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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.

The authors compare perspectives on external evaluation of health service provision between Norway and the USA. External inspection and accreditation are examples of internationally wide-spread external evaluation methods used to assess the quality of care given to patients. Different countries have different national policy strategies and arrangements set up to do these evaluations. Although there is growing attention to the impact and effects on quality and safety from external evaluation, there is still a gap in knowledge to how structures and processes influence these outcomes. Accordingly, the purpose of this article is to describe the structures and processes in external evaluation designed to promote quality improvement in Norway and the USA with attention to comparison of enablers and barriers in external evaluation systems.

Data collection consisted of documentary evidence retrieved from governmental policies, and reviews of the Joint Commission (the US), international guidelines, recommendations and reports from the International Society for Quality in Health Care, and the World Health Organization, and policies and regulations related to Norwegian governmental bodies such as the Ministry of Health and Care Services, the Norwegian Directorate of Health, and the Norwegian Board of Health Supervision . Data were analyzed inspired by a deductive, direct content analytical framework.

The authors found that both accreditation and inspection are strategies put in place to ensure that healthcare providers have adequate quality systems as well as contributing to the wider risk and safety enhancing management and implementation processes in the organizations subjected to evaluation. The US and the Norwegian external regulatory landscapes are complex and include several policymaking and governing institutions. The Norwegian regulatory framework for inspection has replaced an individual blame logic with a model which “blames” the system for inadequate quality and patient harm. This contrasts with the US accreditation system, which focuses on accreditation visits. Although findings indicate an ongoing turning point in accreditation, findings also demonstrate that involving patients and next of kin directly in adverse event inspections is a bigger part of a change in external inspection culture and methods than in processes of accreditation.

The message of this paper is important for policymakers, and bodies of inspection and accreditation because knowledge retrieved from the comparative document study may contribute to better understanding of the implications from the different system designs and in turn contribute to improving external evaluations.

Although there is a growing attention to the impact and effects on quality and safety from external evaluation, the implications of different regulatory strategies and arrangements for evaluation on quality and safety remain unclear.

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.

This study aims to explore nursing home and home care managers’ strategies in handling the COVID-19 pandemic.

This study has a qualitative design with semistructured individual interviews conducted digitally by videophone (Zoom). Eight managers from nursing homes and five managers from home care services located in a large urban municipality in eastern Norway participated. Systematic text condensation methodology was used for the analysis.

The managers used several strategies to handle challenges related to the COVID-19 pandemic, including being proactive and thinking ahead in terms of possible scenarios that might occur, continuously training of staff in new procedures and routines and systematic information sharing at all levels, as well as providing different ways of disseminating information for staff, service users and next-of-kins. To handle staffing challenges, managers used strategies such as hiring short-term staff that were temporary laid off from other industries and bringing in students.

The COVID-19 pandemic heavily affected health-care systems worldwide, which has led to many health-care studies. The situation in nursing homes and home care services, which were strongly impacted by the pandemic and in charge of a vulnerable group of people, has not yet received enough attention in research. This study, therefore, seeks to contribute to this research gap by investigating how managers in nursing homes and home care services used different strategies to handle the COVID-19 pandemic.

The purpose is to share strategies, rationales and lessons learnt from user involvement in a quality and safety improvement research project from the practice field in nursing homes and homecare services.

This is a viewpoint paper summarizing how researchers and co-researchers from the practice field of nursing homes and homecare services (nurse counsellors from different municipalities, patient ombudsman and next-of-kin representatives/and elderly care organization representant) experienced user involvement through all phases of the research project. The project included implementation of a leadership intervention.

Multiple strategies of user involvement were applied during the project including partnership in the consortium, employment of user representatives (co-researchers) and user-led research activities. The rationale was to ensure sound context adaptation of the intervention and development of tailor-made activities and tools based on equality and mutual trust in the collaboration. Both university-based researchers and Co-researchers experienced it as useful and necessary to involve or being involved in all phases of the research project, including the designing, planning, intervention implementation, evaluation and dissemination of results.

User involvement in research is a growing field. There is limited focus on this aspect in quality and safety interventions in nursing homes and homecare settings and in projects focussing on the leadership' role in improving quality and safety.

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.

The purpose of this rapid review was to present current evidence on relations between resilience and self-efficacy among healthcare practitioners in the context of COVID-19 pandemic.

Literature searches were conducted in February/2022 in the online database MEDLINE EBSCO and not date/time limited. Eligibility criteria were as follows: population – healthcare practitioners, interest – relations between resilience and self-efficacy and context – COVID-19.

