Organisationen wie Feuerwehren, med. Rettungsdienste oder Spezialeinheiten der Polizei zeigen auch in Situationen, die durch Unsicherheit, unvollständige Informationen oder eine sehr hohe Dynamik gekennzeichnet sind, eine effiziente und effektive Leistungsfähigkeit. Sie können deswegen als Hochleistungssysteme (HLS) bezeichnet werden. Im vorliegenden Artikel wird dargestellt wie sich Erkenntnisse der High Reliabilty Theory auf die Untersuchung von Hochleistungssystemen auswirken und welche Gemeinsamkeiten und Parallelen bestehen. Dabei wird insbesondere ein Schwerpunkt auf die Thematik des Lernens gelegt.

Hintergrund: Für eine sicherheitsorientierte Versorgung in der Zentralen Notaufnahme (ZNA) bedarf es einer Sicherheitskultur, die aufbauend auf einem transparenten Umgang mit Fehlern das Lernen fördert. Insbesondere in Hochzuverlässigkeitsorganisationen (HRO) wird das Lernen als Chance für die stetige Verbesserung der Sicherheit gesehen. Ein Einflussfaktor für eine sicherheitsorientierte Patientenversorgung ist das Individuum. Aufbauend auf den individuellen Kompetenzen können die Kompetenzen auf allen Ebenen weiterentwickelt werden, welches in einer Lernenden Organisation angestrebt wird. Die Gestaltung einer Sicherheitskultur in einer ZNA im Sinne der Hochzuverlässigkeit durch Kompetenzen von Individuen und Kompetenzentwicklungsmaßnahmen erfolgt durch die Verknüpfung von den Fachdisziplinen der Organisationstheorie und der Bildungswissenschaft. Methodik: Für die Identifikation von Kompetenzen und Kompetenzentwicklungsmaßnahmen wurde ein Multi-Methoden-Ansatz gewählt. Zunächst wurden mögliche Risikofelder in der ZNA durch eine Analyse von 230 Critical Incident Reporting System (CRIS)-Fällen aus der CIRSmedical Datenbank identifiziert. Daraufhin wurde ein Kompetenzkatalog: Patientensicherheit in der Zentralen Notaufnahme aufbauend auf dem Kompetenzkatalog Europäisches Curriculum für Notfallmedizin sowie 34 weiteren Quellen entwickelt. Neben dem Kompetenzkatalog wurde der Basiskompetenzkatalog: Patientensicherheit hochzuverlässig gestalten für die Identifikation von Kompetenzen zugrunde gelegt. Weitere Informationen hinsichtlich der Identifikation und Entwicklung von Kompetenzen wurden durch Interviews mit zehn Experten und sieben Führungskräfte eines Kooperationskrankenhauses generiert. Ergebnisse aus dem Multi-Methoden Ansatz: Die Sicherheitskultur wird durch die Führungskräfte, die Institutionalisierung von Risikomanagementinstrumenten und durch das Individuum gestaltet. Für Professionals in der ZNA bedarf es fachlicher, methodischer, personeller und hochzuverlässiger Kompetenzen, um interprofessionelle, interdisziplinäre und situationsadäquate Entscheidungen zu treffen. Zudem sind die situative Sensibilität und Resilienz erforderlich. Von den Interviewpartnern wurde der kontinuierliche Lernprozess als ein entscheidender Einflussfaktor für die Sicherheitskultur in einer ZNA im Sinne der Hochzuverlässigkeit bezeichnet. Die Kompetenzentwicklung kann neben Personalentwicklungsmaßnahmen auch durch Risikomanagementinstrumente erfolgen. Dennoch gibt es hinsichtlich der Kompetenzentwicklung von Professionals in ZNA auch Herausforderungen. Schlussfolgerung: Die Sicherheitskultur in einer ZNA im Sinne der Hochzuverlässigkeit kann durch ein Kompetenzset aus fachlichen, methodischen, personellen und hochzuverlässigen Kompetenzen sowie der kontinuierlichen Kompetenzentwicklung gestaltet werden. Da bisher ein differenziertes Grundverständnis für die Hochzuverlässigkeit in der ZNA vorliegt und lernfördernde Rahmenbedingungen zu schaffen sind, sollte die ZNA im Hinblick auf den Zusammenhang mit der Hochzuverlässigkeit als high reliability seeking organization (HR-S-O) bezeichnet werden.

