Learning from Everyday Work: Making Organisations Safer by Supporting Staff in Sharing Lessons About Their Everyday Trade-offs and Adaptations

There is broad agreement that organisational learning in healthcare is a key mechanism for improving patient safety, but at the same time frustrations with existing approaches based predominantly on learning from incidents are running high, fuelled by lack of progress and staff disengagement with learning processes. The argument in this chapter is that the struggles with organisational learning in healthcare are, at least in part, due to the narrow way in which learning has been cast as learning from incidents, without proper consideration of how healthcare professionals actually deliver care, and how the learning processes need to be embedded and supported within an organisation. An approach to learning from everyday work based on Resilience Engineering thinking is outlined, and its application in a multi-site study is described. The chapter concludes that healthcare organisations should adopt the Resilience Engineering perspective to create a more positive, inclusive and ultimately more effective learning environment for improving patient safety.