, (ii) nascent measures for examining individual adaptive skill and adaptivity in teams, and (iii) a lack of empirical evidence for the development or efficacy of training interventions to improve or develop adaptive team performance. We build on previous understanding about adaptive performance. Nascent measures of individual and team adaptivity are identified and evaluated. Initial experiences of efforts to experimentally measure adaptive team performance for sensemaking will be presented if available.

Nine Principles for Supporting Distributed Sensemaking
PRESENTER: Simon Attfield

ABSTRACT. The future military operating Environment (FOE) is likely to be one in which operational military units will be less dependent on traditional command and control (C2) structures, operating more as semi-autonomous, self-organising teams. The devolution of C2 functions places a greater emphasis on the need for local peer-to-peer sensemaking and decision making. The work in this paper is a result of a project looking at the idea of sensemaking as a distributed phenomenon in military settings. We discuss this changing context and, as a prelude to the principles, offer a characterisation of distributed sensemaking as a form of distributed cognition which involves the harnessing of disparate information resources. Based on a review of sensemaking and team sensemaking sources from areas including Organisational Studies, Computer Supported Collaborative Work, Naturalistic Decision Making and Human Computer Interaction, we propose nine principles for supporting distributed sensemaking based on specific identified challenges and potential interventions. The nine principles broadly relate to the provision of information, interpretation and communication.

Environmental, Health & Safety management system: Attributes and Barriers
PRESENTER: Vanessa Bertoni

ABSTRACT. Environmental, Health & Safety integrated management systems are widespread in manufacturing industries, despite limitations regarding the system efficiency and performance, especially concerning technical and behavioral factors. The Functional Safety tool can collaborate with better results in the implementation of an integrated management system. This study aims to identify attributes, and barriers in the studies of integrating functional safety and Environmental, Health, & Safety with sustainability and management systems. A systematic literature review was carried out in three phases: i) selection of studies on the topic, ii) bibliometric analysis, and iii) content analysis. This review, done through 702 searched documents from the Scopus, Science Direct, and Web of Science databases, resulted in 84 documents after exclusion criteria and the inclusion of 16 documents via the Snowball method. As the main deliverables, this study listed 30 attributes for the implementation of an integrated management system. Moreover, 25 raised barriers to implementing a system that integrates environmental, health & safety, and functional safety can be used to support practitioners in the implementation of manufactures. Finally, as the main contribution, there is a survey of managerial implications on how to implement this integrated management system in manufacturing industries.

14:00-15:00 Session 7A: Lead talks from implementation - sharing experiences
Location: Main Room
Implementing Safety Differently at Lewis Tree Service
PRESENTER: Asher Balkin

ABSTRACT. Surprise is ubiquitous yet seldom acknowledged nor prepared for in ordinary work situations. We explore the practical application of fundamental Resilience Engineering premises “surprise will happen” and “work is variable” to line clearance work.

“I was felling large, dead locus tree surrounded by slippery, moss covered ground. The tree started to fall in intended direction, but the top broke out and was coming right for me. I fell as I scrambled to get out of the way. I barely escaped on my hands and knees…”

At Lewis Tree Service, we perform the high-risk work of removing trees near power lines including trees on downed power lines after storms.

We discuss how safety programs must change as the attributes of work become more variable. Those who are implementing “safety differently”, “safety II”, or Resilience Engineering will gain practical take-aways that could be applied in most settings. • We are mining close calls. Proactively soliciting stories of serious close calls that happened in the past through targeted questioning. • We are writing and telling stories to build collective memory. In collaboration with a storytelling coach, we crafted a method that includes interviewing people after an event to support developing and sharing people-centered stories. • We create the space to practice through “drill day”. Safety designs drills that are about practicing on the “blue line”, enabling successful adapting to real work variability. • We perform After Action Reviews which enable us to better understand the shape of surprise. • Leaders changed safety conversations by asking different questions to develop a learning culture (help notice tradeoff decisions, take system view, reinforce new view safety, demonstrate caring and empathy, show appreciation for workers, recognize humble, engaged leadership, and prompt new thinking/actions). • We explicitly explore role of uncertainty in decision making and include a discussion of mechanisms to mitigate its effects. We invented an “uncertainty gauge” to support conversations that explore a worker’s ability to control how the tree or limb will come down and their different perceptions of uncertainty. “The things that kill workers seem to be the things that are the most difficult to control.” “Risk is in the eye of the beholder. Risk may be defined as the degree to which a worker is facing uncertainty.” Conklin • We conclude with insights from the past two years of S-II and RE implementation which will be useful to other safety practitioners and researchers.

