The Conceptualization of Health Care Resilience: A Scoping Review

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.

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.

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.

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.