Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience

Abstract

Background: Traditional approaches to safety management in health care have focused primarily on counting errors and understanding how things go wrong. Resilient Health Care (RHC) provides an alternative complementary perspective of learning from incidents and understanding how, most of the time, work is safe. The aim of this review was to identify how RHC is conceptualised, described and interpreted in the published literature, to describe the methods used to study RHC, and to identify factors that develop RHC. Methods: Electronic searches of PubMed, Scopus and Cochrane databases were performed to identify relevant peer-reviewed studies, and a hand search undertaken for studies published in books that explained how RHC as a concept has been interpreted, what methods have been used to study it, and what factors have been important to its development. Studies were evaluated independently by two researchers. Data was synthesised using a thematic approach. Results: Thirty-six studies were included; they shared similar descriptions of RHC which was the ability to adjust its functioning prior to, during, or following events and thereby sustain required operations under both expected and unexpected conditions. Qualitative methods were mainly used to study RHC. Two types of data sources have been used: direct (e.g. focus groups and surveys) and indirect (e.g. observations and simulations) data sources. Most of the tools for studying RHC were developed based on predefined resilient constructs and have been categorised into three categories: performance variability and Work As Done, cornerstone capabilities for resilience, and integration with other safety management paradigms. Tools for studying RHC currently exist but have yet to be fully implemented. Effective team relationships, trade-offs and health care 'resilience' training of health care professionals were factors used to develop RHC. Conclusions: Although there was consistency in the conceptualisation of RHC, methods used to study and the factors used to develop it, several questions remain to be answered before a gold standard strategy for studying RHC can confidently be identified. These include operationalising RHC assessment methods in multi-level and diverse settings and developing, testing and evaluating interventions to address the wider safety implications of RHC amidst organisational and institutional change.

Long-Term Acute Care Hospitals Extend ICU Capacity for COVID-19 Response and Recovery

“…An ongoing awareness of the status of a system is important for designing resilient processes. 28 As such, a vital component of our LTACH’s resilient work system was a central hub communication network, similar in concept to clinical daily huddles and rounds shown to be effective in providing quality patient care, but controlled centrally through the conveyance of essential information in an emergency management and incident command center design. 29 , 30 , 31 Our version of the central hub, called the virtual operational huddle (VOH), began on March 3, 2020, and served as a real-time review of the current status of hospital operations throughout the network ( Fig 2 ).…”

Fuzzy logic decision support system for hospital employee performance evaluation with maple implementation

“…TOPSIS is a combination of quantitative attributions and qualitative attributions. Hwang and Yoon (1981) proposed TOPSIS method (Hwang & Yoon, 1981), by considering the ideal distances between alternatives. The technique of fuzzy TOPSIS has been successfully applied to the areas of supplier evaluation and selection, risk assessment, facility location selection, robot selection, operating system selection, partner selection, customer evaluation, performance evaluation, etc.…”

Resilience in a prehospital setting - a new focus for future research?

“…Therefore, simulation can be an important tool for identifying factors that have an impact on adaptive capacity. However, apart from a small number of studies within certain clinical areas, healthcare research conducted from a resilience perspective in a prehospital setting is still in its infancy [ 7 ].…”

“…Due to the lack of research helping us to understand what factors may influence patient safety in a prehospital setting, the aim of this commentary is to give a better understanding of how the concept and inclusion of resilience can inspire a new approach for future research in prehospital settings. So far, most studies with a resilience perspective have been conducted in Eds [ 7 , 8 ], however, generalizable models and methods for measuring resilience in EDs still remains a significant challenge, while the role of contextual factors in a prehospital setting are unexplored. We therefore need sufficient framework to be able to theorize and apply these concepts in a prehospital setting at individual, group and system levels.…”