This exploratory research is based on an objectivist epistemology with a positivist theoretical perspective that deployed concurrent mixed methods (MMR) design through a quantitative administered survey alongside an in-depth qualitative analysis through interviews exploring the perspectives of leaders on EHS leadership and governance. The research literature review focused on EHS leadership, corporate governance and strongly related topics. This MMR research employed both an expert panel-validated survey and a semi-structured interview protocol which explored 9 themes which emerged from the literature review including EHS/Safety Leadership; Risk Management; Influence and Accountability. Due to pragmatics relating to the number of leaders accessed (N=30) the statistical analysis is limited to descriptive type statistics. Almost all respondents supported the monitoring role of the Board of Directors (BoD), but disagreed that the BoD should play an active role in risk management. Comparisons are drawn between the Oil and Gas and non-Oil and Gas organizations with interesting results especially in matters relating to risk management. Structured thematic content analysis yields that Safety Culture; Leadership; Influence and Accountability were the three leading themes accounting for just over 50% of the responses analysed. Many sub-themes have also emerged and are discussed. A Model of EHS Leadership and Governance was created and is presented which positions themes and factors that influence monitoring of EHS performance and ultimately risk management. The research can be considered as a unique contribution as a relatively small body of currently published work in this subject area, both globally and more so in the GCC.

The industrial needs in the production of goods and control of processes within the factory keep leapfrogging daily by the necessities to fulfil the needs of the ever-growing population. In recent times, the industries are looking towards Industry 4.0 to improve their overall productivity and scalability. One of the significant aspects that are required to meet the requirements of Industry 4.0 is communication networks among industrial applications. Nowadays, industries from the cross markets are looking to replace their existing wired networks with wireless networks, which indeed brings many use-cases and a lot of new business models into existence. To make all these options possible, wireless networks need to meet the stringent requirements of these industrial applications in the form of reliability, latency, and service availability. This thesis focuses on a systematic methodology to integrate wireless networks like 5G, Wi-Fi 6, etc., into real-life automation devices. It also describes a methodology to evaluate their communication and control performance by varying control parameters like topology, cycle time, and type of networks. It also devises some techniques and methods that can improve the overall performance, i.e., both control and communication performance of the control applications. The method used to implement this work is a case study. This work integrates and tests the industrial applications in a real-life scenario. It is the best effort to bring a unique perspective of communication engineers and control engineers together regarding the performance of the industrial applications. This work tries to verify the suitability of the wireless in mission-critical control application scenarios with respect to their communication and control performance. Software for data analysis and visualization and its methodology for analyzing the traffic flow of the control applications via different wireless networks is demonstrated by varying different control parameters. It is shown that it is challenging for 5G to support the shorter cycle time values, and performance will get better and more stable with the increase in the cycle time of the control application. It is also found that the 1-Hop wireless topologies have a comparatively better control performance than 2-Hop wireless topologies. In the end, it is found that the communication and control performance of the motion control application can be improved by using the hybrid topology, which is a mixture of 5G and Wi-Fi 6, by modifying some key aspects. The thesis work helps to introduce a novel systematic methodology for measuring and analyzing the communication and control applications via different wireless networks. It also gives a better idea for the control engineers in the industry about which cycle times the different wireless networks and their topologies support when integrated with industrial automation devices. It also describes which wireless networks support industrial applications better. It ends with a novel methodology that could improve the performance of the mission-critical motion applications by using existing wireless technologies.

