Organizational Resilience in Nursing: A Concept Analysis Using Rodgers' Evolutionary Approach

Organizational Resilience in Nursing: A Concept Analysis Using Rodgers' Evolutionary Approach | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Organizational Resilience in Nursing: A Concept Analysis Using Rodgers' Evolutionary Approach Ying Peng, Huanhuan Huang, Yangli Ou, Chunni Wang, Mingzhao Xiao, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3410621/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Aim To differentiate, clarify, and identify the development, concept, attributes, types, prerequisites, and consequences of organizational resilience, ultimately to contribute improve strategies. Design: Rodgers and Knafl’s evolutionary concept was applied. Methods Five databases (MEDLINE, CINAHL, Web of Science, PubMed, Embase) were searched from 1973 to 2023 to identify relevant sources. Thematic analysis was used to form the conceptual connotation of organizational resilience. Results A total of 45 articles were included for synthesis. Six antecedents of organizational resilience were identified, that is robustness, redundancy, rapidity, and resourcefulness. Nine attributes of organizational resilience include robustness, redundancy, rapidity, resourcefulness, diversity, adaption, self-regulation, flexibility, and recoverability, and the consequence was explored. Conclusions The overall direction for what Organizational resilience involves and its overall qualities could assist an organization with focusing on its activities and systems inside its unique circumstance and arrive at its strength objective, accordingly healthcare system to continue to adapt and evolve in the face of stress and change. Our conceptual analysis of organizational resilience gives a complete comprehension of this phenomenon and a rationale for instrument development, future research and intervention. Impact: This study defines the concept, antecedents, attributes and consequences of organizational resilience. Strengthening resilience could improve the overall adaptability and sustainability of organizations. This study helps to provide guidance and recommendations for health organizations to enhance their resilience and meet future challenges. Organizational resilience adoption nursing concept analysis Figures Figure 1 Figure 2 Introduction In recent years, pandemics such as climate change, local wars, and public health emergencies have superimposed, causing significant systemic risks and enormous social and economic impacts 1,2 . The societies and environments in which organizations operate are becoming increasingly complex as globalization accelerates and the world landscape continues to change. Crises and disasters have become recurring events that organizations need to face as they grow. Organizations need to be more flexible in order to survive and develop in this challenging environment, especially during major crisis events 3,4 . In 2020, the WHO re-released “Strengthening the Resilience of Health Systems: Key Concepts and Strategies (2020)” and proposed that the resilience of health systems is key to responding to catastrophic events 7 . In addition, World Health Organization has integrated resilience into the formulation of the 2030 Sustainable Development Goals 6 . Thus, As a result, the importance and impact of resilience in international disaster-related research and national policies have increased in recent years. COVID-19 has once again tested the ability of organizations to withstand health shocks while maintaining daily functions, and organizations and countries are increasingly focusing on the development of organizational resilience 19 , research and policy have multiplied. However, the specific definition and analysis of organizational resilience remain subjects of debate, with varying perspectives on this matter. The concept of organizational resilience is lacking, particularly in the area of nursing. BACKGROUND Resilience, also known as toughness, elasticity, and reduction, is the capacity of an object to quickly return to its original state when subjected to external forces 8 . It first appeared in the field of materials science. Previous studies have shown that the development of resilience is mainly divided into the following three stages. 1973, C.S. He applies the theory of complex adaptation systems to ecosystems: such systems respond to the imperatives of changing conditions 9 , 10 . Holling developed the concept of “ecological resilience” is proposed. Resilience turn a assessment of how much damage a system can withstand. The concept has been applied to all fields of complex systems science (economics, politics, etc.). The series, called Resilience Minds 11 , 12 and aims to concentrate on how systems change and respond to disturbances. Since then, the concept of resilience has been widely used and popularized. Later, in order to adapt to sudden disasters and environmental changes, a combination of social, managerial, economic, psychological and other multidisciplinary content was gradually introduced into the field of social science, evolving into “ecological social resilience”, also known as “evolutionary resilience” 13 , 14 . With the rapid change in the economic environment and the increasingly furious competition, management scholars introduced the concept of resilience into the field of management and put forward the topic of “organizational resilience” 15 . In the wake of the 2014-16 Ebola outbreak in West Africa, WHO called on all countries to “build resilient and integrated systems capable of responding to and actively responding to any future threats,” 16 and the concept of "resilience" is gradually being extended to health systems 17 , 18 .17,18. Concept analysis is one of literature review aimed at clarifying concepts that are important in academic discourse but poorly definitional clarity concepts in academic discourse, carefully assessing the internal composition of complex concepts and identifying their components in order to improve their exploratory capabilities 20 . Concept analysis helps to identify common meanings used in a discipline and provides a basis for educational, practical, and theoretical development 21 . Thus, our study aimed to differentiate, clarify, and identify the development, concept, attributes, types, prerequisites, and consequences of organizational resilience, ultimately to contribute improved strategies. METHODS 3.1 Study design Rodgers’ evolutionary concept analysis was used in this study 22 , which involves four stages: 1) Identifying the intended concepts and their associated statements and alternative terms; 2) identifying and selecting an appropriate scope for data collection; 3) collecting data related to conceptual characteristics and aligned with contextual changes, including social, cultural, interdisciplinary and temporal changes (antecedents and consequences of the concept); 4) taking into account the characteristics of the data analysis of the concept, identifying suitable examples related to the concept, and identify the assumptions and implications of the analysis to further develop the concept 23 . 3.2 Data sources Search terms included ‘resilience’ or ‘resilient’ or ‘resilienc*’ and ‘organizations’ or ‘organization’ or ‘institution’ or ‘system’ or ‘organization*’ in MEDLINE, CINAHL, Web of Science, PubMed, Embase. There is a limit from 1973 to 2023. Inclusion criteria: 1) theoretical or conceptual models or frameworks related to organizational resilience;2) a review of existing literature related to organizational resilience; or 3) primary research findings on theoretical or conceptual models or frameworks of organizational resilience. Exclusion criteria: 1) Articles that lack references, authors, and full text, 2) Duplicate articles published by the same author in different journals, 3) Focus on psychological, ecological, personal, or other agent resilience rather than organizational resilience. 