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7 Development and evaluation of the resilience analysis grid (RAG) in Dutch hospitals
  1. Caroline Schlinkert
  1. Netherlands Institute for Health Services Research (Nivel)


Introduction Every day, healthcare professionals make trade-offs to respond to unexpected situations while maintaining (patient) safety. This complex work reality asks for resilience. Tools available in the Netherlands are insufficient to capture this work complexity.

Aim Enhancing resilience of hospital departments by making the RAG available for Dutch hospital context.

Methods The RAG is a Safety II measuring instrument and intervention tool that offers healthcare professionals to reflect on their daily work.1 This happens on the basis of the four RAG capacities Responding, Monitoring, Learning and Anticipating.2 The RAG will be tested in this project for suitability of the Dutch hospital context. The project consists of three phases with each phase building on the previous phase. First, the RAG questions will be adapted to the Dutch hospital context. Second, RAG-NL reflection workshops will take place in which the RAG-NL will be further evaluated. Three, an implementation plan will be created.

Results By the time of the conference, phase 2 of this project will be completed so that we can share experiences of translating the RAG to the Dutch hospital context.

Discussion Ideas for further implementation of the RAG-NL as a measurement and intervention tool will be presented and discussed.


  1. Alders MDL. (2019). A reflective process for analysing organisational resilience to improve the quality of care (Doctoral dissertation, King’s College London).

  2. Hollnagel E. (2010, May). How resilient is your organisation? An introduction to the resilience analysis grid (RAG). In Sustainable transformation: Building a resilient organization.

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