Six eligible studies from Italy, China, United Kingdom, India, Pakistan and Spain, published between 2020 and 2021 were included in the review. All studies used quantitative methods. The relations between resilience and self-efficacy were identified in contexts of resilience programs, measuring mental health of frontline nurses, measuring nurses' and nursing students' perception of psychological preparedness for pandemic management, perception of COVID-19 severity and mediating roles of self-efficacy and resilience between stress and both physical and mental quality of life. Findings indicated limited research on this topic and a need for more research.

Broader understanding of the relations between resilience and self-efficacy may help healthcare organizations' leaders/managers aiming to support resilience of their employers under challenging circumstances such as future pandemic.

The latest COVID-19 pandemic presented the opportunity to research relations between resilience and self-efficacy and enrich existed research in a new and extraordinary context.

The purpose of this study is to increase knowledge and understanding of the relationship between full-time-culture and the outcome for quality and safety of care.

The paper is a literature review with a qualitatively oriented thematic analysis concerning quality or safety outcomes for patients, or patients and staff when introducing a full-time culture.

Identified factors that could have a positive or negative impact on quality and patient safety when introducing full-time culture were length of shift, fatigue/burnout, autonomy/empowerment and system/structure. Working shifts over 12 h or more than 40 h a week is associated with increased adverse events and errors, lower quality patient care, less attention to safety concerns and more care left undone. Long shifts give healthcare personnel more flexibility and better quality-time off, but there is also an association between long shifts and fatigue or burnout. Having a choice and flexibility around shift patterns is a predictor of increased wellbeing and health.

A major challenge across healthcare services is having enough qualified personnel to handle the increasing number of patients. One of the measures to get enough qualified personnel for the expected tasks is to increase the number of full-time employees and move towards a full-time culture. It is argued that full-time culture will have a positive effect on work environment, efficiency and quality due to a better allocation of work tasks, predictable work schedule, reduced sick leave, and continuity in treatment and care. There is limited research on how the introduction of full-time culture will affect the quality and safety for patients and staff, and few studies have been focusing on the relationship between longer shift, work schedule, and quality and safety of care.

The purpose of this rapid scoping review was to map existing literature on risk communication strategies implemented by authorities and aimed at vulnerable immigrants in the context of pandemics.

Existing literature on the topic was charted in terms of its nature and volume by summarizing evidence regarding the communication strategies. Literature searches were conducted in Academic Search Premier and CINAHL, databases were searched from 2011 to present on March 31, 2021.

Five articles met the criteria and were included in this review, pointing at limited research in this area. The findings indicated that a close interaction between communication authorities and immigrants is important. Community education, building trust in communication sources, clear risk communication and inclusive decision-making among all were found to be important when communicating health risks to immigrants.

The primary limitation of this rapid scoping review is that the literature searches were conducted in only two databases, namely, Academic Search Premier and CINAHL. A wider search across several other databases could have given more profound results. Furthermore, some studies where immigrants were conceptualized as, for instance, “disadvantaged groups” might be overseen due to a choice of the search strategy used in this study. There are also certain limitations related to the studies included in this review.

Identifying efficient ways of conveying recommendations may further assist authorities and scientists in developing more effective health-related risk communication.

This study covered health-related risk communication in the context of pandemics, addressing the need to investigate different groups of immigrants and the challenges related to communicating risks to these groups.

The purpose of this paper is to increase knowledge of the role organizational factors have in how health personnel make efficiency-thoroughness trade-offs, and how these trade-offs potentially affect clinical quality dimensions.

The paper is a thematic synthesis of the literature concerning health personnel working in clinical, somatic healthcare services, organizational factors and clinical quality.

Identified organizational factors imposing trade-offs were high workload, time limits, inappropriate staffing and limited resources. The trade-offs done by health personnel were often trade-offs weighing thoroughness (e.g. providing extra handovers or working additional hours) in an environment weighing efficiency (e.g. ward routines of having one single handover and work-hour regulations limiting physicians' work hours). In this context, the health personnel functioned as regulators, balancing efficiency and thoroughness and ensuring patient safety and patient centeredness. However, sometimes organizational factors limited health personnel's flexibility in weighing these aspects, leading to breached medication rules, skipped opportunities for safety debriefings and patients being excluded from medication reviews.

Balancing resources and healthcare demands while maintaining healthcare quality is a large part of health personnel's daily work, and organizational factors are suspected to affect this balancing act. Yet, there is limited research on this subject. With the expected aging of the population and the subsequent pressure on healthcare services' resources, the balancing between efficiency and thoroughness will become crucial in handling increased healthcare demands, while maintaining high-quality care.