3.3 Data analysis process Firstly, the full text was reviewed by YLO and CNW. Then, sort the extracted data into an Excel spreadsheet. Secondly, YP and HHH reviewed again for methodical information assortment and to guarantee the legitimacy of the coding and use point investigation to indicate attributes, antecedents, and consequences. Thirdly, YP and HHH Utilizing diagrams and networks, analyze every one of these classifications independently to distinguish key and thorough subjects, then sort the discoveries into attributes, antecedents, consequences, related concepts, alternative terms, and definitions. Inside each segment, the information is explored on different occasions to empower specialists to suffocate in it and concentrate on central issues and names to give an unmistakable clarification of different parts of the idea. Finally, the data on the concept of organizational resilience are summarized and analyzed, and the theme is determined. The data unit includes words and sentences that answer the question: What are the specific attributes of organizational resilience? How to define organizational resilience? What are the signs of organizational resilience? What factors are related to organizational resilience? What are the consequences of organizational resilience? RESULTS 4.1 General results In the first phase, a total of 6,629 articles were identified and only 50 were analyzed according to the inclusion and exclusion criteria. Of which, 2318 were duplicated, 4178 did not meet the study requirements and 21 lacked the use of concepts or full text. Finally, 45 articles were incorporated, As shown in Fig. 1 . 4.2 Concept analysis Finally, six attributes, nine antecedents, and three consequences of organizational resilience were explored, and the conceptual framework is shown in Fig. 2 . 4.2.1 Related concepts Crisis management Crisis management is a universal concept often related to health systems resilience, with a large number of reports, guidelines, and strategic recommendations depending on context, type of crisis, geographic area, etc 25 . A resilient organization ought to know how to oversee emergencies. Endeavoring to make it resilient will require the creation and use of crisis management tools. Nevertheless, organizational resilience in a systemic way seems to be something wider; and crisis management is only one of the many instruments to achieve it. Disarray and shortcomings emerge especially when versatility is viewed as a program to be executed: emergency the executives is one piece of what we ought to do, while resilience is what we ought to nee 26 . Change management An organization is continually exposed to change and the results of progress, such as evolving climate, strategies, methods, markets, and questioners. The capacity to answer change addresses changes in the executives. More than a related term, the concept of change management makes a connection between resilience and health systems: resilience turns into the objective of change management, and the health system becomes the organization that necessities to change to accomplish it 27 . 4.2.2 Antecedents Antecedent variables are characteristics or phenomena that precede or cause conceptual events to occur 28 . This study categorized organizational resilience antecedents into six groups, Resource, Communication, Social Networks, Infrastructure, Organizational structure, and People. Resource related factors It is the material guarantee for resilient organizations in the face of shocks, including sustained service supply capacity, economic strength, technology and skills, and reserves of anti-epidemic materials and emergency materials during shocks 27 . The accessibility of resources is viewed as a key empowering influence of organizational resilience, Organizations need to create and shift resources to cope with unexpected situations 18 . At the point when material resources are utilized in an intelligent way, organizations can defeat disturbance 29 – 32 . Monetary resources are likewise viewed as important to prepare other required assets during a crisis, good cash flow helps organizations to maintain normal operations when a crisis comes 18 , 33 – 35 . Information related factors Organizational resilience is broadly distinguished as being reliant upon how information is overseen and utilized 36 . Information was viewed as a critical fixing to how ideal and enough organizations adjusted to difficulties 33 , 37 . A vital utility of successful information the executives and use is in upgrading what is going on the consciousness of organizations. Organizations can distinguish the early admonition flags that go before an emergency by checking inside and outer conditions 38 . Social Networks related factors How well organizations layout and use their networks decides the degree to which they are resilient to ordinary difficulties and intense shocks. Social networks offer roads for expanded activation and move of information, and dispersal of advancements, in this way expanding the overall resilience of systems 18 , 31 . Collaboration among organizations in a networked environment likewise extends assets that can be drawn on, the capacity to learn, and its ability to respond 18 , 33 , 39 , 40 . Infrastructure related factors It involves construction (safety, layout, and other related channels, etc.), infrastructure (power, water supply, drainage, communication, firefighting, energy, etc.), and emergency materials reserves 31 . Considered siting and planning of infrastructure is a significant component of peril alleviation 41 , 42 . Organizational structure related factors It is the core guarantee of organizing an emergency response system Organizational structure is considered to be the ability to identify, adapt, and resolve the unexpected events and disorders encountered, involving the absorption of shocks, adaptation to interference, change operation, innovation, and change. Only in the case of high attention, careful preparation, and repeated drills and summaries, the organization can form enough strength of resilience, to assume a significant part in the prevention, disposal, and recovery of disaster events 18 , 40 , 43 , 44 . People related factors As the key subject and important element of organizational resilience, people are the core driving force for successful responses to impact events 33 . This includes workforce and leadership. The significance of administration practices to the resilience of organizations is a repetitive subject across the chosen papers in both the wellbeing and different areas and for both intense and regular difficulties 18 . labor force plays in the resilience of organizations to regular difficulties and intense shocks, labor force and the essential abilities were featured as basic supporters of resilience 45 . 4.2.3 Attributes Determining the critical traits of an idea is a significant stage in its explanation and refinement, which brings about a profound comprehension of the idea and its separation from different ideas 28 . Attributes are the constituent elements that shape a concept 46 . This study integrates conceptual attributes by identifying synonyms and clustering related items 47 , including Robustness, Redundancy, Rapidity, Resourcefulness, Diversity, Adaption, Self-regulation, Flexibility, and Recoverability 36 , 48 , 49 . Robustness Robustness is the ability to withstand stress without being affected by it. It is used to describe resource intensity and is represented by a low probability of resource deterioration 2 , 27 , 29 , 36 , 48 – 51 . Redundancy Redundancy refers to the degree to which elements are replaceable in the event of resource disruption or degradation. A condition related to redundancy is resource diversity. Organizations that rely upon resources within a narrow range are less able to inside changes in resource exhaustion, a state sometimes referred to as resource dependence 43 , 48 , 49 , 52 , 53 . Rapidity Rapidity is the ability to achieve goals on time, control damage, and avoid interference 48 , 49 . Resourcefulness Resourcefulness is the capacity to distinguish issues and prepare resources when conditions compromise the system 29 , 48 . Diversity Diversity is when organizations depend on an enormous number of actors with various jobs and qualitie 17 , 32 , 33 . Adaption Adaption is the capacity to change in manners that further develop capability even with profoundly unfavorable circumstances. Any adaptations should enhance performance in the short term and, ideally, contribute to building long-term resilience 6 , 14 – 16 , 21 , 30 , 40 – 44 . Self-regulation Self-regulation is organizations without relying on the government and outside help, through the system network, quickly organize self-rescue and mutual rescue 27 , 54 . Flexibility Flexibility means coordination of infrastructure functions and flexible tradeoffs of management systems 30 , 38 , 58 – 60 . Recoverability Recoverability is the ability to recover from perturbations of uncertain events 2 . 4.2.4 Consequences and Prevention Consequences is an event or situation that results from the creation of a concept 61 . The antecedents and attributes of organizational resilience have been examined, however not the ideal results. The consequences of a concept are the results of that concept. In organizational resilience, the outcome is to enhance the readiness of organizations to respond to crises, limit the harm to organization provision, and lessen the effect that disasters may have on society 32 , 62 . 