1. Bridging complexity theory and resilience to develop surge capacity in health systems
- Author
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Julie-Maude Normandin, Jean-Louis Denis, and Marie-Christine Therrien
- Subjects
Value (ethics) ,Computer science ,Process (engineering) ,Population ,03 medical and health sciences ,0302 clinical medicine ,0502 economics and business ,Humans ,030212 general & internal medicine ,Resilience (network) ,education ,education.field_of_study ,Surge Capacity ,business.industry ,Health Policy ,05 social sciences ,Environmental resource management ,Continuity of Patient Care ,Risk analysis (engineering) ,Preparedness ,Models, Organizational ,Business, Management and Accounting (miscellaneous) ,Mandate ,Socio-ecological system ,business ,Delivery of Health Care ,050203 business & management - Abstract
Purpose Health systems are periodically confronted by crises – think of Severe Acute Respiratory Syndrome, H1N1, and Ebola – during which they are called upon to manage exceptional situations without interrupting essential services to the population. The ability to accomplish this dual mandate is at the heart of resilience strategies, which in healthcare systems involve developing surge capacity to manage a sudden influx of patients. The paper aims to discuss these issues. Design/methodology/approach This paper relates insights from resilience research to the four “S” of surge capacity (staff, stuff, structures and systems) and proposes a framework based on complexity theory to better understand and assess resilience factors that enable the development of surge capacity in complex health systems. Findings Detailed and dynamic complexities manifest in different challenges during a crisis. Resilience factors are classified according to these types of complexity and along their temporal dimensions: proactive factors that improve preparedness to confront both usual and exceptional requirements, and passive factors that enable response to unexpected demands as they arise during a crisis. The framework is completed by further categorizing resilience factors according to their stabilizing or destabilizing impact, drawing on feedback processes described in complexity theory. Favorable order resilience factors create consistency and act as stabilizing forces in systems, while favorable disorder factors such as diversity and complementarity act as destabilizing forces. Originality/value The framework suggests a balanced and innovative process to integrate these factors in a pragmatic approach built around the fours “S” of surge capacity to increase health system resilience.
- Published
- 2017