Practical drift is defined as the unintentional adaptation of routine behaviors from written procedure. The occurrence of practical drift can result in catastrophic disaster in high-reliability organizations (e.g. the military, emergency medicine, space exploration). Given the lack of empirical research on practical drift, this research sought to develop a better understanding by investigating ways to assess and stop the process in high-reliability organizations. An introductory literature review was conducted to investigate the variables that play a role in the occurrence of practical drift in teams. Research was guided by the input-throughput-output model of team adaptation posed by Burke, Stagl, Salas, Pierce, and Kendall (2006). It demonstrates relationships supported by the results of the literature review and the Burke and colleagues (2006) model denoting potential indicators of practical drift in teams. Research centralized on the core processes and emergent states of the adaptive cycle; namely, shared mental models, team situation awareness, and coordination. The resulting model shows the relationship of procedure—practice coupling demands misfit and maladaptive violations of procedure being mediated by shared mental models, team situation awareness, and coordination. Shared mental models also lead to team situation awareness, and both depict a mutual, positive relationship with coordination. The cycle restarts when an error caused by maladaptive violations of procedure creates a greater misfit between procedural demands and practical demands. This movement toward a theory of practical drift in teams provides a conceptual framework and testable propositions for future research to build from, giving practical avenues to predict and prevent accidents resulting from drift in high-reliability organizations. Suggestions for future research are also discussed, including possible directions to explore. By examining the relationships reflected in the new model, steps can be taken to counteract organizational failures in the process of practical drift in teams.

This study aims to shed light on what a comparison between cybersecurity intelligence and public health surveillance systems can yield in practical improvements. The issue at hand is best described by the amount of threats both systems must detect. Intelligent malicious software, malware, designed by humans to spread and reap havoc in the abundance of unprotected networks worldwide and contagious diseases with millions of years of evolution behind their design to bypass human defences, infect and multiply. These two threats stand as mighty competitors to actors who try to monitor their presence to be able to give advice on further action to hinder their spread. The sheer amount of experience in public health of dealing with surveillance of contagious disease can contribute with important lessons to cyber intelligence when malware is becoming an even more alarming threat against everybody who uses the Internet. To compare them both this study uses high reliability theory to understand how Folkhälsomyndigheten, Sweden’s main authority in public health surveillance, and CERT-SE, Sweden’s national computer emergency response team, operate to make their surveillance as reliable as possible to detect emerging threats. Some key findings of the study points to the lack of regional or global binding policy’s to share information in the cyber security sector of which CERT-SE takes part in. The major roll of trust-based information sharing can be subject to shifts in relationships between states and excludes states with which no bilateral arrangements are made, but who may possess information of urgent necessity. The lack of arrangements in the cybersecurity sector, correspondent to the International health regulations by World Health Organization in public health, stands as a major difference between the two sectors access to information. However, this study may not stretch as far as to prove that the greater access to information would have proved to be of ease in a specific cyberincident. Case studies of this kind or further research of how agreements can be made in an anarchistic domain like the Internet are to be continued from this study.

The 2010 BP Deepwater Horizon oil spill in the Gulf of Mexico awakened communities to the increased risk of large-scale damage along their coastlines presented by new technology in deep water drilling. Normal accident theory and high reliability theory offer a framework through which to view the 2010 spill that features predictive criteria linked to a qualitative assessment of risk presented by technology and organizations. The 2010 spill took place in a sociotechnical system that can be described as complex and tightly coupled, and therefore prone to normal accidents. However, the entities in charge of managing this technology lacked the organizational capacity to safely operate within this sociotechnical system.