4.3 Model case The Rogers evolutionary approach encourages the identification of model cases that utilize all the essential attributes described in the literature being analyzed 61 . Model cases depict practical demonstrations of concepts analyzed in real life. None of the included studies possessed all of the attributes of the conceptual components of organizational resilience proposed in the included studies. The following is a typical case based on the first author’s experience. Qinggang Nursing Home, which is the first hospital-affiliated elderly care institution approved by the National Development and Reform Commission, and is a pilot project for the construction of the national basic elderly care service system in 2009, and is the first large-scale public hospital-sponsored elderly care institution in China 63 . It proclaimed a “condition of caution” and took on a progression of versatile procedures when the Coronavirus pandemic was first pronounced. During the COVID-19 outbreak, the organization immediately pronounced a condition of readiness and embraced a progression of resilience strategies, starting with leaders immediately activating emergency plans, setting up emergency management teams, and unifying the organization. In terms of infrastructure, the organization separated the working area, the living area, and the isolation area by dividing the major partitions and establishing a buffer zone to block the spread of the virus from the space aspect. In terms of information, the organization continuously collects data to respond to repeated changes and shocks, through the monitoring and recording of health data of people within the organization, as well as lessons learned and changes in external data. In terms of resources, immediately mobilize the available resources within the organization, rationally plan the use of resources, what’s more, set up a getting and testing point for external drugs, express bundles, and vehicles to guarantee the inventory of materials during the epidemic. In terms of social networks, The organization has built a close social network with relevant medical institutions. When there is a lack of material resources in the organization, the medical institutions will support them. At the same time, the medical institutions also play a good role in guaranteeing the change of the elderly's condition in the organization, and once the condition changes, they will be transferred to the medical institutions for treatment. In terms of people, the epidemiological detection, monitoring, and prevention of all employees should be conducted according to the infectious characteristics of COVID-19, and online training should be conducted for employees, such as basic knowledge of COVID-19, hand hygiene, wearing of medical masks, disinfection, etc. At the same time, leaders also pay attention to changes in employees' workload, timely appease their negative emotions, and provide support, such as psychological counseling. When the epidemic situation is stable, organization leaders do not relax their vigilance, but help the organization quickly recover from the epidemic state, help the organization regenerate from nirvana, and operate normally. Finally, leaders draw lessons from this outbreak to make up for infrastructure and resource deficiencies and update and improve emergency plans to help organizations stay in good shape when the next shock hits. Qinggang Nursing Home had good resilience during the impact period, therefore, the organization was not affected by the impact but still operates well, achieved “zero infection” among 335 residents and 276 healthcare personnel, and maintained good vitality during the impact. Discussion Frequent public health events in recent years, especially COVID-19, which has a wide negative radiation effect, have made the public realize that only by placing an organization in the context of a major emergency and seeking actual improvement of the organization's comprehensive capacity with the help of resilient governance strategies, can an organization achieve a forward-looking transformation from its vulnerability to resilience. Overcome the actual difficulties faced by organizations in the process of disaster response and governance, such as their vulnerability and the surge of catastrophic medical needs, and build a truly resilient organizational governance mechanism that is connected with major disasters. Until now, a large part of the writing that explicitly references organizational resilience has zeroed in on high-level attributes, as opposed to recognizing explicit limits that the organization should be versatile to irresistible illness flare-ups and regular perils. The concept of organizational resilience adds dynamism and direness to the longstanding work of the organization fortifying and offering an opportunity to gain from different areas 56 , 64 – 66 . This study pointed toward giving a clearer depiction of organizational resilience by indicating various components of organizational resilience and recognizing it from comparable concepts and phrasings. Our study found that organizational resilience is described mainly concerning resources, communication, social networks, infrastructure, organizational structure, and people. The connections among the blocks make up a resilient organization. The linkages among the blocks, including the role of people as actors who drive the system forward, are fundamental to understanding a resilient organization. Although different organizations face different risk probabilities of natural event threats and social event threats, organizational resilience could provide a new observation perspective for internal management and external governance of organizations and is conducive to building a normalized risk treatment platform for organizations in dynamic uncertainty. The overall direction for what organizational resilience involves and its overall qualities could assist an organization with focusing on its activities and systems inside its unique circumstance and arrive at its resilience objective, accordingly adding to resilience worldwide. The general guidance for what organizational resilience entails and its general characteristics could help an organization prioritize its actions and strategies within its context and reach its own resilience goal, thereby contributing to resilience globally. We have to admit that our study has certain limitations. As the current research on organizational resilience in the field of nursing is not enough, articles in other fields are widely included, and there may be some differences in organizational resilience in the field of nursing. Moreover, the research method of conceptual analysis itself has limitations in the research process and the views of researchers, which may lead to bias. In the future, the author will continue to explore the application of organizational resilience in the field of nursing and conduct a time study to deeply explore the influencing factors of organizational resilience in the field of nursing to develop reasonable assessment tools to promote higher-quality nursing services. Conclusion A conceptual understanding of organizational resilience is critical and could provide the intellectual basis for an integrated approach to systems development. To date, there is no agreed framework for organizations to form the basis for resilience measurement. Findings from this concept analysis contribute to the understanding and clarity of organizational resilience in the context of crisis, providing a theoretical basis for the evaluation and quantification of organizational resilience. Declarations Author contributions: Ying Peng: Study design, Visualization, Writing - original draft, Writing - review & editing. Huanhuan Huang: Writing - review & editing, Supervision. Yangli Ou: Data collection. Chunni Wang: Data collection Mingzhao Xiao: Writing - review & editing. Qinghua Zhao: Writing - review & editing. Funding: This study was funded by the National Health Commission of China (RCLX2220028) and Chongqing Science and Technology Bureau (CSTC2021jscx-gksb-N0021). However, the funders had no role in the study design, data collection, management, analysis, interpretation, manuscript writing, or decision to submit the report for publication. Competing interests: The authors have no conflict of interests. Acknowledgments: The author thanks all those who contributed to this article. Availability of data and materials: All data generated or used during the study are available from the corresponding author by request. Ethics approval and consent to participate: The ethics committee of the First Affiliated Hospital of Chongqing Medical University where the current study took place reviewed and approved the study (K2023-250). Patient or public contribution: This project was a conceptual analysis of the literature thusly no patient or public contribution was important. References Orsetti E, Tollin N, Lehmann M, Valderrama VA, Morató J. Building Resilient Cities: Climate Change and Health Interlinkages in the Planning of Public Spaces. Int J Environ Res Public Health . 