背景:冠状病毒大流行对护理的组织和提供产生了深远的影响。医疗机构在应对大流行方面面临的挑战加剧了人们对复原力概念的兴趣。虽然努力已经进入了韧性的概念化,关于如何评估组织弹性的工作相对较少。本文报道了对实证医疗保健研究中韧性测量和评估方法的广泛回顾,并检查它们对研究人员的有用性,政策制定者和医疗保健经理。
方法:各种数据库(MEDLINE,EMBASE,PsycINFO,CINAHL(EBSCO主机),CochraneCENTRAL(Wiley),CDSR,科学引文索引,和社会科学引文索引)从2000年1月到2021年9月进行了搜索。我们包括定量的,定性和建模研究,重点是衡量或定性评估医疗保健背景下的组织弹性。所有研究都是根据标题筛选的,摘要和全文。对于每种方法,关于测量或评估格式的信息,数据收集和分析方法,并提取了其他相关信息。我们将组织弹性的方法分为五个对比主题领域:(1)冲击类型;(2)弹性阶段;(3)包括特征或指标;(4)产出的性质;(5)目的。在这些主题领域中对这些方法进行了叙述性总结。
结果:35项研究符合纳入标准。我们发现在如何评估医疗保健中的组织弹性方面缺乏共识,应该测量或评估什么,什么时候,以及使用什么弹性特征和指标。测量和评估方法的范围各不相同,格式,内容和目的。方法不同,无论是前瞻性(休克前的弹性)还是回顾性(休克期间或休克后),以及它们在多大程度上解决了一套预先定义的和特定于冲击的特征和指标。
结论:已经开发了一系列具有不同特征和指标的方法来评估医疗保健中的组织弹性,可能对研究人员有价值,政策制定者和医疗保健经理。在实践中使用的方法的选择应取决于冲击的类型,评估的目的,结果的预期用途,以及数据和资源的可用性。
BACKGROUND: The coronavirus pandemic has had a profound impact on organization and delivery of care. The challenges faced by healthcare organizations in dealing with the pandemic have intensified interest in the concept of resilience. While effort has gone into conceptualising resilience, there has been relatively little work on how to evaluate organizational resilience. This paper reports on an extensive review of approaches to resilience measurement and assessment in empirical healthcare studies, and examines their usefulness for researchers, policymakers and healthcare managers.
METHODS: Various databases (MEDLINE, EMBASE, PsycINFO, CINAHL (EBSCO host), Cochrane CENTRAL (Wiley), CDSR, Science Citation Index, and Social Science Citation Index) were searched from January 2000 to September 2021. We included quantitative, qualitative and modelling studies that focused on measuring or qualitatively assessing organizational resilience in a healthcare context. All studies were screened based on titles, abstracts and full text. For each approach, information on the format of measurement or assessment, method of data collection and analysis, and other relevant information were extracted. We classified the approaches to organizational resilience into five thematic areas of contrast: (1) type of shock; (2) stage of resilience; (3) included characteristics or indicators; (4) nature of output; and (5) purpose. The approaches were summarised narratively within these thematic areas.
RESULTS: Thirty-five studies met the inclusion criteria. We identified a lack of consensus on how to evaluate organizational resilience in healthcare, what should be measured or assessed and when, and using what resilience characteristic and indicators. The measurement and assessment approaches varied in scope, format, content and purpose. Approaches varied in terms of whether they were prospective (resilience pre-shock) or retrospective (during or post-shock), and the extent to which they addressed a pre-defined and shock-specific set of characteristics and indicators.
CONCLUSIONS: A range of approaches with differing characteristics and indicators has been developed to evaluate organizational resilience in healthcare, and may be of value to researchers, policymakers and healthcare managers. The choice of an approach to use in practice should be determined by the type of shock, the purpose of the evaluation, the intended use of results, and the availability of data and resources.