A systematic literature review of the relationship between management and resilience in healthcare

Background

Resilience in healthcare (RiH) is about the capacity to adapt to challenges and changes at different system levels, to maintain high quality care. Managers play a critical role in enabling, fostering and supporting RiH. Despite the wide range of management approaches, strategies, and interventions that have been put into practice and examined in the healthcare field, there remains a knowledge gap regarding managers' impact on resilience within healthcare organizations and what type of management strategies and approaches promote RiH.

Aim

This systematic review aimed to identify and synthesize research evidence concerning management strategies and RiH as well as to explore the relationship between, and impact of management approaches and strategies on promoting RiH.

Data sources

CINAHL, MEDLINE, Pubmed and Embase.

Eligibility criteria

(1) primary qualitative, quantitative, and mixed-method research studies, published in English; and (2) (a) evaluated the relationship between management and RiH and/or explored management activities, strategies, approaches, and interventions promoting RiH, (b) in the context of healthcare settings.

Screening, data extraction and synthesis

Study titles, abstracts (n = 2433), and full-texts were (n = 75) screened for inclusion by pairs of independent reviewers. Discrepancies were resolved via discussion. Data were extracted independently by pairs of reviewers using a predesigned data extraction form.

Results

Sixteen studies were included in the review. The analysis resulted in seven themes: Development of relations; Trade-offs; Making room for adaptations; Innovative solutions; Contextual understanding and Collaborative learning.

Conclusion

Management strategies for RiH include the development of relations with workers, conducting sound trade-offs, make room for adaptations (e.g., absorptive, adaptive, and transformative strategies), to initiate, implement and being open to innovative solutions, developing a contextual understanding of their workplace, ensuring good communication between workers and leaders at the macro level, and to enable collaborative learning. Management strategies for RiH are likely to be context specific due to differences in work culture and access to resources. New ways of supporting RiH might be developed, using existing management strategies as the foundation to support resilience within healthcare organizations.