Healthcare resilience: a meta-narrative systematic review and synthesis of reviews.

Healthcare resilience: a meta-narrative systematic review and synthesis of reviews.

Publication date: Sep 20, 2023

The COVID-19 pandemic has tested global healthcare resilience. Many countries previously considered ‘resilient’ have performed poorly. Available organisational and system frameworks tend to be context-dependent and focus heavily on physical capacities. This study aims to explore and synthesise evidence about healthcare resilience and present a unified framework for future resilience-building. Systematic review and synthesis of reviews using a meta-narrative approach. Healthcare organisations and systems. Definitions, concepts and measures of healthcare resilience. We used thematic analysis across included reviews to summarise evidence on healthcare resilience. The main paradigms within healthcare resilience include global health, disaster risk reduction, emergency management, patient safety and public health. Definitions of healthcare resilience recognise various hierarchical levels: individual (micro), facility or organisation (meso), health system (macro) and planetary or international (meta). There has been a shift from a focus on mainly disasters and crises, to an ‘all-hazards’ approach to resilience. Attempts to measure resilience have met with limited success. We analysed key concepts to build a framework for healthcare resilience containing pre-event, intra-event, post-event and trans-event domains. Alongside, we synthesise a definition which dovetails with our framework. Resilience increasingly takes an all-hazards approach and a process-oriented perspective. There is increasing recognition of the relational aspects of resilience. Few frameworks incorporate these, and they are difficult to capture within measurement systems. We need to understand how resilience works across hierarchical levels, and how competing priorities may affect overall resilience. Understanding these will underpin interdisciplinary, cross-sectoral and multi-level approaches to healthcare resilience for the future. CRD42022314729.

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Concepts Keywords
Competing Hospitals
Healthcare Systematic Review


Type Source Name
disease MESH COVID-19 pandemic
disease MESH emergency
disease IDO facility
drug DRUGBANK Methionine
drug DRUGBANK Spinosad
disease IDO process
disease MESH infection
disease VO vaccine
drug DRUGBANK Tretamine
drug DRUGBANK Coenzyme M
disease VO protocol
disease VO volume
disease IDO quality
disease MESH shock
disease IDO country
drug DRUGBANK Etoperidone
disease VO time
disease VO frequency
disease MESH infectious diseases
disease VO effective
disease MESH sepsis
drug DRUGBANK Isoxaflutole
drug DRUGBANK Trestolone
disease IDO history
disease VO effectiveness
pathway REACTOME Translation
disease VO vaccination
disease IDO healthcare facility
drug DRUGBANK Pentaerythritol tetranitrate
disease IDO object
disease VO Canada
drug DRUGBANK Dimercaprol
disease VO report
disease MESH septic shock

Original Article

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