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Bridging complexity theory and resilience to develop surge capacity in health systems

Marie-Christine Therrien (Ecole nationale d’administration publique a Montreal, Montreal, Canada)
Julie-Maude Normandin (Ecole nationale d’administration publique a Montreal, Montreal, Canada)
Jean-Louis Denis (Department of Public Health, Ecole nationale d’administration publique a Montreal, Montreal, Canada)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 20 March 2017

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.

Keywords

Citation

Therrien, M.-C., Normandin, J.-M. and Denis, J.-L. (2017), "Bridging complexity theory and resilience to develop surge capacity in health systems", Journal of Health Organization and Management, Vol. 31 No. 1, pp. 96-109. https://doi.org/10.1108/JHOM-04-2016-0067

Publisher

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Emerald Publishing Limited

Copyright © 2017, Emerald Publishing Limited