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Resilience and Systems Engineering

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Pediatric and Congenital Cardiac Care

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Abstract

Pediatric cardiac surgery is a complex, high-risk field characterized by a vulnerable patient population, technically demanding surgery, and technological and team challenges. Human factor studies have identified the importance of teamwork, communication, and standardization of some processes of care to improve outcomes. With demonstrable improvement in safety still lacking, continued reflection is warranted on the fundamental concepts which underlie safety efforts. Most studies have adapted a linear accident model with emphasis on error commission and recovery, adverse events, and latent conditions. More recent approaches to safety based on systems and resilience engineering are more applicable to complex systems of care, such as cardiac surgery. Systems engineering seeks to minimize risk through redesign. Resilience engineering explores how individuals and organizations negotiate complexity to create safety.

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Acknowledgements

The authors offer their sincere thanks to Sidney Dekker and Nancy Poirier for their review of this chapter and for their helpful comments.

Portions of this chapter are reprinted from Harrington K. Patient safety in pediatric cardiac surgery [MSc thesis]. Lund, Sweden: Lund University, Sweden; 2011.

Author information

Authors and Affiliations

  1. Departments of Pediatrics and Critical Care, CHU Ste Justine, 3175 Côte Ste Catherine, Montreal, QC, H3T 1C5, Canada

    Karen Harrington MDCM, MSc

  2. Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada

    Peter C. Laussen MBBS, FCICM

  3. Department of Anaesthesia, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada

    Peter C. Laussen MBBS, FCICM

Authors
  1. Karen Harrington MDCM, MSc
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  2. Peter C. Laussen MBBS, FCICM
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Corresponding author

Correspondence to Karen Harrington MDCM, MSc .

Editor information

Editors and Affiliations

  1. School of Medicine,, University of Oslo, Oslo, Norway

    Paul R. Barach

  2. Division of Cardiac Surgery, Department of Surgery,, Division of Cardiac Surgery, Department of Surgery, Johns Hopkins All Children’s Heart Institute, All Children’s Hospital and Florida Hospital for Children, Johns Hopkins University, St. Petersburg, Tampa, Orlando, FL, USA, Johns Hopkins University, Baltimore, Maryland, USA

    Jeffery P. Jacobs

  3. School of Medicine, Wayne State University, Detroit, Michigan, USA

    Steven E. Lipshultz

  4. University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada

    Peter C. Laussen

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Harrington, K., Laussen, P.C. (2015). Resilience and Systems Engineering. In: Barach, P., Jacobs, J., Lipshultz, S., Laussen, P. (eds) Pediatric and Congenital Cardiac Care. Springer, London. https://doi.org/10.1007/978-1-4471-6566-8_26

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  • DOI: https://doi.org/10.1007/978-1-4471-6566-8_26

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6565-1

  • Online ISBN: 978-1-4471-6566-8

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