Evidence map›Paper›PMID 37730383›Full record

SynthesisBMJ open2023

Healthcare resilience: a meta-narrative systematic review and synthesis of reviews.

Mark Z Y Tan, Gabrielle Prager, Andrew McClelland, Paul Dark

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Measuring hospital care resilience: a systematic literature review.The European journal of health economics : HEPAC : health economics in prevention and care · 2026
    Pooled it
  2. Article
  3. Article
  4. Interventions for enhancing resilience in breast cancer patients: a realist review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Review
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Mark Z Y TanHumanitarian and Conflict Response Institute, The University of Manchester, Manchester, UK mark.tan.zy@gmail.com.ORCID 0000-0003-3330-728X
Gabrielle PragerDepartment of International Health, Johns Hopkins University, Baltimore, Maryland, USA.
Andrew McClellandAlliance Manchester Business School, The University of Manchester, Manchester, UK.
Paul DarkHumanitarian and Conflict Response Institute, The University of Manchester, Manchester, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe COVID-19 pandemic has tested global healthcare resilience. Many countries previously considered 'resilient' have performed poorly. Available organisational and system frameworks tend to be context-dependent and focus heavily on physical capacities. This study aims to explore and synthesise evidence about healthcare resilience and present a unified framework for future resilience-building.

designSystematic review and synthesis of reviews using a meta-narrative approach.

settingHealthcare organisations and systems. PRIMARY AND SECONDARY OUTCOME MEASURES: Definitions, concepts and measures of healthcare resilience. We used thematic analysis across included reviews to summarise evidence on healthcare resilience.

resultsThe main paradigms within healthcare resilience include global health, disaster risk reduction, emergency management, patient safety and public health. Definitions of healthcare resilience recognise various hierarchical levels: individual (micro), facility or organisation (meso), health system (macro) and planetary or international (meta). There has been a shift from a focus on mainly disasters and crises, to an 'all-hazards' approach to resilience. Attempts to measure resilience have met with limited success. We analysed key concepts to build a framework for healthcare resilience containing pre-event, intra-event, post-event and trans-event domains. Alongside, we synthesise a definition which dovetails with our framework.

conclusionResilience increasingly takes an all-hazards approach and a process-oriented perspective. There is increasing recognition of the relational aspects of resilience. Few frameworks incorporate these, and they are difficult to capture within measurement systems. We need to understand how resilience works across hierarchical levels, and how competing priorities may affect overall resilience. Understanding these will underpin interdisciplinary, cross-sectoral and multi-level approaches to healthcare resilience for the future. PROSPERO REGISTRATION NUMBER: CRD42022314729.

Indexed as

COVID-19DisastersHealth FacilitiesHumansPandemicsPatient SafetyHEALTH SERVICES ADMINISTRATION & MANAGEMENTHospitalsPUBLIC HEALTHQUALITATIVE RESEARCHSystematic Review

Identifiers

PMID37730383
PMCPMC10514640

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.