Exploring the resilience potentials of a responsive team managing clinical deterioration: A systems analysis

Ganasan-Ryan, Shalini, Kumar, Maneesh ORCID: https://orcid.org/0000-0002-2469-1382, Slater, David, Krishnan, Rajesh, Frost, Paul and Carson-Stevens, Andrew ORCID: https://orcid.org/0000-0002-7580-7699 2027. Exploring the resilience potentials of a responsive team managing clinical deterioration: A systems analysis. Applied Ergonomics: Human Factors in Technology and Society 138 , 104845. 10.1016/j.apergo.2026.104845

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Abstract

Clinically deteriorating patients require timely care to prevent harm. This study examines how a responsive team delivers resilient care via the Rapid Response System (RRS) by analysing the four resilience potentials (anticipating, monitoring, responding, and learning). Using an integrated Systems Thinking for Everyday Work (STEW) and Functional Resonance Analysis Method (FRAM) approach, we investigated functional interdependencies and sensemaking through documentary analysis, non-participant observations, and semi-structured interviews. Three system conditions (limitations in clinical tools, misalignment between technology and user needs, and resource constraints) shaped how resilient performance addressed coordination and communication challenges to maintain patient flow and safety. Unique to responsive teams, awareness of operational boundaries and experience influenced how adaptations unfolded across system levels. While some adaptations supported safe care, others led to non-value-added activities. The findings show how resilience potentials and hidden adaptations can inform leading safety indicators and system improvement through a human factors and design perspective.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Business (Including Economics) Schools > Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by/4.0/, Start Date: 2026-06-19
Publisher:	Elsevier
ISSN:	0003-6870
Funders:	ESRC
Projects:	Doctoral Training Partnership (DTP)
Date of First Compliant Deposit:	26 June 2026
Date of Acceptance:	16 June 2026
Last Modified:	25 Sep 2026 09:53
URI:	https://orca.cardiff.ac.uk/id/eprint/187753

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