Citation

Becker Bertoni V, Abreu Saurin T, Sanson Fogliatto F. Safety Sci. 2022; 155: e105895.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.ssci.2022.105895

PMID

unavailable

Abstract

The law of requisite variety (LRV) posits that the variety of the regulated process should match the variety of the controller. However, the LRV is hardly operationalized and lacks empirical scrutiny. Our study addresses this gap by introducing an approach for assessing the match between the risk of the regulated process and the actors' (i.e., controller) contribution to resilient performance. The approach was applied to an intensive care unit (ICU), in which staff members answered a questionnaire composed of two main sections. Initially, respondents answered a social network analysis survey, indicating their peers most frequently contacted for advice-seeking.

RESULTS gave rise to a resilience score for each actor, calculated as the product of three variables related to the actor's network centrality and two related to the actor's availability and reliability. Next, respondents were presented with the list of ICU tasks and assigned scores for the frequency of carrying them out and the probability and severity of unwanted outcomes. We then calculated an average risk score for each actor. Actors' resilience scores were used as input in cluster analysis, leading to a best solution with two clusters of first-order (higher scores) and second-order (lower scores) resilience actors. Clusters did not significantly differ regarding actors' risk scores. Considering that the ICU performance is more often than not successful, our findings suggest that even the second-order resilience actors reach a minimum threshold of effective social interactions.

Language: en

Keywords

Intensive care unit; Law of requisite variety; Resilient performance; Risk; Social network analysis