2022;19(3). doi:10.3390/ijerph19031355 Rai SS, Rai S, Singh NK. Organizational resilience and social-economic sustainability: COVID-19 perspective. Environ Dev Sustain . 2021;23(8):12006-12023. doi:10.1007/s10668-020-01154-6 Grimm PY, Wyss K. What makes health systems resilient? A qualitative analysis of the perspectives of Swiss NGOs. Glob Health . 2022;18:55. doi:10.1186/s12992-022-00848-y Hanefeld J, Mayhew S, Legido-Quigley H, et al. 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Department of Health Economics and Management, Faculty of Public Health, Medical University-Varna, Bulgaria., Koeva S, Rohova M, Department of Health Economics and Management, Faculty of Public Health, Medical University-Varna, Bulgaria. HEALTH SYSTEM RESILIENCE: CONCEPT DEVELOPMENT. J IMAB - Annu Proceeding Sci Pap . 2020;26(3):3251-3258. doi:10.5272/jimab.2020263.3251 Abimbola S, Topp SM. Adaptation with robustness: the case for clarity on the use of “resilience” in health systems and global health. BMJ Glob Health . 2018;3(1). doi:10.1136/bmjgh-2018-000758 Adger WN. Social and ecological resilience: are they related? Prog Hum Geogr . 2000;24(3):347-364. doi:10.1191/030913200701540465 Zhong S, Clark M, Hou XY, Zang Y, FitzGerald G. Development of key indicators of hospital resilience: a modified Delphi study. J Health Serv Res Policy . 2015;20(2):74-82. doi:10.1177/1355819614561537 Kruk ME, Ling EJ, Cammett M, et al. Building resilient health systems: a proposal for a resilience index. BMJ-Br Med J . 2017;357. doi:10.1136/bmj.j2323 Pilevari N, Shiva MV. Country-Wide Resilience Model for the Health System: A Case Study on Iran, under Coronavirus Outbreak. Iran J Public Health . 2021;50(4):806-815. doi:10.18502/ijph.v50i4.6007 Kruk ME, Myers M, Varpilah ST, Dahn BT. What is a resilient health system? Lessons from Ebola. The Lancet . 2015;385(9980):1910-1912. doi:10.1016/S0140-6736(15)60755-3 Grimm PY, Oliver S, Merten S, Han WW, Wyss K. Enhancing the Understanding of Resilience in Health Systems of Low- and Middle-Income Countries: A Qualitative Evidence Synthesis. Int J Health Policy Manag . 2021;11(7):899-911. doi:10.34172/ijhpm.2020.261 Foroughi Z, Ebrahimi P, Aryankhesal A, Maleki M, Yazdani S. Toward a theory-led meta-framework for implementing health system resilience analysis studies: a systematic review and critical interpretive synthesis. BMC Public Health . 2022;22(1):287. doi:10.1186/s12889-022-12496-3 Groschke D, Hofmann E, Muller ND, Wolf J. Individual and organizational resilience-Insights from healthcare providers in Germany during the COVID-19 pandemic. Front Psychol . 2022;13:965380-965380. doi:10.3389/fpsyg.2022.965380 Heagele T. Disaster-Related Community Resilience: A Concept Analysis and a Call to Action for Nurses. PUBLIC Health Nurs . 2017;34(3):295-302. doi:10.1111/phn.12292 Rodgers BL, Knafl KA. Concept Development in Nursing: Foundations, Techniques, and Applications . W.B. Saunders Company; 1993. Quantick O. Emergency Preparedness, Resilience and Response (EPRR). BMJ Mil Health . 2020;166(1):30-33. doi:10.1136/jramc-2018-000965 Huang H, Xie Y, Chen Z, et al. Nursing Home in the COVID-19 Outbreak：Challenge，Recovery, and Resiliency. J Gerontol Soc Work . 2020;63(6-7):646-650. doi:10.1080/01634372.2020.1787576 Meyer D, Kirk Sell T, Schoch-Spana M, et al. Lessons from the domestic Ebola response: Improving health care system resilience to high consequence infectious diseases. Am J Infect Control . 2018;46(5):533-537. doi:10.1016/j.ajic.2017.11.001 Harries AD, Zachariah R, Tayler-Smith K, et al. Keeping health facilities safe: one way of strengthening the interaction between disease-specific programmes and health systems. Trop Med Int Health TM IH . 2010;15(12):1407-1412. doi:10.1111/j.1365-3156.2010.02662.x Pathmanathan I, O’Connor KA, Adams ML, et al. Rapid Assessment of Ebola Infection Prevention and Control Needs — Six Districts, Sierra Leone, October 2014. Morb Mortal Wkly Rep . 2014;63(49):1172-1174. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Huanhuan","middleName":"","lastName":"Huang","suffix":""},{"id":238190736,"identity":"648ce900-8d66-4471-861f-d527c72ca270","order_by":2,"name":"Yangli Ou","email":"","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yangli","middleName":"","lastName":"Ou","suffix":""},{"id":238190737,"identity":"db0d1ee4-5c35-46dc-a53b-eff2f0dce313","order_by":3,"name":"Chunni Wang","email":"","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chunni","middleName":"","lastName":"Wang","suffix":""},{"id":238190738,"identity":"e56de148-0d7c-433e-9b74-5c1778e67f01","order_by":4,"name":"Mingzhao Xiao","email":"","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Mingzhao","middleName":"","lastName":"Xiao","suffix":""},{"id":238190739,"identity":"065a22c5-7a9b-4647-a92b-5bcf69b38ea1","order_by":5,"name":"Qinghua Zhao","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAu0lEQVRIiWNgGAWjYDACCeYDBxIqauTY2NsPEKuFLfHBhzPHjPl4ziQQq4XH2HBmC3PiPAkHA+J08N1uMJPmbWBLb5NgSGD4UbGNsBbJOwfSpHl3yOS2STceYOw5c5uwFoMbCcekec+w5bbJHEhgZmwjSktimzRvG3M6m0SCAbFakpkNZ7YxJxCvRfJGGiMokA3bgIF8kCi/8N3I/wCKSnn59vaDD35UEKGF4QAONpFaRsEoGAWjYBRgBQBokkDVSMV0tgAAAABJRU5ErkJggg==","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Qinghua","middleName":"","lastName":"Zhao","suffix":""}],"badges":[],"createdAt":"2023-10-04 13:29:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3410621/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3410621/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":44453513,"identity":"9c32f600-09ec-4708-9c9a-4497b49bc81f","added_by":"auto","created_at":"2023-10-11 17:04:41","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":103157,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFlow chart of the article selection process.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-3410621/v1/58ee7a4b99264bbd0d3c94b4.png"},{"id":44453514,"identity":"2e1ac2e9-b8d2-44e1-9f0d-720828afe507","added_by":"auto","created_at":"2023-10-11 17:04:41","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":646192,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThe conceptual framework of organizational resilience.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-3410621/v1/d7b8b7265c4c4aa6473c0150.png"},{"id":44833057,"identity":"864f7391-3608-4d36-928a-0082a34c6cf7","added_by":"auto","created_at":"2023-10-18 07:37:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3726619,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3410621/v1/3f49db57-fb6f-4f3b-b3d4-738c3a289658.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Organizational Resilience in Nursing: A Concept Analysis Using Rodgers' Evolutionary Approach","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn recent years, pandemics such as climate change, local wars, and public health emergencies have superimposed, causing significant systemic risks and enormous social and economic impacts\u003csup\u003e1,2\u003c/sup\u003e. The societies and environments in which organizations operate are becoming increasingly complex as globalization accelerates and the world landscape continues to change. Crises and disasters have become recurring events that organizations need to face as they grow. Organizations need to be more flexible in order to survive and develop in this challenging environment, especially during major crisis events\u003csup\u003e3,4\u003c/sup\u003e. In 2020, the WHO re-released \u0026ldquo;Strengthening the Resilience of Health Systems: Key Concepts and Strategies (2020)\u0026rdquo; and proposed that the resilience of health systems is key to responding to catastrophic events\u003csup\u003e7\u003c/sup\u003e. In addition, World Health Organization has integrated resilience into the formulation of the 2030 Sustainable Development Goals\u003csup\u003e6\u003c/sup\u003e. Thus, As a result, the importance and impact of resilience in international disaster-related research and national policies have increased in recent years.