Combining insights from biology, ecology and human systems

ABSTRACT. Highlights from recent work

14:00-15:00 Session 7B: Workshop: Defining an Integrative Framework of Sensemaking and Sustainability for Building Organizational and Community Resilience

Interactive workshop

Location: Workshops
Defining an Integrative Framework of Sensemaking and Sustainability for Building Organizational and Community Resilience

ABSTRACT. Organizations and communities are embracing the principles and practices of sustainability and resilience in response to wicked issues such as climate change, income inequality, technological disruption, economic displacement, and emerging infectious diseases. Many of them find stakeholder aspirations and interests conflict even when they are well aligned on the need for decisive action to meet these challenges.

This workshop establishes a framework for and seeks engagement from interested experts to further develop an approach to sensemaking and sustainability to guide public participation processes among diverse stakeholders to facilitate constructive dialogue. The workshop seeks to establish specific criteria for each dimension of the framework to help users define individual and organizational roles and responsibilities in developing community resilience.

The proposed framework builds on the concepts of public value and co-production of public goods. It consists of five key elements of resilience to guide sustainable community engagement for organizational and community resilience. Workshop participants will employ the framework to examine diverse stakeholder interests and activities related to key resilience challenges facing communities.

• Open – How can individuals and organizations share data and insights with one another without compromising data integrity, personal privacy, or competitive advantage?

• Varied – What critical infrastructure pathways, key resources, and information sources support confidence, reliability, and redundancy under crisis conditions?

• Simple – What systems or methods are available or required to manage complexity, support situational awareness, and promote a common operating picture?

• Local – What resources exist within the community to sustain life and maintain critical functions during extreme events? How will individuals and organizations fill key gaps?

• Connected – How are individuals and organizations integrated within regional, national, and international networks and cooperative agreements that can provide critical insights or key resources before, during or after a crisis?

This workshop is an opportunity for experienced emergency management practitioners, public policy analysts, decision- support researchers, and crisis communication experts among others to expand and develop the proposed framework for public participation and community engagement. Participants in this workshop will contribute to an enhanced understanding of this framework, its application to various policy and practice challenges, and how it can be developed and applied as a tool for community engagement, comprehensive emergency planning, and policy analysis. Participants will be invited to collaborate in further development and deployment of this framework as a community engagement strategy.

15:15-17:00 Session 8: Societal and community resilience

Lightning talk, fish bowl discussion, and panel

Location: Main Room
Understanding the applicability of resilience practices: proposed approach in the investigation of solutions to support societal resilience
PRESENTER: Matthieu Branlat

ABSTRACT. To improve its capacities, an organisation might want to learn from tools and practices successful elsewhere. Focused on societal resilience and disaster management, project ENGAGE proposes a path to understand the conditions for applying such practices in another context. The approach is based on acknowledging that effective solutions will necessarily be related to how societal resilience manifests in a given location. We ask, for example, what makes certain solutions viable in one local context but not (or only partially so) in another? To make the link between the solutions and societal resilience, we first consider what elements of the local context are factors that support or hinder societal resilience. We then distinguish between aspects of society on which one can act upon directly (the target aspects) from aspects that are part of the local context and cannot easily be changed (the contextual aspects). This distinction between target and contextual dimensions allows us to state the underlying idea of the approach: a solution aims to have an impact on a population, but its impact is influenced (positively or negatively) by the context of use. The project aims to improve knowledge by identifying and relating such elements and dynamics, and to improve practices by providing enriched descriptions of solutions that authorities and emergency organizations can implement to better support societal resilience in local contexts. In the end, a solution involving a population in disaster management might be successful in one location but only be implementable elsewhere under some conditions. The overall ideas discussed, which underly the work in project ENGAGE, provide a path to understand why such a solution might be successful and how sensitive it is to its context of use.

How to foster participatory innovation during crisis management?

