Resilience in Healthcare (RiH): a longitudinal research programme protocol

Abstract

IntroductionOver the past three decades, extensive research has been undertaken to understand the elements of what constitutes high quality in healthcare. Yet, much of this research has been conducted on individual elements and their specific challenges. Hence, goals other than understanding the complex of factors and elements that comprises quality in healthcare have been privileged. This lack of progress has led to the conclusion that existing approaches to research are not able to address the inherent complexity of healthcare systems as characterised by a significant degree of performance variability within and across system levels, and what makes them resilient. A shift is, therefore, necessary in such approaches. Resilience in Healthcare (RiH) adopts an approach comprising a comprehensive research programme that models the capacity of healthcare systems and stakeholders to adapt to changes, variations and/or disruptions: that is, resilience. As such, RiH offers a fresh approach capable of capturing and illuminating the complexity of healthcare and how high-quality care can be understood and advanced.Methods and analysisMethodologically, to illuminate what constitutes quality in healthcare, it is necessary to go beyond single-site, case-based studies. Instead, there is a need to engage in multi-site, cross-national studies and engage in long-term multidisciplinary collaboration between national and international researchers interacting with multiple healthcare stakeholders. By adopting such processes, multiple partners and a multidisciplinary orientation, the 5-year RiH research programme aims to confront these challenges and accelerate current understandings about and approaches to researching healthcare quality.The RiH research programme adopts a longitudinal collaborative interactive design to capture and illuminate resilience as part of healthcare quality in different healthcare settings in Norway and in five other countries. It combines a meta-analysis of detailed empirical research in Norway with cross-country comparison from Australia, Japan, Netherlands, Switzerland and the UK. Through establishing an RiH framework, the programme will identify processes with outcomes that aim to capture how high-quality healthcare provisions are achieved. A collaborative learning framework centred on engagement aims to systematically translate research findings into practice through co-construction processes with partners and stakeholders.Ethics and disseminationThe RiH research programme is approved by the Norwegian Centre for Research Data (No. 864334). The empirical projects selected for inclusion in this longitudinal research programme have been approved by the Norwegian Centre for Research Data or the Regional Committees for Medical and Health Research Ethics. The RiH research programme has an embedded publication and dissemination strategy focusing on the progressive sharing of scientific knowledge, information and results, and on engaging with the public, including relevant patient and stakeholder representatives. The findings will be disseminated through scientific articles, PhD dissertations, presentations at national and international conferences, and through social media, newsletters and the popular media.

Multilevel influences on resilient healthcare in six countries: an international comparative study protocol

“…Open access increase resilience, and supporting collaborative learning about RHC. 33 Although implementing interventions is not the purpose of the current study, intervention testing will be part of the overall work of the SHARE Centre and in the Norwegian part of the RiH programme. The results from this multinational study will inform this future work.…”

“…This international comparative study is part of the Resilience in Healthcare (RiH) research programme led by the Norwegian Centre for Resilience in Healthcare (SHARE), comprising five work packages to advance the theory and practice of RHC. 33 The aim of the crosscountry comparative study described here is to investigate how adaptive capacity in hospital teams is influenced by team, organisational and healthcare system factors.…”

“…Patient and public involvement (PPI) representatives were involved in the development of the proposal for the overall RiH research programme, 33 of which this study protocol is a key component. The RiH research programme furthermore has a patient and citizen representative as co-chair of its international Expert Advisory Board, who has been involved in the project development and has contributed to key aspects of its design.…”

Patient and stakeholder involvement in resilient healthcare: an interactive research study protocol

“…The details on this screening protocol and the trigger tool have already been Open access published as part of the overall RiH research programme protocol. 1 Specifically, the sample will be drawn from a pool of approximately 50 research projects, including post-doctoral projects and PhD projects, which involve researchers from the SHARE-Centre for Resilience in Healthcare and were conducted in Norway between 2010 and 2021 (some are ongoing). The screening process will establish if and how the projects relate to resilience and which healthcare quality components they cover.…”

“…Resilience in healthcare (RiH) is fundamental to understanding quality in healthcare provision 1 and is defined by Wiig and colleagues as ‘the capacity to adapt to challenges and changes at different system levels, to maintain high-quality care’. 2 As an emerging field of study within health services research, RiH views healthcare as a complex adaptive system.…”