Using Systems and Resilience Engineering Literature to Understand Labor and Delivery Work Systems

Abstract

Obstetric medicine is a complex healthcare domain requiring the simultaneous care of multiple patients, making it an ideal setting to apply systems and resilience engineering approaches. This study conducted two literature reviews. The first one focused on systems engineering and the other on resilience engineering to examine how these methods have been used in surgical environments. Over 2,000 articles were screened from major databases. Findings show that while resilience engineering has gained more traction in healthcare literature, systems thinking is less frequently applied. The SEIPS and RETIPS frameworks offer structured ways to understand variability in clinical environments and provider adaptation. By identifying gaps in how these methods are used, especially in labor and delivery, this study provides direction for future research. Integrating both approaches may enable more effective tools for capturing provider feedback and designing work systems that improve safety, performance, and adaptability in obstetric care.