Conclusion

We conclude this volume by bringing together the core concepts the authors in the book have explored as they examined, theoretically or empirically, resilient performance in health care settings. The previous chapters explain how muddling actions, performed to accomplish a purpose, are on display everywhere in health care. The three sections of the book shed light on muddling activities and resilient practices from different perspectives. The first part provided case study accounts; the second, specific applications of FRAM as a way of analysing muddling; and the third part comprised studies with a focus on hospitals and their contexts. In the end, the book articulates the way in which resilient health care improvisations and practices are illustrated by an understanding of muddling through with purpose. Purposeful action, aiming to do as well as possible, and realising good care for patients, whether the contributions are from people at the blunt end of the system or those at the sharp end, manifests everywhere you look. The twin aims of the book are therefore to help people appreciate more clearly this point, and to help people be aware of their own and other’s purposeful muddling as they make their way in their corner of the health care system.