Resilience engineering in practice: Reflecting on a pediatric hospital’s preparation for unknown coronavirus outbreak

Abstract

At the start of 2020, hospitals around the world were trying to adapt during the COVID-19 pandemic. From the resilience engineering perspective, this outbreak would be a significant test as healthcare institutions try to tolerate and manage this major disruption. This paper shares insights on what a stand-alone paediatric hospital in Singapore had done to stay ahead since the beginning of the outbreak. Observations were conducted from 25-Jan-20 to 25-Mar-20 to capture evidence of resilient behavior, notably in the form of improvisations. Findings revealed adaptations made across various organization levels: at the macrosystem to create capacity to isolate safely, at the mesosystem to facilitate teamwork, and at the microsystem to manage compromises at the frontlines. Juxtaposing this episode with other examples of organizational resilience, this paper maps out common resilience engineering themes in the hospital’s response to COVID-19, but also questions what defines an organization’s success in being