Expertise, deference

You will also have power that derives from your particular expertise or knowledge. People defer to your directions because they believe you know best. 

This section is especially important for the residents and stakeholders. It illustrates to what lengths the military will go to come up with a plausible story as to why there is no problem at your site. While the stories will be different for each site, there will be contrived explanations for not taking action. Your regulators may be inexperienced in military sites and there may be a tendency to defer to military expertise. This section may provide clues to the method of operation that might be employed. 

Deference to expertise is a most important concept and one with immediate and clear relevance to healthcare. Weick and Sutcliffe explain that, for various reasons, rigid hierarchies have their own special vulnerability to errors. If only senior staff are mandated to act, and those lower down have to wait for orders, this can be fatal in a fast changing, hazardous situation. Junior doctors, for instance, are expected to act as best they can in an emergency if no senior help is available. Deference to expertise however is more subtle, allowing junior staff to take the lead even when senior staff are present. In hazardous, crisis situations, senior commanders will defer to those with knowledge of the immediate environment, often, in the military, non-commissioned officers or enlisted men. At these times open communication and negotiation of differences of view, as opposed to a blind following of orders, become critical (La Porte and Consolini, 1991). 

A structure of collaboration takes over in situations of increased risk with deference to expertise. 

The Columbia Accident Investigation Board fingered the issue of a lack of deference to expertise as a key contributor to the Columbia accident. NASA s culture of bureaucratic accountability emphasized chain of command, procedure, following the rules, and going by the book. While rules and procedures were essential for coordination, they had an unintended negative effect. Allegiance to hierarchy and procedure had replaced deference to NASA engineer s technical expertise (CAIB, 2003 200). 

The fragmentation of problem-solving also illustrates Karl Weick s points about how effective organizations exhibit a deference to expertise, reluctance to simplify interpretations, and preoccupation with potential for failure, none of which was in operation in NASA s organizational decision-making leading up to and during Columbia (Weick et al., 1999). 

Deference to expertise, especially having an organisation flexible enough to allow responsibihty for decision making in emergency situations to be passed to experts close to the situatiom... 

Provide resource and time for hazard and risk analysis, effective training and comprehensive scenario planning for potential incidents. Defer to the expertise of personnel, and do not dismiss expert opinions. They provide a process or system to ensure company leaders get expert operational safety input as a critical part of the decision making process for commercial projects or activities. 

---