Metrics and indicators used to assess health system resilience in response to shocks to health systems in high income countries—A systematic review

Fleming, Pádraic; O'Donoghue, Catherine; Almirall‐Sanchez, Arianna; Mockler, David; Keegan, Conor; Cylus, Jonathan; Sagan, Anna; Thomas, Steve

doi:10.1016/j.healthpol.2022.10.001

Cited by 18 publications

(16 citation statements)

References 83 publications

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“…Most research into the measurement of resilience in healthcare has focused on conceptualising or measuring resilience at the macro-level of the health system, with indicators differing in the level at which data were collected [ 8 ]. Thomas et al’s [ 7 ] rapid review of literature provides a list of metrics that can be used to assess health system resilience in relation to governance, financing, resource generation and service delivery, whereas Fleming et al’s [ 18 ] systematic review explores different metrics and indicators used to assess health system resilience in response to shocks. Arguably, however, much of the work involved in responding to the demands of Covid-19, along with other chronic stressors such as winter pressures, is situated at the meso or organisational level.…”

Section: Introductionmentioning

confidence: 99%

Organizational resilience in healthcare: a review and descriptive narrative synthesis of approaches to resilience measurement and assessment in empirical studies

Ignatowicz

Tarrant

Mannion

et al. 2023

BMC Health Serv Res

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Background The coronavirus pandemic has had a profound impact on organization and delivery of care. The challenges faced by healthcare organizations in dealing with the pandemic have intensified interest in the concept of resilience. While effort has gone into conceptualising resilience, there has been relatively little work on how to evaluate organizational resilience. This paper reports on an extensive review of approaches to resilience measurement and assessment in empirical healthcare studies, and examines their usefulness for researchers, policymakers and healthcare managers. Methods Various databases (MEDLINE, EMBASE, PsycINFO, CINAHL (EBSCO host), Cochrane CENTRAL (Wiley), CDSR, Science Citation Index, and Social Science Citation Index) were searched from January 2000 to September 2021. We included quantitative, qualitative and modelling studies that focused on measuring or qualitatively assessing organizational resilience in a healthcare context. All studies were screened based on titles, abstracts and full text. For each approach, information on the format of measurement or assessment, method of data collection and analysis, and other relevant information were extracted. We classified the approaches to organizational resilience into five thematic areas of contrast: (1) type of shock; (2) stage of resilience; (3) included characteristics or indicators; (4) nature of output; and (5) purpose. The approaches were summarised narratively within these thematic areas. Results Thirty-five studies met the inclusion criteria. We identified a lack of consensus on how to evaluate organizational resilience in healthcare, what should be measured or assessed and when, and using what resilience characteristic and indicators. The measurement and assessment approaches varied in scope, format, content and purpose. Approaches varied in terms of whether they were prospective (resilience pre-shock) or retrospective (during or post-shock), and the extent to which they addressed a pre-defined and shock-specific set of characteristics and indicators. Conclusion A range of approaches with differing characteristics and indicators has been developed to evaluate organizational resilience in healthcare, and may be of value to researchers, policymakers and healthcare managers. The choice of an approach to use in practice should be determined by the type of shock, the purpose of the evaluation, the intended use of results, and the availability of data and resources.

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Section: Introductionmentioning

confidence: 99%

Organizational resilience in healthcare: a review and descriptive narrative synthesis of approaches to resilience measurement and assessment in empirical studies

Ignatowicz

Tarrant

Mannion

et al. 2023

BMC Health Serv Res

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“…(39,(45)(46)(47)(48) . Combined with the concomitant sociopolitical and weather disruptions, this observation calls for renewed efforts to promote HSR to ensure population health and prepare for future shocks (2,38) . Despite this reality, no consensus has been reached so far on how to approach and/or evaluate HSR.…”

Section: Discussionmentioning

confidence: 99%

“…Despite this reality, no consensus has been reached so far on how to approach and/or evaluate HSR. As such, there is still a need to continue exploring and evaluating the topic in various contexts, particularly for the small island developing states (SIDS) of the Caribbean (32,38) .…”

Section: Discussionmentioning

confidence: 99%

“…The nal two stages are concerned with managing the shock and its impact and recovering from it. Throughout these stages, the system ought to assimilate, adapt, transform and then recover while learning and remaining aware of future changes and implications that may result from the shock (37,38,40) .…”

Section: Health System Resilience De Nition and Associated Conceptsmentioning

confidence: 99%

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A scoping review to explore the materialisation of health system resilience across three Caribbean countries, Saint Lucia, Dominica, and Haiti: A protocol