\u003c/p\u003e\n\u003cp\u003eCOVID-19 has once again tested the ability of organizations to withstand health shocks while maintaining daily functions, and organizations and countries are increasingly focusing on the development of organizational resilience\u003csup\u003e19\u003c/sup\u003e, research and policy have multiplied. However, the specific definition and analysis of organizational resilience remain subjects of debate, with varying perspectives on this matter. The concept of organizational resilience is lacking, particularly in the area of nursing.\u003c/p\u003e"},{"header":"BACKGROUND","content":"\u003cp\u003eResilience, also known as toughness, elasticity, and reduction, is the capacity of an object to quickly return to its original state when subjected to external forces\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. It first appeared in the field of materials science. Previous studies have shown that the development of resilience is mainly divided into the following three stages. 1973, C.S. He applies the theory of complex adaptation systems to ecosystems: such systems respond to the imperatives of changing conditions\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. Holling developed the concept of \u0026ldquo;ecological resilience\u0026rdquo; is proposed. Resilience turn a assessment of how much damage a system can withstand. The concept has been applied to all fields of complex systems science (economics, politics, etc.). The series, called Resilience Minds \u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e and aims to concentrate on how systems change and respond to disturbances. Since then, the concept of resilience has been widely used and popularized. Later, in order to adapt to sudden disasters and environmental changes, a combination of social, managerial, economic, psychological and other multidisciplinary content was gradually introduced into the field of social science, evolving into \u0026ldquo;ecological social resilience\u0026rdquo;, also known as \u0026ldquo;evolutionary resilience\u0026rdquo; \u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. With the rapid change in the economic environment and the increasingly furious competition, management scholars introduced the concept of resilience into the field of management and put forward the topic of \u0026ldquo;organizational resilience\u0026rdquo;\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. In the wake of the 2014-16 Ebola outbreak in West Africa, WHO called on all countries to \u0026ldquo;build resilient and integrated systems capable of responding to and actively responding to any future threats,\u0026rdquo; \u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003eand the concept of \"resilience\" is gradually being extended to health systems\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e.17,18.\u003c/p\u003e \u003cp\u003eConcept analysis is one of literature review aimed at clarifying concepts that are important in academic discourse but poorly definitional clarity concepts in academic discourse, carefully assessing the internal composition of complex concepts and identifying their components in order to improve their exploratory capabilities\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. Concept analysis helps to identify common meanings used in a discipline and provides a basis for educational, practical, and theoretical development\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. Thus, our study aimed to differentiate, clarify, and identify the development, concept, attributes, types, prerequisites, and consequences of organizational resilience, ultimately to contribute improved strategies.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Study design\u003c/h2\u003e \u003cp\u003eRodgers\u0026rsquo; evolutionary concept analysis was used in this study\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e, which involves four stages: 1) Identifying the intended concepts and their associated statements and alternative terms; 2) identifying and selecting an appropriate scope for data collection; 3) collecting data related to conceptual characteristics and aligned with contextual changes, including social, cultural, interdisciplinary and temporal changes (antecedents and consequences of the concept); 4) taking into account the characteristics of the data analysis of the concept, identifying suitable examples related to the concept, and identify the assumptions and implications of the analysis to further develop the concept\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Data sources\u003c/h2\u003e \u003cp\u003eSearch terms included \u0026lsquo;resilience\u0026rsquo; or \u0026lsquo;resilient\u0026rsquo; or \u0026lsquo;resilienc*\u0026rsquo; and \u0026lsquo;organizations\u0026rsquo; or \u0026lsquo;organization\u0026rsquo; or \u0026lsquo;institution\u0026rsquo; or \u0026lsquo;system\u0026rsquo; or \u0026lsquo;organization*\u0026rsquo; in MEDLINE, CINAHL, Web of Science, PubMed, Embase. There is a limit from 1973 to 2023.\u003c/p\u003e \u003cp\u003eInclusion criteria: 1) theoretical or conceptual models or frameworks related to organizational resilience;2) a review of existing literature related to organizational resilience; or 3) primary research findings on theoretical or conceptual models or frameworks of organizational resilience.\u003c/p\u003e \u003cp\u003eExclusion criteria: 1) Articles that lack references, authors, and full text, 2) Duplicate articles published by the same author in different journals, 3) Focus on psychological, ecological, personal, or other agent resilience rather than organizational resilience.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Data analysis process\u003c/h2\u003e \u003cp\u003eFirstly, the full text was reviewed by YLO and CNW. Then, sort the extracted data into an Excel spreadsheet. Secondly, YP and HHH reviewed again for methodical information assortment and to guarantee the legitimacy of the coding and use point investigation to indicate attributes, antecedents, and consequences. Thirdly, YP and HHH Utilizing diagrams and networks, analyze every one of these classifications independently to distinguish key and thorough subjects, then sort the discoveries into attributes, antecedents, consequences, related concepts, alternative terms, and definitions.\u003c/p\u003e \u003cp\u003eInside each segment, the information is explored on different occasions to empower specialists to suffocate in it and concentrate on central issues and names to give an unmistakable clarification of different parts of the idea. Finally, the data on the concept of organizational resilience are summarized and analyzed, and the theme is determined. The data unit includes words and sentences that answer the question: What are the specific attributes of organizational resilience? How to define organizational resilience? What are the signs of organizational resilience? What factors are related to organizational resilience? What are the consequences of organizational resilience?\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e4.1 General results\u003c/h2\u003e \u003cp\u003eIn the first phase, a total of 6,629 articles were identified and only 50 were analyzed according to the inclusion and exclusion criteria. Of which, 2318 were duplicated, 4178 did not meet the study requirements and 21 lacked the use of concepts or full text. Finally, 45 articles were incorporated, As shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Concept analysis\u003c/h2\u003e \u003cp\u003eFinally, six attributes, nine antecedents, and three consequences of organizational resilience were explored, and the conceptual framework is shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e4.2.1 Related concepts\u003c/h2\u003e \u003cp\u003e \u003cb\u003eCrisis management\u003c/b\u003e \u003c/p\u003e \u003cp\u003eCrisis management is a universal concept often related to health systems resilience, with a large number of reports, guidelines, and strategic recommendations depending on context, type of crisis, geographic area, etc\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. A resilient organization ought to know how to oversee emergencies. Endeavoring to make it resilient will require the creation and use of crisis management tools. Nevertheless, organizational resilience in a systemic way seems to be something wider; and crisis management is only one of the many instruments to achieve it. Disarray and shortcomings emerge especially when versatility is viewed as a program to be executed: emergency the executives is one piece of what we ought to do, while resilience is what we ought to nee\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eChange management\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAn organization is continually exposed to change and the results of progress, such as evolving climate, strategies, methods, markets, and questioners. The capacity to answer change addresses changes in the executives. More than a related term, the concept of change management makes a connection between resilience and health systems: resilience turns into the objective of change management, and the health system becomes the organization that necessities to change to accomplish it\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003e4.2.2 Antecedents\u003c/h2\u003e \u003cp\u003eAntecedent variables are characteristics or phenomena that precede or cause conceptual events to occur \u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. This study categorized organizational resilience antecedents into six groups, Resource, Communication, Social Networks, Infrastructure, Organizational structure, and People.