| Título | Coping with variability towards procedure design guidelines: Supporting a large hospital’s role in public referral prioritization |
|---|---|
| Tipo | Artigo em Periódico Científico |
| Abstract | Procedures are important for safety and efficiency but must be clear and relevant, particularly in complex domains like healthcare. From a Resilience Engineering perspective, procedures should emphasize the natural properties and behaviors of the systems rather than imposing structures and instructions. This paper identifies contextual factors contributing to variability in opening medical appointments in a specialized care provider. It also underscores the role of staff strategies in improving outcomes and how these can be integrated into process guidelines. Data were collected through observations and interviews, followed by thematic analysis and the application of the Functional Resonance Analysis Method to examine the interplay among the system’s functions and variabilities, as well as mechanisms to manage variability. The findings highlight that information flow is critical for timely processes and that knowledge and expertise are essential for implementing coping strategies. A proposal was made to recognize these strategies in the workflow, enhancing the ability to prevent the loss of medical appointments. The new proposed workflow representation leverages workers’ expertise to improve decision-making, ensuring that guidelines remain relevant and effective in practice and helping to bridge the gap between work-as-imagined and work-as-done. |
| Ano | 2025 |
| DOI | 10.1007/s10111-025-00818-5 |
