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医疗保健领域的组织韧性:一项范围综述

Organizational Resilience in Healthcare: A Scoping Review.

作者信息

Ratliff Hannah C, Lee Kathryn A, Buchbinder Mara, Kelly Lesly A, Yakusheva Olga, Costa Deena Kelly

机构信息

Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.

Johns Hopkins School of Nursing, Baltimore, Maryland.

出版信息

J Healthc Manag. 2025;70(3):165-188. doi: 10.1097/JHM-D-24-00084. Epub 2025 May 9.

Abstract

GOAL

Healthcare organizations have always faced challenges, yet the past decade has been particularly difficult due to workforce shortages, the COVID-19 pandemic, and economic demands, all of which can impact quality of care. While some healthcare organizations have demonstrated the ability to adapt to such stressors-which has been termed "organizational resilience"-others have not. Most of the research on resilience in healthcare has been on individual clinicians; less is known about how extra-individual groups such as teams, units, and systems develop resilience. Understanding what organizational resilience is, how to measure it, and how healthcare organizations can develop it is essential to responding effectively to future acute and chronic stressors in the healthcare industry. The purpose of this scoping review is to synthesize how organizational resilience is defined and measured in the current healthcare literature and to inform future interventions to improve organizational resilience.

METHODS

We searched PubMed and Scopus databases for articles mentioning organizational resilience in healthcare. Eligible sources were those published in English through December 2023 in any format, and that described or measured organizational resilience in healthcare. Titles and abstracts were screened, and information was extracted from eligible articles.

PRINCIPAL FINDINGS

We screened 243 articles and included 97 in our review. Across these studies, organizational resilience was described as a healthcare system's ability to continue functioning and meet its objectives when exposed to stressful stimuli. Reactive and proactive strategies, as well as reflection, were identified as key components of organizational resilience. Four measures of organizational resilience were developed for use in healthcare, but only two have been validated.

PRACTICAL APPLICATIONS

Future studies should focus on validating and comparing existing measures of organizational resilience and using them to investigate how organizational resilience may impact quality of care and clinician well-being, allowing the field to move beyond the focus on individual clinician resilience.

摘要

目标

医疗保健机构一直面临挑战,但由于劳动力短缺、新冠疫情和经济需求,过去十年尤为艰难,所有这些都会影响医疗质量。虽然一些医疗保健机构已展现出适应这些压力源的能力——这被称为“组织韧性”——但其他机构则不然。医疗保健领域关于韧性的研究大多针对个体临床医生;对于团队、科室和系统等个体之外的群体如何培养韧性,我们了解得较少。了解什么是组织韧性、如何衡量它以及医疗保健机构如何培养它,对于有效应对医疗行业未来的急性和慢性压力源至关重要。本范围综述的目的是综合当前医疗保健文献中组织韧性的定义和衡量方法,并为未来提高组织韧性的干预措施提供参考。

方法

我们在PubMed和Scopus数据库中搜索提及医疗保健领域组织韧性的文章。符合条件的来源是截至2023年12月以任何格式用英文发表的、描述或衡量医疗保健领域组织韧性的文章。对标题和摘要进行筛选,并从符合条件的文章中提取信息。

主要发现

我们筛选了243篇文章,其中97篇纳入综述。在这些研究中,组织韧性被描述为医疗系统在面临压力刺激时继续运作并实现其目标的能力。反应性和前瞻性策略以及反思被确定为组织韧性的关键组成部分。已开发出四种用于医疗保健领域的组织韧性衡量方法,但只有两种经过验证。

实际应用

未来的研究应侧重于验证和比较现有的组织韧性衡量方法,并使用它们来研究组织韧性如何影响医疗质量和临床医生的福祉,从而使该领域能够超越对个体临床医生韧性的关注。

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