ABSTRACT. ● This action-research provides a proof-of-concept that participatory innovation during crisis management cycles can be used to facilitate the improvement of organizations’ resilience ● Lessons learned from the roll out of participative innovation during COVID-19 pandemic (formalized as an AFNOR-Spec) 2. SUMMARIZE NEW RESULTS ● Brief overview of the background and the aim Back in 1976, M. F. Weiner wrote an article in the journal Medical Economics entitled “Don’t Waste a Crisis — Your Patient’s or Your Own.” Weiner meant by this that a medical crisis can be used to improve aspects of personality, mental health, or lifestyle. Thus, our research project aims to promote the emergence of new solutions to workplace-related problems raised by COVID-19 and establish a foundation for on-going processes to deal with such disruptions and crises in the future. Unlike the “top-down” approach to innovation management, “bottom-up” management is implemented to directly solicit employees and/or users, whose experiences and perceptions in the field will serve as foundation to the emergence of new ideas. This action-research was carried out as part of project SURVIE (SURpassing the Virus with Innovations in Emergence), funded by the National Research Agency in France. ● Method A participatory innovation action has been deployed in five domains (transport, maternities, start-up business, university, specialized hospital). Concretely, this consisted of the implementation of an idea management system, intended to encourage the emergence of staff and/or users’ ideas and to facilitate their exploitation during the COVID-19 crisis. The approach involved 3 kinds of partners: o Academic team (authors) with diverse background: ergonomics, psychology, psychiatry, creativity and innovation. o Experts in management from AFNOR group: International Institute for Competency Development – HR21 –(ICD-HR21). o 5 organizations: a specialized hospital in Britanny (Centre Hospitalier Guillaume Régnier), a network of Maternities in eastern France (CoPéGE - Champagne-Ardennes- Lorraine region), a university faculty (Aix Marseille University), SNCF-Transilien (RER Paris region transport), OCUS (a French start-up in the international cultural industry sector). ● Results o The implementation of a transversal approach, analyses performed on data gathered in the 5 organizations and return on operating experience (through interviews, questionnaires) allowed the definition of specifications, which were formalized into the form of an AFNOR Specs. o The AFNOR Specs includes a set of organisational principles and guidance on the characteristic of an effective innovation climate as well as 5-step framework for the roll out of a participative innovation action during crisis management.

A tale of two “cities”: comparing the State of Ohio and The Ohio State University’s ability to enact massive change
PRESENTER: Michael Rayo

ABSTRACT. We will share our front-row-seat perspective of how the State of Ohio (population 11.7 million) and the community of The Ohio State University (population of ~100,000) generated new capabilities to meet the demands of the pandemic. It reveals the barriers and facilitators for change (i.e., adaptation) and generating new capabilities amid a climate in which the need for change was urgent and unambiguous. Will will discuss how these organizations' adaptive capacity was shaped by how and when these organizations accepted extra external resources, their willingness to engage with their broader communities, and the continuous, inexorable pressures both faced to dissolve these new, "extra" capabilities.

16:00-20:00 Session 9: Emergent Talents Programme

Emergent Talents:

  • Natalie Sanford
  • Shanee Honig
  • Nichole Pereira
  • Karl Hybinette
  • Lida David
  • Claudia Guerra Disconzi
  • Bruna Gayer
  • Ann-Therese Hedqvist
  • Atif Ashraf
  • Arie Adriaensen
  • Clément Cornière 
  • Elleke Ketelaars 
  • Floris Van den Oever 
  • Gertrude Spiteri 
  • David Grimm 
  • Matt Woodward 
  • Myke Cohen 
  • Sahinya Susindar 
  • Samuel Muir 
  • Catherine Stevens
16:15-17:00 Session 10: Workshop: From critical infrastructure to society as a whole: Can Naturalistic Decision Making and Resilience Engineering scale up?

