Jeffrey Braithwaite

Jeffrey Braithwaite is the professor and Foundation Director of the Australian Institute of Health Innovation, and professor and Director of the Centre for Health Care Resilience and Implementation Science, both based in the Faculty of Medicine and Health Sciences at Macquarie University. He is also a Fellow of the Australian Institute of Management (FAIM, 2000), the Australian College of Health Service Management (FCHSM, 2001) and Fellow in the distinction grade, Faculty of Public Health, Royal Colleges of Physicians, United Kingdom (FFPH, RCP (UK) 2014). He holds visiting places including Honorary Senior International Research Fellow at the Canon Institute for Global Studies (Japan), Honorary Professor, University of Birmingham (UK), and Adjunct Professor for Resilient Health Care and Patient Safety, Faculty of Health Sciences, University of Southern Denmark (Denmark).

Braithwaite has published on health services and systems improvement including organisational and professional cultures,^[1] change,^[2] restructuring,^[3] patient safety^[4] and the value of accreditation.^[5]

He has received almost A$60 million of research funding through multiple grants, and published more than 400 refereed contributions and 600 total publications as of 2014.^[6] His Google Scholar details can be accessed here.

Professor Braithwaite has consulted to the World Health Organization (WHO) and AusAid, particularly to the Governments of East Timor, Laos, Papua New Guinea and the People's Republic of China; to WHO Kobe in Japan and the Shanghai Municipal Health Bureau. He has also consulted to ACT Health in Canberra, the New South Wales Health Department, various Commonwealth Government agencies, peak bodies, universities,^[7] colleges and member organisations, and a range of area health services, metropolitan and teaching hospitals.

Patient safety

Braithwaite has conducted many studies in patient safety including A root cause analysis of clinical error: confronting the disjunction between formal rules and situated clinical activity. ^[8] His work aims to identify key factors and themes which contribute to errors and adverse events in medical settings, in an effort to advocate for strategies which would reduce such clinical incidents, thus improving patient safety.

Improvement studies and implementation science

One of the key areas that Braithwaite's research addresses is the improvement of health care systems through various initiatives, including but not limited to; developing and implementing policy, enhancing collaboration and effective communication between varying levels of health care professionals, advocating for a patient-centred approach to health care, and investigating the quality and safety of existing health care systems. Braithwaite has produced a multitude of research on the improvement of health care systems and implementation science including, A tale of two hospitals: Assessing cultural landscapes and compositions, ^[9] and A four-year, systems-wide intervention promoting interprofessional collaboration. ^[10]

Resilient health care

Health care is a complex, multi-faceted system facing pressures to provide quality care and safety to patients, while at the same time being cost efficient, and balancing fluctuating factors such as workforce stress, demand for care, technological advances and ageing populations. The current approach to improving health care systems focuses on identifying all the things that can go wrong and how to prevent errors in a medical setting. With Professor Erik Hollnagel from the University of Southern Denmark and Professor Bob Wears from the University of Florida, Braithwaite has edited a series of books on health care resilience ,^[11][12] which propose that the current approach implies a predictability to health care systems and neglects to take into consideration the complexities of the industry. They present an alternative approach by arguing that there needs to be an additional focus on resilience, that is, how health care systems succeed by adapting to disturbances, changing circumstances and opportunities that present themselves. To implement policies and practices that lead to improvement, Braithwaite and colleagues reason that there needs to be an emphasis on what goes right in health care systems—what things work and why they work—and not only address what things go wrong or fail.

Gaps

Braithwaite introduced a theory of ‘gap-thinking’. He proposes that to solve certain pervasive problems in health care and elsewhere, it is necessary to understand the gap which is being filled. "Structural holes, spaces between social clusters and weak or absent ties represent fissures in networks, located in less densely populated parts of otherwise closely connected social structures. Such gaps are useful as they illustrate how communication potentially breaks down or interactivity fails.".^[13]

He sees 'gap-thinking' as a way of thinking creatively about a problem to close gaps. More information on this topic as well as his weekly blog, can be found at: http://www.jeffreybraithwaite.com Further information regarding Jeffrey Braithwaite’s bio and publications can be located at: http://aihi.mq.edu.au/people/professor-jeffrey-braithwaite

Selected publications

• Hollnagel, E., Braithwaite, J., Wears, R. (eds) (2013) Resilient Health Care, London, Ashgate. ISBN 978-1-4094-6978-0 .
• Long, JC., Cunningham, FC., and Braithwaite, J. (2013) Bridges, brokers and boundary spanners in collaborative networks: a systematic review. BMC health services research, 13(1): 158.
• Runciman, W.B., Hunt, T.D., Hannaford, N.A., Hibbert, P.D., Westbrook, J.I., Coiera, E., Day, R.O., Hindmarsh, D.M., McGlynn, E.A. and Braithwaite, J. (2012) CareTrack: assessing the appropriateness of healthcare delivery in Australia. Medical Journal of Australia, 197(2):100–105. doi: 10.5694/mja12.10510.
• Braithwaite, J., Greenfield, D., Westbrook, J., Pawsey, M., Westbrook, M., Gibberd, R., Naylor, J., Nathan, S., Robinson, M., Runciman, B., Jackson, M., Travaglia, J., Johnston, B., Yen, D., McDonald, H., Low, L., Redman, S., Johnston, B., Corbett, A., Hennessy, D., Clark, J. and Lancaster, J. (2010) Health service accreditation as a predictor of clinical and organizational performance: a blinded, random, stratified study. Quality and Safety in Health Care [now BMJ Quality & Safety], 19:14–21.
• Greenfield, D. and Braithwaite, J. (2008) Health sector accreditation research: a systematic review. International Journal of Quality in Health Care, 20:172–183.
• Westbrook, J.I., Braithwaite, J., Georgiou, A., Ampt, A., Creswick, N., Coiera, E. and Iedema, R. (2007) Multi-method evaluation of information and communication technologies in health in the context of wicked problems and socio-technical theory. Journal of the American Medical Informatics Association, 14: 746–755.
• Braithwaite, J. (2007) How to restructure-proof your health service, British Medical Journal, 335(7610):99.
• Braithwaite, J., Westbrook, M.T., Mallock, N.A., Travaglia, J.F. and Iedema, R.A. (2006) Experiences of health professionals who conducted root cause analyses after undergoing a safety improvement program. Quality and Safety in Health Care [now BMJ Quality & Safety], 15:393–399.

References