\u003c/p\u003e \u003cp\u003e \u003cb\u003eResource related factors\u003c/b\u003e \u003c/p\u003e \u003cp\u003eIt is the material guarantee for resilient organizations in the face of shocks, including sustained service supply capacity, economic strength, technology and skills, and reserves of anti-epidemic materials and emergency materials during shocks\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. The accessibility of resources is viewed as a key empowering influence of organizational resilience, Organizations need to create and shift resources to cope with unexpected situations \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. At the point when material resources are utilized in an intelligent way, organizations can defeat disturbance\u003csup\u003e\u003cspan additionalcitationids=\"CR30 CR31\" citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e. Monetary resources are likewise viewed as important to prepare other required assets during a crisis, good cash flow helps organizations to maintain normal operations when a crisis comes\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan additionalcitationids=\"CR34\" citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eInformation related factors\u003c/b\u003e \u003c/p\u003e \u003cp\u003eOrganizational resilience is broadly distinguished as being reliant upon how information is overseen and utilized \u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e. Information was viewed as a critical fixing to how ideal and enough organizations adjusted to difficulties\u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e,\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e. A vital utility of successful information the executives and use is in upgrading what is going on the consciousness of organizations. Organizations can distinguish the early admonition flags that go before an emergency by checking inside and outer conditions\u003csup\u003e\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eSocial Networks related factors\u003c/b\u003e \u003c/p\u003e \u003cp\u003eHow well organizations layout and use their networks decides the degree to which they are resilient to ordinary difficulties and intense shocks. Social networks offer roads for expanded activation and move of information, and dispersal of advancements, in this way expanding the overall resilience of systems\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e. Collaboration among organizations in a networked environment likewise extends assets that can be drawn on, the capacity to learn, and its ability to respond\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e,\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e,\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eInfrastructure related factors\u003c/b\u003e \u003c/p\u003e \u003cp\u003eIt involves construction (safety, layout, and other related channels, etc.), infrastructure (power, water supply, drainage, communication, firefighting, energy, etc.), and emergency materials reserves\u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e. Considered siting and planning of infrastructure is a significant component of peril alleviation\u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e,\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eOrganizational structure related factors\u003c/b\u003e \u003c/p\u003e \u003cp\u003eIt is the core guarantee of organizing an emergency response system Organizational structure is considered to be the ability to identify, adapt, and resolve the unexpected events and disorders encountered, involving the absorption of shocks, adaptation to interference, change operation, innovation, and change. Only in the case of high attention, careful preparation, and repeated drills and summaries, the organization can form enough strength of resilience, to assume a significant part in the prevention, disposal, and recovery of disaster events\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e,\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e,\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003ePeople related factors\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAs the key subject and important element of organizational resilience, people are the core driving force for successful responses to impact events\u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e. This includes workforce and leadership. The significance of administration practices to the resilience of organizations is a repetitive subject across the chosen papers in both the wellbeing and different areas and for both intense and regular difficulties\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. labor force plays in the resilience of organizations to regular difficulties and intense shocks, labor force and the essential abilities were featured as basic supporters of resilience\u003csup\u003e\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e \u003ch2\u003e4.2.3 Attributes\u003c/h2\u003e \u003cp\u003eDetermining the critical traits of an idea is a significant stage in its explanation and refinement, which brings about a profound comprehension of the idea and its separation from different ideas\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. Attributes are the constituent elements that shape a concept\u003csup\u003e\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u003c/sup\u003e. This study integrates conceptual attributes by identifying synonyms and clustering related items\u003csup\u003e\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e\u003c/sup\u003e, including Robustness, Redundancy, Rapidity, Resourcefulness, Diversity, Adaption, Self-regulation, Flexibility, and Recoverability\u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e,\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e,\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRobustness\u003c/b\u003e \u003c/p\u003e \u003cp\u003eRobustness is the ability to withstand stress without being affected by it. It is used to describe resource intensity and is represented by a low probability of resource deterioration\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e,\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e,\u003cspan additionalcitationids=\"CR49 CR50\" citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRedundancy\u003c/b\u003e \u003c/p\u003e \u003cp\u003eRedundancy refers to the degree to which elements are replaceable in the event of resource disruption or degradation. A condition related to redundancy is resource diversity. Organizations that rely upon resources within a narrow range are less able to inside changes in resource exhaustion, a state sometimes referred to as resource dependence\u003csup\u003e\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e,\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e,\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e,\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e,\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRapidity\u003c/b\u003e \u003c/p\u003e \u003cp\u003eRapidity is the ability to achieve goals on time, control damage, and avoid interference \u003csup\u003e\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e,\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eResourcefulness\u003c/b\u003e \u003c/p\u003e \u003cp\u003eResourcefulness is the capacity to distinguish issues and prepare resources when conditions compromise the system\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e,\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eDiversity\u003c/b\u003e \u003c/p\u003e \u003cp\u003eDiversity is when organizations depend on an enormous number of actors with various jobs and qualitie\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e,\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eAdaption\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAdaption is the capacity