The Conceptualization of Health Care Resilience: A Scoping Review.

Abstract

Objectives: In recent years, health care resilience has garnered increased attention, particularly since COVID-19. Resilience in health care is commonly framed across four interconnected levels: individual, team, organisational, and systemic. While individual-level resilience is relatively well explored, conceptualisations at other levels remain poorly defined.

Methods: To address this gap, we conducted a scoping review exploring conceptualisations of health care resilience outside of the individual-level using systematic searches of MEDLINE, EMBASE, PsycINFO, and Google Scholar.

Results: From 3734 initial records, 58 met our criteria. Of these, 7 (12.1%) articles did not explicitly define resilience. System-level resilience was the most explored (n=38, 65.5%), followed by organisational (n=12, 20.7%), and cross-level studies (n=8, 13.8%), with no studies exclusively focusing on team-level resilience. Conceptualisations of resilience revealed 5 themes: the goal of resilience; what systems are resilient to; resilience characteristics; its classification as ability, capacity, or capability; and the temporal dimension of resilience. Notably, no distinct patterns emerged specific to a conceptual level, suggesting resilience can be conceptualised across team, organisation, and system levels.

Conclusions: Our findings underscore significant diversity in resilience definitions, indicating an evolving health care resilience paradigm. On the basis of these insights, we propose the following definition, applicable across all levels: health care resilience is the ability to anticipate, absorb, adapt or transform in response to everyday pressures, threats and opportunities to maintain efficient, high quality, and safe performance. A shared understanding of health care resilience would promote the critical imperative for research to bolster health care recovery post-COVID-19 and to prepare for future disruptive events.