During the spring of 2020, COVID-19 rapidly started to spread within Sweden, causing a crisis that affected the entire society, and in particular, the health care sector. What makes the COVID-19 pandemic a unique crisis is that it did not appear as a complete surprise when it reached Sweden. Partly because pandemics are expected to happen and therefore anticipated, partly because reports of COVID-19 and its effects were available before the disease caused a crisis in Sweden. This makes the phase before the crisis, known as the pre-crisis phase, quite long. For this study, it is argued that the pre-crisis phase encompasses actions taken before COVID-19 was known, predominantly in the form of the development of pandemic preparedness plans, as well as the actions taken when COVID-19 was known before it reached Sweden. However, due to the decentralisation of the Swedish political system, the twenty-one regions being responsible for the health care sector, and the uneven geographical transmission of the virus, the pre-crisis phase most likely differed across the country. In this study, it is the pre-crisis phase of Region Östergötland which has been examined and evaluated as a part of the Center for Disaster Medicine and Traumatology’s general evaluation of the COVID-19 pandemic in Östergötland. The study has aimed to answer the research questions related to how the pre-crisis phase was conducted, and how three different theories can contribute to the understanding of the pre-crisis phase. The theories used were Conflicting Objectives Perspective, High Reliability Organisation, and Resilience Engineering. To answer the research questions, semi-structured interviews with eight employees of Region Östergötland involved in the pre-crisis phase were conducted. The interviews were analysed using the thematic analysis approach. The thematic analysis showed that the pre-crisis phase was mainly characterised by organisational changes within the regular organisational structures, different challenges predominately related to acquiring personal protective equipment, a lack of information from the national agencies, and a slight underestimation. These themes were used to answer the first research question. To answer the second research question, the aforementioned theories were applied to the themes. This application showed that there are aspects of the three theories that can contribute to the understanding of the pre-crisis phase. These aspects can also be used during future pre-crisis phases. Furthermore, based on the contributions of the three theories and the thematic analysis, a new model was developed which can be used to describe the different phases of the pre-crisis phase. The application of the theories and the new model resulted in general guidelines highlighting the important processes during a pre-crisis phase, including the processes of monitoring, anticipating, planning, and preparing.

Under början av 1990-talet infördes reformer som än idag påverkar svensk äldreomsorg. Dessa reformer föranledde till stora förändringar i den offentliga sektorn, där privatiseringen av offentliga tjänster är en del av resultatet. I nästan tre decennier har resultatet av dessa reformer varit väl omdiskuterade i både politiska sammanhang och samhället, där äldreomsorgen är en av de stora reformerna som diskuteras. Föreliggande studie jämför och analyserar tillförlitlig kvalitet på given vård i äldreomsorgen mellan den offentliga och privata sektorn eftersom den privata sektorn ibland har ett vinstintresse, vilket den offentliga sektorn saknar. Syftet med studien var att jämföra och analysera hur chefer uppfattar möjligheten att ge tillförlitlig kvalitet i verksamheten. Arbetet i den dagliga verksamheten utförs av chefer och medarbetare tillsammans, vilket föranledde att det i studien intervjuades åtta chefer på äldreboenden i Sverige, där fyra chefer från respektive offentlig eller privat given äldrevård utgjorde studiens empiriska material. Intervjufrågorna var konstruerade utifrån studiens analysmodell som bygger på karaktäristiska egenskaper för organisationer med hög tillförlitlighet. Föreliggande studie visar att cheferna i både den offentliga och privata sektorn uppfattar, utifrån de förutsättningar som finns i äldreomsorgen, möjlighet till tillförlitlig kvalitet. Dock visar resultatet av studien att det finns brister i den tillförlitliga kvaliteten. Studiens vetenskapliga bidrag visar på kvaliteten utifrån de förutsättningar som chefer har att ge en tillförlitlig kvalitet i äldreomsorgen. / During the start of the 1990´s reforms were introduced that to this day affect Swedish elderly care. These reforms brought forth large alterations in the public sector where in multiple, previously public services were privatized. In the following three decades have these reforms been regularly discussed in both political contexts and society, where the reforms of the elderly care have been prominent. This study compares and analyze reliable quality of administrated care of elderly between the public and private sectors, because of the private sector´s common profit orientation, which the public sector does not have. The purpose of this study was to compare and analyze how management perceive the opportunity to give reliable quality within the organization. Operational labor is performed by both management and coworkers together which resulted in eight managers within the Swedish elderly care being interviewed wherein four worked in the public sector and private, respectively. These interviews became the empirical basis for the study. The interview questions were constructed using the studies analytical model which is based on characteristic properties within organization with high reliability. The result of this study shows that managers in both the public and private sectors perceive the possibility of reliable quality based on the conditions that exist in elderly care. However, the results of the study show that there are shortcomings in the reliable quality. The study´s scientific contribution indicates the quality based on the conditions that managers have to provide a reliable quality in elderly care.

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