The book demonstrates how Resilient Health Care principles can enable those on the frontline to work more effectively towards interdisciplinary care by gaining a deeper understanding of the boundaries that exist in everyday clinical settings. This is done by presenting a set of case studies, theoretical chapters and applications that relate experiences, bring forth ideas and illustrate practical solutions. The chapters address many different issues such as resolving conflict, overcoming barriers to patient-flow management, and building connections through negotiation. They represent a range of approaches, rather than a single way of solving the practical problems, and have been written to serve both a scientific and an andragogical purpose.

Working Across Boundaries is primarily aimed at people who are directly involved in the running and improvement of health care systems, providing them with practical guidance. It will also be of direct interest to health care professionals in clinical and managerial positions as well as researchers.

  • Presents the latest work of the lauded Resilient Health Care Net group, developing applications of Resilience Engineering to health care, furthering safety thinking and generating applicable solutions that will benefit patient safety worldwide
  • Enables health care professionals to become aware of the boundaries that affect their work so that they are able to use their strengths and overcome their weaknesses
  • Written from a Safety-II perspective, where the purpose is to make sure that as much as possible goes well and the focus therefore is on everyday work rather than on failures. There are at present no other books that adopt this perspective nor which go into the practical details
  • Provides a concise presentation of the state of resilient health care as a science, in terms of major theoretical issues and practical methods and techniques on the overarching and important topics of boundary-crossing and integration of care settings

part I|13 pages


chapter 1|6 pages

Introduction: The Journey to Here and What Happens Next

ByJeffrey Braithwaite, Erik Hollnagel, Garth S Hunte

chapter 2|4 pages

Bon Voyage: Navigating the Boundaries of Resilient Health Care

ByJeffrey Braithwaite, Erik Hollnagel, Robert L. Wears

part II|23 pages

Negotiating Across Boundaries

chapter 3|11 pages

Working across Boundaries: Creating Value and Producing Safety in Health Care Using Empathic Negotiation Skills

ByAndrew Johnson, Paul Lane, Michael Klug, Robyn Clay-Williams

chapter 4|9 pages

Untangling Conflict in Health Care

ByRob Robson

part III|42 pages

Theorising About Boundaries

chapter 5|14 pages

‘Practical’ Resilience: Misapplication of Theory?

BySam Sheps, Robert L. Wears

chapter 6|14 pages

Creating Resilience in Health Care Organisations through Various Forms of Shared Leadership

ByLev Zhuravsky, Eric Arne Lofquist, Jeffrey Braithwaite

chapter 7|11 pages

Simulation: A Tool to Detect and Traverse Boundaries

ByMary D. Patterson, Peter Dieckmann, Ellen S. Deutsch

part IV|84 pages

Empiricising Boundaries

chapter 8|12 pages

Looking Back Over the Boundaries of Our Systems and Knowledge

ByKate Churruca, Janet C. Long, Louise A. Ellis, Jeffrey Braithwaite

chapter 9|9 pages

Understanding Medication Dispensing as Done in Real Work Settings – Combining Conceptual Models and an Empirical Approach

ByPeter Dieckmann, Marianne Hald Clemmensen, Saadi Lahlou

chapter 11|10 pages

Patient Flow Management: Codified and Opportunistic Escalation Actions

ByJonathan Back, Janet E. Anderson, Alastair J. Ross, Peter Jaye, Katherine Henderson

chapter 12|12 pages

Trust and Psychological Safety as Facilitators of Resilient Health Care

ByMark A. Sujan, Huayi Huang, Deborah Biggerstaff

chapter 13|15 pages

Collaborative Use of Slack Resources as a Support to Resilience: Study of a Maternity Ward

ByNatália Basso Werle, Tarcisio Abreu Saurin, Marlon Soliman

chapter 14|10 pages

Resilient Performance in Acute Health Care: Implementation of an Intervention across Care Boundaries

ByRobyn Clay-Williams, Brette Blakely, Paul Lane, Siva Senthuran, Andrew Johnson

part V|9 pages


chapter 15|7 pages

Discussion, Integration and Concluding Remarks

ByJeffrey Braithwaite, Erik Hollnagel, Garth S Hunte