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Resilience in healthcare is fundamental for what constitutes quality in healthcare. To understand healthcare resilience, resilience research needs a multilevel perspective, diverse research designs, and taking advantage of different data sources. However, approaching resilience researchers as a data source is a new approach within this field and needs careful consideration to ensure that research is trustworthy and ethically sound. The aim of this short “backstage” general review paper is to give a snapshot of how the Resilience in Healthcare (RiH) research program identified and dealt with potential methodological and ethical challenges in researching researcher colleagues.

The authors first provide an overview of the main challenges and benefits from the literature on researching researcher colleagues. Second, the authors demonstrate how this literature was used to guide strategies and principles adopted in the RiH research process.

The paper describes established principles and a checklist for data collection and analysis to overcome potential dilemmas and challenges to ensure trustworthiness and transparency in the process.

Mining the knowledge and experience of resilience researchers is fundamental for taking the research field to the next step, and furthermore an approach that is relevant across different research fields. This paper provides guidance on how other research projects can approach researcher colleagues in similar ways to gain new insight, build theory and advance their research field based on insider competence.

While there are a number of diversity programs centered on advanced science, technology, engineering, and mathematics (STEM) initiatives at colleges and universities throughout the country, the Chicago Area Health and Medical Careers Program (CAHMCP) is unique because of combination of the longevity of the program, its healthcare focus, its affiliation over the years with multiple institutions, and the scale of its impact. CAHMCP is a pipeline program focused on identifying and recruiting students at any point in their academic development, providing educational programming, and supporting them until they are medical professionals.

Over the course of its nearly 40-year history, CAHMCP has recruited participants as early as elementary school and advised them until they were established in their careers. With its combination of personalized mentoring, classroom teaching, and community healthcare engagement, CAHMCP has succeeded in identifying the needs of the community and its young people. Beyond helping students enhance their academic profile over time, CAHMCP helps youth develop as community leaders. Giving back to the community has been a core principle of the program, so as they are matured, CAHMCP alumni have given back to the program as well as influencing broader healthcare and medical education initiatives. This chapter discusses the unique nature of the CAHMCP program and its successes.

To discuss how managers contribute in promoting resilience in healthcare, and to suggest a model of managers' role in supporting resilience and elaborate on how future research and implementation studies can use this to further operationalize the concept and promote healthcare resilience.

The authors first provide an overview of and discuss the main approaches to healthcare resilience and research on management and resilience. Second, the authors provide examples on how managers work to promote healthcare resilience during a one-year Norwegian longitudinal intervention study following managers in nursing homes and homecare services in their daily quality and safety work. They use this material to propose a model of management and resilience.

The authors consider managerial strategies to support healthcare resilience as the strategies managers use to engage people in collaborative and coordinated processes that adapt, enhance or reorganize system functioning, promoting possibilities of learning, growth, development and recovery of the healthcare system to maintain high quality care. The authors’ model illustrates how managers influence the healthcare systems ability to adapt, enhance and reorganize, with high quality care as the key outcome.

In this study, the authors argue that managerial strategies should be considered and operationalized as part of a healthcare system's overall resilience. They propose a new model of managers' role in supporting resilience to be used in practice, interventions and future research projects.

Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and managerial differences, if any, differences of ownership make to healthcare providers. The purpose of this paper is to examine the connections between ownership, organisational structure and managerial regime within an elaboration of Donabedian’s reasoning about organisational structures. Using new data from England, it considers: how do the internal managerial regimes of differently owned healthcare providers differ, or not? In what respects did any such differences arise from differences in ownership or for other reasons?

An observational systematic qualitative comparison of differently owned providers was the strongest feasible research design. The authors systematically compared a maximum variety (by ownership) sample of community health services; out-of-hours primary care; and hospital planned orthopaedics and ophthalmology providers (n=12 cases). The framework of comparison was the ownership theory mentioned above.

The connection between ownership (on the one hand) and organisation structures and managerial regimes (on the other) differed at different organisational levels. Top-level governance structures diverged by organisational ownership and objectives among the case-study organisations. All the case-study organisations irrespective of ownership had hierarchical, bureaucratic structures and managerial regimes for coordinating everyday service production, but to differing extents. In doctor-owned organisations, the doctors’, but not other occupations’, work was controlled and coordinated in a more-or-less democratic, self-governing ways.

This study was empirically limited to just one sector in one country, although within that sector the case-study organisations were typical of their kinds. It focussed on formal structures, omitting to varying extents other technologies of power and the differences in care processes and patient experiences within differently owned organisations.

Type of ownership does appear, overall, to make a difference to at least some important aspects of an organisation’s governance structures and managerial regime. For the broader field of health organisational research, these findings highlight the importance of the owners’ agency in explaining organisational change. The findings also call into question the practice of copying managerial techniques (and “fads”) across the public–private boundary.

Ownership does make important differences to healthcare providers’ top-level governance structures and accountabilities and to work coordination activity, but with different patterns at different organisational levels. These findings have implications for understanding the legitimacy, governance and accountability of healthcare organisations, the distribution and use power within them, and system-wide policy interventions, for instance to improve care coordination and for the correspondingly required foci of healthcare organisational research.

Brad Astbury is research fellow in the Centre for Program Evaluation, Melbourne Graduate School of Education at the University of Melbourne where he lectures within the Masters of Evaluation course. His interests lie in evaluation theory and social research methodology. Brad has conducted evaluations in a number of areas, including corrections, education, health promotion and various family and community service interventions.

The purpose of this conceptual paper is to develop a model of the hypothesized relationships between investments and outcomes of resilient health care (RHC).

Based on the extant literature, the aforementioned model is described along with proxy measures of its composing variables and a matrix for assessing the cost-effectiveness of RHC instantiations. Additional possible relationships are set out in two propositions for theory testing.

The model conveys that RHC gives rise to both desired and undesired outcomes. Investments moderate the relationships between RHC and its outcomes. Both investments and outcomes can be broadly categorized as either human or technical. Moreover, the propositions refer to what type and how much investment is necessary to perform in a resilient manner, what are the intended or desired outcomes of RHC, for how long and who is affected by these outcomes.

The cost-effectiveness perspective of RHC is new and the proposed model opens opportunities for empirical and theoretical research.