Using the Resilience Assessment Grid to Analyse and Improve Organisational Resilience of a Hospital Ward

Helping organisations to perform in a resilient manner is an emerging area of research in healthcare, but despite philosophical development there remains a lack of practical tools that can be used by practitioners. Tools and methods for analysing resilient performance are needed to inform organisational improvement. This chapter describes a new method for analysing resilience in hospital systems based on the Resilience Assessment Grid (RAG). The RAG is a tool for analysing the four resilience potentials (Hollnagel, 2018) proposed to underpin resilient system performance: anticipating, monitoring, responding, and learning (Hollnagel, 2010). Its purpose is to assist users to analyse their own system and diagnose areas of weakness by answering a series of questions about the four resilience potentials. However, the original questions proposed in the RAG were high level and abstract. They were designed to be adapted to the local context in which it was to be applied and used in a survey administered to staff, but there was little guidance provided for adapting the questions to the context. Previous research has used different methods for developing contextual RAG survey items, but these are either too close to the original theoretical items and not very clear for healthcare professionals (Hunte, 2016; Engvall et al., 2017) or include conceptual additions which are not developed sufficiently for understanding resilient performance (Van der Beek and Schraagen, 2015; Rigaud et al., 2015).