Interactive workshop

Location: Workshops
From critical infrastructure to society as a whole: Can Naturalistic Decision Making and Resilience Engineering scale up?
PRESENTER: Matthieu Branlat

ABSTRACT. In light of events such as the Fukushima accident or the current pandemics, disaster management has been shifting in recent years from a “critical infrastructure” to a “societal” focus. In RE and NDM, we are used to deal with the former, the more professional or formal side of management of disruptive events, through our concepts and methods: we investigate, learn from and try to better support expert behaviour or resilient organisations/HROs. The potential and limits of applying our analytical tools to informal social actors remains less studied. The proposed panel aims to address questions such as the following: - Are we, as fields of research, equipped to look at the larger societal context and dynamics? - How can we account for non-professional individuals and groups actions? - Should we, as a field, be involved in this larger scale, or should we only ensure we can interact with other fields who look more broadly? In the latter case, what can we bring to such discussions? - What additional competences do we need to bring in or what fields do we need to be inspired by in order to be able to ask better questions on societal scales?

17:15-19:00 Session 11A: Resilient healthcare and NDM

Panel, lightning talk, and fish bowl discussion: administrated by USA node

Location: Main Room
Resilient healthcare during the COVID-19 pandemic: a case study in a Brazilian hospital

ABSTRACT. The COVID-19 pandemic has challenged the resilience of healthcare services in several countries. This exploratory study presents the lessons learned by a leading private hospital in Southern Brazil, using the lens of resilience engineering.

Learning to Adapt, as we Adapt: A Hospital’s Experience of Learning During the Pandemic
PRESENTER: Sudeep Hegde

ABSTRACT. The COVID-19 pandemic is a case of fundamental surprise, a crisis that emerged suddenly, without warning, and which had no preceding pattern. Like most organizations, hospitals were caught off-guard with few to no pre-existing protocols, norms, standards or guidelines in place. Furthermore, public health and institutional leadership did not have enough available information to make informed decisions in the beginning. Hospitals’ management and operations have been challenged with elevated patient volumes; infection prevention; lack of resources; decisions about mode of care-delivery. Hospitals have been hit with a paradox: while it’s increasingly important to safely deliver care, it’s more difficult to do so. While there have been multiple challenges, frontline and management staff have devised numerous solutions to harrowing working conditions. Recent literature has surfaced on how various organizations have coped with the COVID-19 pandemic finding solutions from the ground up through surge planning, patient monitoring dashboards, telehealth and remote medical services, and workforce protection, strengthening value-based payment. In all of the examples, adaptation at multiple institutional levels has been key. Despite declining cases of COVID-19 and immunizations, infection control measures will continue for the foreseeable future. There is a need and an opportunity to learn about what has worked during this past year, and to ensure preparedness as hospitals transition beyond the current crisis. Previous work exists on the use of knowledge-elicitation techniques to proactively learn about successful adaptative practices. In particular, the Resilience Engineering Tool to Improve Patient Safety (RETIPS) has been used on a pilot-basis to learn about adaptive capabilities of anesthesia residents3. RETIPS is a semi-structured self-reporting tool designed to elicit narratives of adaptation in everyday clinical work. The current study tailored RETIPS to the case of a radiology unit to learn from its operational staff about what went well as they adapted to the pandemic. Fifty-eight reports were received between July 29th and October 12th 2020 with over 90% received during the month of August. Participants’ roles included radiology leadership (21%), technologist (19%), nursing (13%), radiologists (10%), and sedation/anesthesia (10%). Participants described examples of lessons-learned, and indicated the success factors, challenges, and resources pertinent to their examples. The thematic analysis of the descriptions of their examples of an ‘adjustment or coping strategy or preventive practice’ identified several prominent themes. The lessons from this experience need to be learned in order to sustain these capabilities going forward, even beyond the pandemic itself.

The Workload Implications of Resilient Healthcare: The Role of Social Interactions

