Methodological strategies in resilient health care studies: An integrative review

Berg, Siv Hilde; Akerjordet, Kristin; Ekstedt, Mirjam; Aase, Karina

doi:10.1016/j.ssci.2018.08.025

Cited by 94 publications

(135 citation statements)

References 33 publications

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“…13). For example, what forms does ongoing adaptation take within regulators, in response to challenge and feedback from regulated organizations, the public, or stakeholders [1]? More broadly, understanding the roles of different stakeholders in the active 'co-creation' of resilience is emerging as a key issue and focus for future empirical work, particularly in the contexts of healthcare, disaster planning and recovery, and international operations.…”

mentioning

confidence: 99%

Resilience: From Practice to Theory and Back Again

Macrae

Wiig

2018

SpringerBriefs in Applied Sciences and Technology

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This book offers a purposefully broad exploration of resilience: it presents a variety of diverse perspectives in a range of practical contexts across various scales of system from a range of disciplinary positions. One of the core organising principles of this book is a concern with understanding how ideas of resilience can be translated into practice, and how practices of resilience can in turn be theorised and explainedirrespective of whether those practices are conducted at the 'street-level' by frontline actors or in the committee rooms of policymakers. To do this, the book explores empirical, methodological and theoretical challenges in analysing resilience, defining resilience, organising resilience, building resilience, leading resilience and regulating resilience-to name just a few of the activities that provide the focus of concern in these chapters. In this chapter, we provide a brief and necessarily partial survey of the varieties and commonalities of resilience that have emerged throughout the book, and then explore how-and why-we might move towards an integrated theoretical framework of resilience.

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mentioning

confidence: 99%

Resilience: From Practice to Theory and Back Again

Macrae

Wiig

2018

SpringerBriefs in Applied Sciences and Technology

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“…The study was conducted as a retrospective longitudinal correlation study with a strategic selection. The research design originated from the idea that quantitative data was lacking when studying resilient health care [10]. New sources were needed to support decision makers and to understand performance variability at a meso-level.…”

Section: Description Of Research Designmentioning

confidence: 99%

“…In resilient health care research, a micro-level approach and qualitative research design are frequently used. However, to study resilience as a complex adaptive system [10] suggest data collection on meso and macro level to increase the understanding of organizational context dependency, and strengthen the understanding of resilient health care. Furthermore, from a complexity perspective; considering dimensions of time and space becomes highly important for the configuration of work [11], and studying resilience at a meso-level trough new methodological tools can benefit the understanding of organizational strain through time and space [12].…”

Section: Introductionmentioning

confidence: 99%

Patterns of performance variability: a meso-level understanding of psychiatric discharge

Svensson¹,

Bergström²

2020

Proceedings: 8th REA Symposium on Resilience Engineering: Scaling Up and Speeding Up Linnaeus Univerity, Kalmar, Sweden, 24th-2

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Incident reports, as well as surveys, indicate that there is a risk of healthcare injuries when psychiatric patients are discharged from the hospital, with continued treatment as an outpatient. In this study, we are ultimately interested in the resilience of psychiatric care in this risky discharge, i.e. how the system adapts to cope with the risks. We understand that there are margins of maneuver in everyday psychiatric work, with several strategies potentially leading to acceptable performance and we seek to map the performance variability of such strategies. The aim of this study is to visualize retrospective discharge and compare findings of variability within the Stockholm Center of Dependency Disorder different wards. To understand what is "normal" from an organizational point of view, the study will analyze patterns from clinic visits where patients had been discharged with a follow-up visit between 2009 and 2018. This is a retrospective longitudinal correlation study with a strategic selection. Data consist of 71 125 anonymous quantified patients, who have been hospitalized and who, at the time with discharge, have been booked to a revisit as an outpatient. Results are compared between 81 different wards in Stockholm County. Results show that a significant amount (42%) of the patients do not visit the outward as planned by health care, but instead seek help from the emergency ward. Further, a variance in cancellation of the follow-up visit appear as an outcome for the data. Retrospective analysis of quantified data seems to be a valuable tool for widening the understanding of performance variability and could help healthcare management understand where resources should be prioritized. The results also show how patients themselves have, and use, adaptive capacities in order to navigate the system, and that this has consequences at higher system levels.

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“…Resilient systems have been characterised as strong, reliable, robust, dependable and safe systems [10,[17][18][19]. High quality reviews [8,16,20,21] have been conducted that pull together de nitions and methods of studying system resilience across diverse elds. However, no review has synthesised "what it takes" to operate resiliently within a complex system.…”

Section: Studying Resiliencementioning

confidence: 99%

“…From this perspective, resilience cannot be measured; like culture, it is a gestalt that can only be observed in behaviours and within relationships that form the parts that make up the greater whole. This paradigm is currently popular in RHC where authors typically study resilient behaviours of systems by qualitatively assessing at the micro (individual) or meso (hospital/institution) levels [20].…”

Section: The Epistemology Of Resilient Health Carementioning

confidence: 99%

Identifying Leading Indicators of System Resilience and the Strategy for Developing Them: A Review of Reviews

Pereira¹,

Churruca²,

Egan³

et al. 2019

Preprint

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Background: System resilience describes the performance or capacity of a system to absorb and adapt in response to stressors and perturbations. This protocol outlines the search strategy to identify indicators or metrics of system resilience from across diverse fields and examine the methods/processes for developing these indicators or metrics.Methods: This protocol is grounded in the Joanna Briggs Institute (JBI) Scoping Review methodology. We will search Web of Science and Scopus for reviews that report on system resilience assessment and measurement techniques. We will also employ snowball sampling techniques. Due to the breadth of the topic, this search will be limited to systematic reviews, meta-analyses, or literature reviews with a structured, documented search strategy reporting on primary research studies published in the English language. We will not limit the search by date or discipline. Reviews that report on psychological resilience or resilience at the level of an individual will be excluded. Discussion: The ability to assess or measure resilience is important to identify risks, opportunities, and strategies to influence sustained, reliable, and predictable system operations. We hypothesise that there are commonalities in the types of indicators used and how they are developed. These patterns may have relevance to other fields, like healthcare. The findings from this review may help others develop their own indicators and assessment strategies for understanding resilience within their own systems. Ethics and Dissemination: This study is ethics exempt. We will disseminate the results of this work at national and international quality and safety conferences, and through publication of a manuscript.

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Methodological strategies in resilient health care studies: An integrative review

Cited by 94 publications

References 33 publications

Resilience: From Practice to Theory and Back Again

Resilience: From Practice to Theory and Back Again

Patterns of performance variability: a meso-level understanding of psychiatric discharge

Identifying Leading Indicators of System Resilience and the Strategy for Developing Them: A Review of Reviews

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