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Since the outbreak of the COVID-19 pandemic, most organizations have experienced a sudden and unprecedented drop in revenue and productivity. However, the pandemic did not exclusively negatively impact organizations; rather, it resulted in both negative and positive effects. To delve into the multi-level process through which organizational outcomes change from negative to positive indicators, this study focuses on organizational resilience as a theoretical concept to overcome pandemic-related turmoil.

The authors conducted a multi-level analysis based on grounded theory with a sample of 30 healthcare employees who worked in hospitals and were simultaneously enrolled in a part-time master of business administration (MBA) program at a university in the Midwest. Of the 30 participants, 21 were from a single university hospital (UH), and the remaining 9 participants were from other hospitals (non-UH).

The authors analyzed the data and incorporated three existing perspectives of organizational resilience (attribute, process and multi-level views) into an integrated model. The authors identified 25 first-order concepts and 8 second-order themes and categorized them into 4 aggregate dimensions at different unit levels: organizational field, leadership, operation and individual units.

A resilient hospital operates as a cohesive system, with entities at various levels – from individuals and teams to the broader organization – collaborating seamlessly to foster resilience. Top management team (TMT) should persistently communicate with employees to provide information about the current crisis and clear strategic directions to reduce employees' fear and prevent anomie stemming from future uncertainty. Managers should not only be concerned about employees' physical safety from infection and psychological safety from isolation but also encourage employees to elicit meaningfulness from their work. Furthermore, TMT and human resource (HR) teams should adapt human resource management (HRM) practices to allow for flexibility and optimism in employee roles.

In this study, the authors utilized a qualitative methodology with grounded theory in order to develop a comprehensive model that holds theoretical, methodological and practical significance. Theoretically, the authors' novelty lies in the synthesis of three distinct perspectives: attribute, process and multi-level. The authors merged these approaches into a unified model, identifying precursors of resilience at different levels. Methodologically, the authors focused on hospitals as target samples, which were the foremost and representative organizations severely confronting the crisis and turmoil brought by the pandemic. The authors documented organizations' experiences amidst the crisis as they unfolded in real time rather than in hindsight. This approach highlights the immediacy and significance of the authors' research in the realm of crisis management. Practically, the authors' findings illuminate that organizational resilience can be developed through a collaborative effort. It emerges from coordinated interactions across various organizational actors, from employees and middle managers to the TMT.