Dyson College of Arts and Sciences

knowledge not just of medical processes and procedures, but also of the broader context in which it operates, thereby allowing it to develop a level of resilience in its systems which provide for the organization's long-term survival and renewal. Sensitivity to Operations: Continuous Quality Improvement Related to the process of limiting simplifying assumptions, sensitivity to operations requires organizations developing resiliency to develop integrated, big-picture views of their operations in real time. This entails achieving a high level of situational awareness which allows the integration tightly-coupled sets of activities and interactive complexity, thereby forestalling the occurrence of major mistakes through numerous tiny adjustments which prevent errors from cumulating in the broader system (Weick, Sutcliffe & Obstfeld, 2009). By stopping the accumulation of errors in this manner, organizational systems greatly reduce the likelihood that any one error interact with others in ways not previously predicted and/or planned for. While surprises nevertheless occur, resilient organizations develop a high level of situational awareness and sensitivity to operations among their members which has the effect of limiting the extent of inaction when faced with uncertainty. At Aravind, the ability to provide free and/or low cost surgeries to those unable to pay full price while being financially self-sustaining stems from the level of operational efficiency inherent it its organizational system. In addition to generating demand through vision camps, which helps the organization to maintain a high volume of surgeries due to a constant flow of patients, a key contributor to Aravind's high level of efficiency is the cost cutting it has managed to achieve via establishing internal centers of excellence. One of these key centers of excellence is Aurolab, the lens manufacturing division of Aravind. From 1976 until 1992, the intraocular lenses required for cataract surgeries were donated by American manufacturers to Aravind as part of their social responsibility initiatives. However, as the number of surgeries in the system grew, having a donation-based system for intraocular lens was not sustainable. In order to overcome this dependence on external contributions, Aravind established Aurolab in 1992 with the goal of producing its own intraocular lenses. Whereas these lenses retailed for two-hundred dollars, Aravind was able to produce them for ten dollars apiece (Sezgi & Mair, 2010). In additional to providing the organizational system with increased flexibility and decreased dependence on outside resources, Aurolab also developed the organization's capabilities process innovation, a key feature of the organization's goal of increasing overall research and development in the decades to come. Continuous Learning and Knowledge-Sharing: Commitment to Resilience For organizations to develop resilience, there must also be a concomitant effort to develop activities and processes which develop its ability to anticipate future problems and potential shocks. While many organizations have systems for anticipating surprises or averting risks, the manner in which these systems are developed contributes to the overall resilience of the organization. In this sense, anticipation must also include a capacity to bounce back from errors when they occur, and to utilize changes in the environment in a positive manner for the organization. By expanding the stock of general knowledge and technical capacity within the organization, resilient organizations are able to pay attention to both to error-prevention and error- containment (Weick, Sutcliffe & Obstfeld, 2009). At Aravind, the clearest example of this commitment to resilience combined with capabilities for anticipating future 23

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