ABSTRACT. The extra effort of clinicians´ to provide care to their patients, which is a manifestation of resilience, usually goes unnoticed due to successful outcomes that occur most of the time. Therefore, clinicians’ self-sacrifice and overreliance on resilience become “normal work”. This study investigates the workload implications of resilient healthcare. The study setting was the radiology department of a major teaching hospital. The centrality of each clinician in four ability-based social networks (i.e., the resilience abilities of monitoring, responding, anticipating, and learning) was considered a proxy of each actor’s contribution to the overall system resilience. As such, a resilience score was calculated for each actor in each ability-based network, combining five indicators theoretically connected to the actor’s resilience: in-degree, closeness, and betweenness, which are derived from social network analysis, and availability and reliability, which are non-network attributes assessed through Likert-style questions. In turn, the individual workload was assessed based on the NASA-TLX questionnaire, which produces indicators related to six dimensions of workload (in addition to an overall score): mental, physical, temporal, performance, effort, and frustration. Both questionnaires – social network analysis and NASA-TLX – were answered by 155 out of the 220 staff of the radiology department. Follow-up interviews with 10 respondents were conducted to understand the influence of contextual factors on the actors´ workload and their resilience score based on network centrality. Preliminary data analysis indicates that the overall workload of the actors with the higher and lower resilience scores is similar, although there are significant differences in the workload dimensions (e.g., actors with higher resilience scores are subject to higher temporal and mental demand in comparison to those with lower resilience scores). As another finding, mental demand was the major workload dimension significantly correlated (95% confidence interval) to the resilience score. Furthermore, actors that take the initiative to help their coworkers without being requested had a higher overall workload than those that are more passive – the frequency at which actors take the initiative to help others was assessed by a specific question in the social network analysis survey. Overall, our findings indicated that social interactions related to the four resilience abilities mattered to the workload of the professionals surveyed. The adopted research method is expected to be replicable to other settings. It might be a new approach for the analysis of the human costs of resilient performance. The workload is proposed as a proxy of that human cost.


Running out of resilience: coping with the COVID-19 pandemic in Brazilian intensive care units

ABSTRACT. Intensive care units (ICUs) have been the most visible facet of healthcare services affected by the COVID-19 pandemic. This paper presents an exploratory investigation of how ICUs in Brazil have coped with the pandemic. A resilience engineering perspective is adopted, using a mixed-method research design. The quantitative stage comprised an exploratory survey for assessing the uptake of five work system guidelines that are logically related to resilience. The guidelines are: provide slack resources; give visibility to processes and outcomes; support diversity of perspectives when making decisions; monitor and understand the gap between work-as-imagined and work-as-done; and monitor unintended consequences of improvements and changes. These guidelines were described as statements in the survey, accompanied by ICU examples. There was a sliding bar with two endpoints: fully disagree (zero) and fully agree (100). For example, one of the statements related to the guideline on slack was as follows: there are extra or standby human resources that can be quickly deployed, and these are available in sufficient quantity to cope with unforeseen events. There were 33 valid responses, all from different ICUs. All respondents were invited to be interviewed and seven agreed with that. These interviews shed light on the rationale for the survey responses. The qualitative stage followed with interviews with two public health officials and non-participant observations of the meetings of a municipal COVID-19 crisis management committee in a capital city. Joint data analysis from the quantitative and qualitative stages supported the identification of five lessons learned, each corresponding to one of the aforementioned guidelines. Results indicated the guideline on slack resources as the most relevant as it addressed the key pandemic issue of matching capacity to demand. The provision of sufficient and experienced staff was found to be more challenging than the provision of facilities and supplies. Running out of resilience was part of everyday work in the ICUs, as evidenced by: (i) the lack of effective treatments, which means that despite all efforts the mortality rates were very high; (ii) exhausted professionals who could not cope with the stressful working conditions; and (iii) chronic and acute mismatches between capacity and demand, which implied that many patients received sub-standard care. ICU resilience was inextricably dependent on the resilience of society at large. An integrated approach to resilient healthcare is necessary, encompassing the micro, meso, and macro levels, besides accounting for the broader societal resilience.

17:15-18:00 Session 11B: Workshop - How has the COVID-19 pandemic changed how child welfare workers assess the safety of children? How has the pandemic changed other critical practices and decisions in child welfare?

Interactive workshop


Location: Workshops
Safety in Child Welfare: Challenges, Innovations, and Opportunities
PRESENTER: Emily Newsome

ABSTRACT. Child welfare organizations are tasked with maintaining the safety of children under complex circumstances. As such, they must be highly adaptable and resilient, while also supporting child welfare practitioners who make decisions that affect the lives of children and families. This panel will bring together experienced practitioners, researchers, and thought leaders in child welfare to explore decision making in child welfare. Topics will include: challenges of safety assessments and decisions in child welfare, how practitioners and systems have responded to the COVID-19 pandemic, and innovations for systems in which these decisions are made. Panellist backgrounds include experts in social work practice; managers of public child welfare systems in the U.S.; and researchers exploring innovative ideas for helping shift organizational cultures toward a culture of learning and promoting expertise.