Comic Strip Conversation: Reconciling “Work as Imagined” and “Work as Done”
This activity helps healthcare professionals who deliver care and leaders who manage care – including policy developers and those who receive audit results – to hold fun, reflective conversations that shed light on the reliability of practices.
- Topics
- Patient safety
- Audience
Community organization
Healthcare leader
Person with lived/living experience
- Format
Facilitation guide for the Comic Strip Conversation: Reconciling “Work as Imagined” and “Work as Done”
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What's inside
By exploring the difference between “work as imagined” and “work as done”, participants can gain valuable insights into why practices may not be implemented as intended.
The goals of this activity are to:
uncover and reflect on the gaps between work as imagined and work as done
discuss potential unintended consequences of efforts to ensure reliability
work towards bridging the gap between work as imagined and work as done
move beyond compliance-driven safety strategies toward more meaningful solutions
Understanding work as imagined and work as done
Work as imagined describes what should happen under normal working conditions. It reflects the work we imagine others do and the work that we imagine we do, currently or in the future. Work as done describes what actually happens, what people do and how work unfolds over time in complex contexts. It takes place in an environment that is often different than imagined, with multiple, shifting goals, variable and often unpredictable demands, limited resources and a system of constraints and incentives – all of which can have unintended consequences.
Why this matters
It is often believed that safety can be achieved by ensuring that work as done is identical to work as imagined. However, safety is not the result of people simply following procedures. Rather, it comes from people making thoughtful and reasonable adjustments in response to the demands of a situation. Understanding these adjustments and learning from them is essential to delivering safe and reliable care.