Louis

Wautié

Makali

et al. 2023

Preprint

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Background The COVID-19 pandemic offers a window of opportunity for building resilient health systems. As such, it is important to use this opportunity to redesign, strengthen, and adapt health systems to meet current population needs. Health systems resilience (HSR) is even more critical in Caribbean countries which face health, environmental, economic shocks and in certain cases political and social upheavals. This study aims to explore the extent to which Haiti, Dominica, and Saint Lucia have developed HSR into their respective contexts.Methods It will consist of a scoping review of available literature on HSR and/or health systems strengthening (HSS) covering Saint Lucia, Dominica, and Haiti, from 2010 to 2023. It will follow the five-point methodological framework proposed by Arksey and O'Malley (2005) and will answer the following question. What approaches, strategies or interventions contribute to building or strengthening HSR in dealing with shocks across these three countries? The perspectives, concepts, dimensions, and definitions from relevant scientific literature will be combined to generate the research equations. The papers identified via PubMed, Scopus, ProQuest, Google Scholar and OpenGrey will then be processed on EndNote and independently filtered by two researchers, reinforced by a third researcher in case of disagreement, according to the PRISMA method adjusted to scoping reviews. Following a deductive-inductive method, the material will be analysed thematically to identify the key approaches, strategies and interventions outlined in the retained materials.Results This scoping review intends to produce a preliminary assessment of how HSR is implemented in the three participating countries. It holds the potential to shed new light on the experiences of these three countries in their efforts to attain resilience in their health systemsConclusions This study might offer insight into the role of stakeholders and processes activated for the achievement of HSR in the Caribbean. In addition, it provides the starting point for the development of a tool to understand and realise HSR, tailored to the three countries.

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“…The literature also focuses on how shocks affect health systems and their preparedness for such events. Some researchers thus differentiate the recurrent failures with which a health system is confronted daily (for example, lack of funding or shortage of human resources) from more acute shocks that entail a profound disruption of health systems' functioning (for example, pandemics and natural disasters) (37)(38)(39) . Referring to the latter category, several authors propose strategies to strengthen a health system's resilience.…”

Section: Health System Resilience De Nition and Associated Conceptsmentioning

confidence: 99%

A scoping review to explore the materialisation of health system resilience across three Caribbean countries, Saint Lucia, Dominica, and Haiti: A protocol

Louis

Wautié

Makali

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: The COVID-19 pandemic offers a window of opportunity for building resilient health systems. As such, it is important to use this opportunity to redesign, strengthen, and adapt health systems to meet current population needs. Health system resilience (HSR) is even more critical in Caribbean countries, which face health, environmental, and economic shocks and,in certain cases, political and social upheavals. This study aims to explore the extent to which Haiti, Dominica, and Saint Lucia have developed HSR into their respective contexts. Methods: This study will consist of a scoping review of the available literature on HSR and/or health systemstrengthening (HSS) covering Saint Lucia, Dominica, and Haiti from 2010 to 2023. It will follow the five-point methodological framework proposed by Arksey and O'Malley (2005) and will answer the following question. What approaches, strategies or interventions contribute to building or strengthening HSR in dealing with shocks across these three countries? The perspectives, concepts, dimensions, and definitions from relevant scientific literature will be combined to generate the research equations. The papers identified via PubMed, Scopus, ProQuest, Google Scholar and OpenGrey will then be processed on EndNote and independently filtered by two researchers, reinforced by a third researcher in case of disagreement, according to the PRISMA method adjusted to scoping reviews. Following a deductive-inductive method, the material will be analysed thematically to identify the key approaches, strategies and interventions outlined in the retained materials. Results: This scoping review intends to produce a preliminary assessment of how HSR is implemented in the three participating countries. It holds the potential to shed new light on the experiences of these three countries in their efforts to attain resilience in their health systems. Conclusions: This study might offer insight into the role of stakeholders and processes activated for the achievement of HSR in the Caribbean. In addition, it provides the starting point for the development of a tool to understand and realise HSR tailored to the three countries.

show abstract

Metrics and indicators used to assess health system resilience in response to shocks to health systems in high income countries—A systematic review

Cited by 18 publications

References 83 publications

Organizational resilience in healthcare: a review and descriptive narrative synthesis of approaches to resilience measurement and assessment in empirical studies

Organizational resilience in healthcare: a review and descriptive narrative synthesis of approaches to resilience measurement and assessment in empirical studies

A scoping review to explore the materialisation of health system resilience across three Caribbean countries, Saint Lucia, Dominica, and Haiti: A protocol

A scoping review to explore the materialisation of health system resilience across three Caribbean countries, Saint Lucia, Dominica, and Haiti: A protocol

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