"If you can't measure it, you can't improve it": why do we need a new tool to assess hospital resilience?

Hospital resilience is a critical determinant of health system function during emergencies and disasters, as hospitals are often the last line of healthcare. Strengthening hospital resilience is a way to ensure uninterrupted, safe, and effective care when crises strike. However, the varied interpretations of resilience hinder its operationalization and evaluation. The lack of standardized, measurable indicators highlights the complexity of hospital resilience and the inadequacy of current assessment tools. This viewpoint explores existing gaps and challenges in effectively assessment of hospital resilience, including failures to measure dynamic capacities, community engagement, and external risk factors. We suggest the urgent development of a participatory, evidence-based tool to guide hospital administrators, policymakers, and researchers. Such a tool would aid in informing focused interventions, enhancing system-wide readiness, and enhancing global response capacity to respond to future disasters.