to change in manners that further develop capability even with profoundly unfavorable circumstances. Any adaptations should enhance performance in the short term and, ideally, contribute to building long-term resilience\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan additionalcitationids=\"CR15\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e,\u003cspan additionalcitationids=\"CR41 CR42 CR43\" citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eSelf-regulation\u003c/b\u003e \u003c/p\u003e \u003cp\u003eSelf-regulation is organizations without relying on the government and outside help, through the system network, quickly organize self-rescue and mutual rescue\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e,\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eFlexibility\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFlexibility means coordination of infrastructure functions and flexible tradeoffs of management systems\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e,\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e,\u003cspan additionalcitationids=\"CR59\" citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRecoverability\u003c/b\u003e \u003c/p\u003e \u003cp\u003eRecoverability is the ability to recover from perturbations of uncertain events\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003e4.2.4 Consequences and Prevention\u003c/h2\u003e \u003cp\u003eConsequences is an event or situation that results from the creation of a concept\u003csup\u003e\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e\u003c/sup\u003e. The antecedents and attributes of organizational resilience have been examined, however not the ideal results. The consequences of a concept are the results of that concept. In organizational resilience, the outcome is to enhance the readiness of organizations to respond to crises, limit the harm to organization provision, and lessen the effect that disasters may have on society\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e,\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Model case\u003c/h2\u003e \u003cp\u003eThe Rogers evolutionary approach encourages the identification of model cases that utilize all the essential attributes described in the literature being analyzed\u003csup\u003e\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e\u003c/sup\u003e. Model cases depict practical demonstrations of concepts analyzed in real life. None of the included studies possessed all of the attributes of the conceptual components of organizational resilience proposed in the included studies. The following is a typical case based on the first author\u0026rsquo;s experience.\u003c/p\u003e \u003cp\u003eQinggang Nursing Home, which is the first hospital-affiliated elderly care institution approved by the National Development and Reform Commission, and is a pilot project for the construction of the national basic elderly care service system in 2009, and is the first large-scale public hospital-sponsored elderly care institution in China\u003csup\u003e\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e\u003c/sup\u003e. It proclaimed a \u0026ldquo;condition of caution\u0026rdquo; and took on a progression of versatile procedures when the Coronavirus pandemic was first pronounced. During the COVID-19 outbreak, the organization immediately pronounced a condition of readiness and embraced a progression of resilience strategies, starting with leaders immediately activating emergency plans, setting up emergency management teams, and unifying the organization. In terms of infrastructure, the organization separated the working area, the living area, and the isolation area by dividing the major partitions and establishing a buffer zone to block the spread of the virus from the space aspect. In terms of information, the organization continuously collects data to respond to repeated changes and shocks, through the monitoring and recording of health data of people within the organization, as well as lessons learned and changes in external data. In terms of resources, immediately mobilize the available resources within the organization, rationally plan the use of resources, what\u0026rsquo;s more, set up a getting and testing point for external drugs, express bundles, and vehicles to guarantee the inventory of materials during the epidemic. In terms of social networks, The organization has built a close social network with relevant medical institutions. When there is a lack of material resources in the organization, the medical institutions will support them. At the same time, the medical institutions also play a good role in guaranteeing the change of the elderly's condition in the organization, and once the condition changes, they will be transferred to the medical institutions for treatment. In terms of people, the epidemiological detection, monitoring, and prevention of all employees should be conducted according to the infectious characteristics of COVID-19, and online training should be conducted for employees, such as basic knowledge of COVID-19, hand hygiene, wearing of medical masks, disinfection, etc. At the same time, leaders also pay attention to changes in employees' workload, timely appease their negative emotions, and provide support, such as psychological counseling. When the epidemic situation is stable, organization leaders do not relax their vigilance, but help the organization quickly recover from the epidemic state, help the organization regenerate from nirvana, and operate normally. Finally, leaders draw lessons from this outbreak to make up for infrastructure and resource deficiencies and update and improve emergency plans to help organizations stay in good shape when the next shock hits. Qinggang Nursing Home had good resilience during the impact period, therefore, the organization was not affected by the impact but still operates well, achieved \u0026ldquo;zero infection\u0026rdquo; among 335 residents and 276 healthcare personnel, and maintained good vitality during the impact.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eFrequent public health events in recent years, especially COVID-19, which has a wide negative radiation effect, have made the public realize that only by placing an organization in the context of a major emergency and seeking actual improvement of the organization's comprehensive capacity with the help of resilient governance strategies, can an organization achieve a forward-looking transformation from its vulnerability to resilience. Overcome the actual difficulties faced by organizations in the process of disaster response and governance, such as their vulnerability and the surge of catastrophic medical needs, and build a truly resilient organizational governance mechanism that is connected with major disasters.\u003c/p\u003e \u003cp\u003eUntil now, a large part of the writing that explicitly references organizational resilience has zeroed in on high-level attributes, as opposed to recognizing explicit limits that the organization should be versatile to irresistible illness flare-ups and regular perils. The concept of organizational resilience adds dynamism and direness to the longstanding work of the organization fortifying and offering an opportunity to gain from different areas\u003csup\u003e\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e,\u003cspan additionalcitationids=\"CR65\" citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e\u003c/sup\u003e. This study pointed toward giving a clearer depiction of organizational resilience by indicating various components of organizational resilience and recognizing it from comparable concepts and phrasings. Our study found that organizational resilience is described mainly concerning resources, communication, social networks, infrastructure, organizational structure, and people. The connections among the blocks make up a resilient organization. The linkages among the blocks, including the role of people as actors who drive the system forward, are fundamental to understanding a resilient organization.\u003c/p\u003e \u003cp\u003eAlthough different organizations face different risk probabilities of natural event threats and social event threats, organizational resilience could provide a new observation perspective for internal management and external governance of organizations and is conducive to building a normalized risk treatment platform for organizations in dynamic uncertainty. The overall direction for what organizational resilience involves and its overall qualities could assist an organization with focusing on its activities and systems inside its unique circumstance and arrive at its resilience objective, accordingly adding to resilience worldwide.