Key drivers of organizational resilience in healthcare: a dynamic capabilities perspective

This study aims to investigate how healthcare organizations enact and sustain resilience amid persistent disruptions such as pandemics, regulatory changes and resource shortages. It applies dynamic capabilities theory (DCT) to clarify the mechanisms that enable organizations to sustain essential services in complex and resource-constrained environments.

A qualitative design was employed, using the healthcare organization as the unit of analysis. Data were collected through 30 semi-structured interviews with healthcare professionals and 15 patient interviews across primary, secondary and tertiary facilities in India. Thematic analysis combined inductive coding of first-order concepts with deductive alignment to DCT dimensions. Peer debriefing enhanced the reliability of interpretation.

The analysis identified three dynamic capabilities - sensing, seizing and reconfiguring - as core antecedents of organizational resilience. Practices such as environmental scanning, strategic planning and change management emerged as microfoundations that highlighted how deliberate managerial choices shape resilience. These capabilities enabled organizations to anticipate disruptions, mobilize resources and adapt workflows to maintain continuity of care.

The qualitative design and single-country context limit generalizability. Future studies should validate the findings through larger cross-national samples. Despite these limitations, this study provides healthcare leaders with actionable strategies to enact and sustain organizational resilience. Organizations that sustain essential services during crises enhance public trust and protect vulnerable populations.

This study extends DCT into the underexplored healthcare domain and provides empirical grounding through multi-stakeholder perspectives. A dual-lens account - integrating professional and patient views - shows how resilience is both enacted within organizations and experienced in care delivery. The identification of novel microfoundations enriches theoretical understanding and offers practical strategies for healthcare leaders.