This article presents research conducted within the Vessel Traffic Service (VTS) domain. VTS is a service that is provided close to ports and geographically challenging areas to support merchant vessels in their navigation. Although VTS is legally an advice and assistance service, applying concepts from Cognitive Systems Engineering and Resilience Engineering can highlight how the joint human-machine system works to promote safe and efficient traffic movements. The VTS is a Joint Cognitive System that maintains control through a mixture of opportunistic and tactical control. Strategic control is only partially supported by the higher levels of system aggregation that provide the basis for defining daily operations within the settings of the VTS. To increase the VTS system’s ability to anticipate, respond, monitor, and learn, and therefore the ability to be resilient, there is a need to promote more strategic and tactical control within daily operations.

Background: Hospital discharge is a complex process encompassing multiple interactions and requiring coordination. To identify potential improvement measures in care transitions for people with complex care needs, intra- and inter-organisational everyday work needs to be properly understood, including its interdependencies, vulnerabilities and gaps. The aims of this study were to 1) map coordination and team collaboration across healthcare and social care organisations, 2) describe interdependencies and system variability in the discharge process for older people with complex care needs, and 3) evaluate the alignment between discharge planning and the needs in the home. Methods: Data were collected through participant observations, interviews, and document review in a region of southern Sweden. The Functional Resonance Analysis Method (FRAM) was used to model the discharge process and visualise and analyse coordination of care across healthcare and social care organisations. Results: Hospital discharge is a time-sensitive process with numerous couplings and interdependencies where healthcare professionals’ performance is constrained by system design and organisational boundaries. The greatest vulnerability can be found when the patient arrives at home, as maladaptation earlier in the care chain can lead to an accumulation of issues for the municipal personnel in health and social care working closest to the patient. The possibilities for the personnel to adapt are limited, especially at certain times of day, pushing them to make trade-offs to ensure patient safety. Flexibility and appropriate resources enable for handling variability and responding to uncertainties in care after discharge. Conclusions: Mapping hospital discharge using the FRAM reveals couplings and interdependencies between various individuals, teams, and organisations and the most vulnerable point, when the patient arrives at home. Resilient performance in responding to unexpected events and variations during the first days after the return home requires a system allowing flexibility and facilitating successful adaptation of discharge planning.

Aim: The aim of this study was to visualize vulnerabilities and explore the dynamics of inter‐professional collaboration and organizational adaptability in the context of care transitions for patients with complex care needs. Design: An ethnographic design using multiple convergent data collection techniques. Methods: Data collection involved document review, participant observations and interviews with healthcare and social care professionals (HSCPs). Narrative analysis was employed to construct two illustrative patient scenarios, which were then examined using the Functional Resonance Analysis Method (FRAM). Thematic analysis was subsequently applied to synthesize the findings. Results: Inconsistencies in timing and precision during care transitions pose risks for patients with complex care needs as they force healthcare systems to prioritize structural constraints over individualized care, especially during unforeseen events outside regular hours. Such systemic inflexibility can compromise patient safety, increase the workload for HSCPs and strain resources. Organizational adaptability is crucial to managing the inherent variability of patient needs. Our proposed ‘safe care transition pathway’ addresses these issues, providing proactive strategies such as sharing knowledge and increasing patient participation, and strengthening the capacity of professionals to meet dynamic care needs, promoting safer care transitions. Conclusion: To promote patient safety in care transitions, strategies must go beyond inter‐professional collaboration, incorporating adaptability and flexible resource planning. The implementation of standardized safe care transition pathways, coupled with the active participation of patients and families, is crucial. These measures aim to create a resilient, person‐centred approach that may effectively manage the complexities in care transitions. Implications: The recommendations of this study span the spectrum from policy‐level changes aimed at strategic resource allocation and fostering inter‐professional collaboration to practical measures like effective communication, information technology integration, patient participation and family involvement. Together, the recommendations offer a holistic approach to enhance care transitions and, ultimately, patient outcomes. Reporting Method: Findings are reported per the Consolidated Criteria for Reporting Qualitative research (COREQ). Patient or Public Contribution: No patient or public contribution.