Developing Methods to Support Collaborative Learning and Co-creation of Resilient Healthcare-Tips for Success and Lessons Learned From a Norwegian Hospital Cancer Care Study

The Conceptualization of Health Care Resilience: A Scoping Review

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.

Relocation of hospital facilities: guidelines for resilient performance

BACKGROUND

The relocation of a hospital unit is a complex process that demands both formal planning and informal self-organization on the spot to cope with unexpected events under time pressure. However, guidelines to support this process are fragmented and concealed in the literature. This article addresses this gap by presenting guidelines for the relocation of hospital facilities, using the complexity-informed lens of organizational resilience.

METHODS

The guidelines were based on the study of relocating a surgical unit, in which the new facilities were approximately 400% larger. Data collection involved interviews with professionals holding leadership positions in the relocation project, non-participant observations of the meetings of the relocation project committee, and guided tours at the old and new facilities. An initial deductive thematic analysis was conducted to identify instances of resilience and brittleness. Then, inductive reasoning gave rise to the relocation guidelines.

RESULTS

Seventeen guidelines for resilient relocation of hospital facilities are proposed. All guidelines are applicable to the period before the change, highlighting their proactive nature. They also operationalize seven principles of designing for resilient performance, mainly those related to the provision of slack resources and creation of opportunities for learning.

CONCLUSIONS

The guidelines consist of new prescriptive knowledge, explicitly connected to the resilience perspective. They are particularly relevant to hospital managers that lead the relocation process.

The role of collaborative learning in resilience in healthcare-a thematic qualitative meta-synthesis of resilience narratives

BACKGROUND

To provide high quality services in increasingly complex, constantly changing circumstances, healthcare organizations worldwide need a high level of resilience, to adapt and respond to challenges and changes at all system levels. For healthcare organizations to strengthen their resilience, a significant level of continuous learning is required. Given the interdependence required amongst healthcare professionals and stakeholders when providing healthcare, this learning needs to be collaborative, as a prerequisite to operationalizing resilience in healthcare. As particular elements of collaborative working, and learning are likely to promote resilience, there is a need to explore the underlying collaborative learning mechanisms and how and why collaborations occur during adaptations and responses. The aim of this study is to describe collaborative learning processes in relation to resilient healthcare based on an investigation of narratives developed from studies representing diverse healthcare contexts and levels.

METHODS

The method used to develop understanding of collaborative learning across diverse healthcare contexts and levels was to first conduct a narrative inquiry of a comprehensive dataset of published health services research studies. This resulted in 14 narratives (70 pages), synthesised from a total of 40 published articles and 6 PhD synopses. The narratives where then analysed using a thematic meta-synthesis approach.

RESULTS

The results show that, across levels and contexts, healthcare professionals collaborate to respond and adapt to change, maintain processes and functions, and improve quality and safety. This collaboration comprises activities and interactions such as exchanging information, coordinating, negotiating, and aligning needs and developing buffers. The learning activities embedded in these collaborations are both activities of daily work, such as discussions, prioritizing and delegation of tasks, and intentional educational activities such as seminars or simulation activities.

CONCLUSIONS

Based on these findings, we propose that the enactment of resilience in healthcare is dependent on these collaborations and learning processes, across different levels and contexts. A systems perspective of resilience demands collaboration and learning within and across all system levels. Creating space for reflection and awareness through activities of everyday work, could support individual, team and organizational learning.