\u003c/p\u003e \u003cp\u003eThe general guidance for what organizational resilience entails and its general characteristics could help an organization prioritize its actions and strategies within its context and reach its own resilience goal, thereby contributing to resilience globally.\u003c/p\u003e \u003cp\u003eWe have to admit that our study has certain limitations. As the current research on organizational resilience in the field of nursing is not enough, articles in other fields are widely included, and there may be some differences in organizational resilience in the field of nursing. Moreover, the research method of conceptual analysis itself has limitations in the research process and the views of researchers, which may lead to bias. In the future, the author will continue to explore the application of organizational resilience in the field of nursing and conduct a time study to deeply explore the influencing factors of organizational resilience in the field of nursing to develop reasonable assessment tools to promote higher-quality nursing services.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eA conceptual understanding of organizational resilience is critical and could provide the intellectual basis for an integrated approach to systems development. To date, there is no agreed framework for organizations to form the basis for resilience measurement. Findings from this concept analysis contribute to the understanding and clarity of organizational resilience in the context of crisis, providing a theoretical basis for the evaluation and quantification of organizational resilience.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eYing Peng:\u003c/strong\u003e Study design, Visualization, Writing - original draft, Writing - review \u0026amp; editing. \u003cstrong\u003eHuanhuan Huang:\u003c/strong\u003e Writing - review \u0026amp; editing, Supervision. \u003cstrong\u003eYangli Ou:\u0026nbsp;\u003c/strong\u003eData collection. \u003cstrong\u003eChunni Wang:\u0026nbsp;\u003c/strong\u003eData collection\u003cstrong\u003e\u0026nbsp;Mingzhao Xiao:\u0026nbsp;\u003c/strong\u003eWriting - review \u0026amp; editing. \u003cstrong\u003eQinghua Zhao:\u0026nbsp;\u003c/strong\u003eWriting - review \u0026amp; editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by the National Health Commission of China (RCLX2220028) and Chongqing Science and Technology Bureau (CSTC2021jscx-gksb-N0021).\u0026nbsp;However, the funders had no role in the study design, data collection, management, analysis, interpretation, manuscript writing, or decision to submit the report for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no conflict of interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author thanks all those who contributed to this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or used during the study are available from the corresponding author by request.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe ethics committee of the First Affiliated Hospital of Chongqing Medical University where the current study took place reviewed and approved the study (K2023-250).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cstrong\u003ePatient or public contribution:\u0026nbsp;\u003c/strong\u003eThis project was a conceptual analysis of the literature thusly no patient or public contribution was important.\u003c/p\u003e\n"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eOrsetti E, Tollin N, Lehmann M, Valderrama VA, Morat\u0026oacute; J. 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How Does Entrepreneurial Team Relational Governance Promote Social Start-Ups\u0026rsquo; Organizational Resilience? \u003cem\u003eInt J Environ Res Public Health\u003c/em\u003e. 2022;19(11):6677. doi:10.3390/ijerph19116677\u003c/li\u003e\n\u003cli\u003eSustainable Development Goals | United Nations Development Programme. UNDP. Accessed August 9, 2023. https://www.undp.org/sustainable-development-goals\u003c/li\u003e\n\u003cli\u003eEuropean Observatory on Health Systems and Policies, Thomas S, Sagan A, et al. \u003cem\u003eStrengthening Health Systems Resilience: Key Concepts and Strategies\u003c/em\u003e. World Health Organization. Regional Office for Europe; 2020. Accessed August 9, 2023. https://apps.who.int/iris/handle/10665/332441\u003c/li\u003e\n\u003cli\u003eLinkov I, Fox-Lent C, Read L, et al. Tiered Approach to Resilience Assessment. \u003cem\u003eRisk Anal\u003c/em\u003e. 2018;38(9):1772-1780. doi:10.1111/risa.12991\u003c/li\u003e\n\u003cli\u003eLevin SA. Ecosystems and the Biosphere as Complex Adaptive Systems. \u003cem\u003eEcosystems\u003c/em\u003e. 1998;1(5):431-436. doi:10.1007/s100219900037\u003c/li\u003e\n\u003cli\u003eHolling CS. Resilience and Stability of Ecological Systems. \u003cem\u003eAnnu Rev Ecol Syst\u003c/em\u003e. 1973;4(1):1-23. doi:10.1146/annurev.es.04.110173.000245\u003c/li\u003e\n\u003cli\u003e\u003cem\u003eResilience Thinking\u003c/em\u003e. Accessed August 10, 2023. https://sc.panda321.com/extdomains/books.google.com/books/about/Resilience_Thinking.html?hl=zh-CN\u0026amp;id=NFqFbXYbjLEC\u003c/li\u003e\n\u003cli\u003eTurenne CP, Gautier L, Degroote S, Guillard E, Chabrol F, Ridde V. Conceptual analysis of health systems resilience: A scoping review. \u003cem\u003eSoc Sci Med\u003c/em\u003e. 2019;232:168-180. doi:10.1016/j.socscimed.2019.04.020\u003c/li\u003e\n\u003cli\u003eBodin P, Wiman B. 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Dealing with Unexpected Crises: Organizational Resilience and Its Discontents. \u003cem\u003eAdv Health Care Manag\u003c/em\u003e. 2022;21. doi:10.1108/S1474-823120220000021001\u003c/li\u003e\n\u003cli\u003eWiig S, Aase K, Billett S, et al. Defining the boundaries and operational concepts of resilience in the resilience in healthcare research program. \u003cem\u003eBMC Health Serv Res\u003c/em\u003e. 2020;20:330. doi:10.1186/s12913-020-05224-3\u003c/li\u003e\n\u003cli\u003eBarasa EW, Cloete K, Gilson L. From bouncing back, to nurturing emergence: reframing the concept of resilience in health systems strengthening. \u003cem\u003eHealth Policy Plan\u003c/em\u003e. 2017;32(suppl_3):iii91-iii94. doi:10.1093/heapol/czx118\u003c/li\u003e\n\u003cli\u003eHaldane V, Ong SE, Chuah FLH, Legido-Quigley H. 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Measures of emergency preparedness contributing to nursing home resilience. \u003cem\u003eJ Gerontol Soc Work\u003c/em\u003e. 2018;61(7). doi:10.1080/01634372.2017.1416720\u003c/li\u003e\n\u003cli\u003eCorbett CF, Setter SM, Daratha KB, Neumiller JJ, Wood LD. Nurse identified hospital to home medication discrepancies: implications for improving transitional care. \u003cem\u003eGeriatr Nurs N Y N\u003c/em\u003e. 2010;31(3):188-196. doi:10.1016/j.gerinurse.2010.03.006\u003c/li\u003e\n\u003cli\u003eShahsavari H, Zarei M, Aliheydari Mamaghani J. Transitional care: Concept analysis using Rodgers\u0026rsquo; evolutionary approach. \u003cem\u003eInt J Nurs Stud\u003c/em\u003e. 2019;99:103387. doi:10.1016/j.ijnurstu.2019.103387\u003c/li\u003e\n\u003cli\u003eZhong S, Clark M, Hou XY, Zang YL, Fitzgerald G. Development of hospital disaster resilience: conceptual framework and potential measurement. \u003cem\u003eEmerg Med J\u003c/em\u003e. 2014;31(11):930-938. doi:10.1136/emermed-2012-202282\u003c/li\u003e\n\u003cli\u003eZhong S, Clark M, Hou XY, Zang YL, Fitzgerald G. Proposing and developing a definition and conceptual framework for health care resilience to cope with disasters. \u003cem\u003eEMERGENCIAS\u003c/em\u003e. 2014;26(1):69-77.\u003c/li\u003e\n\u003cli\u003eDepartment of Health Economics and Management, Faculty of Public Health, Medical University-Varna, Bulgaria., Koeva S, Rohova M, Department of Health Economics and Management, Faculty of Public Health, Medical University-Varna, Bulgaria. HEALTH SYSTEM RESILIENCE: CONCEPT DEVELOPMENT. \u003cem\u003eJ IMAB - Annu Proceeding Sci Pap\u003c/em\u003e. 2020;26(3):3251-3258. doi:10.5272/jimab.2020263.3251\u003c/li\u003e\n\u003cli\u003eAbimbola S, Topp SM. Adaptation with robustness: the case for clarity on the use of \u0026ldquo;resilience\u0026rdquo; in health systems and global health. \u003cem\u003eBMJ Glob Health\u003c/em\u003e. 2018;3(1). doi:10.1136/bmjgh-2018-000758\u003c/li\u003e\n\u003cli\u003eAdger WN. Social and ecological resilience: are they related? \u003cem\u003eProg Hum Geogr\u003c/em\u003e. 2000;24(3):347-364. doi:10.1191/030913200701540465\u003c/li\u003e\n\u003cli\u003eZhong S, Clark M, Hou XY, Zang Y, FitzGerald G. Development of key indicators of hospital resilience: a modified Delphi study. \u003cem\u003eJ Health Serv Res Policy\u003c/em\u003e. 2015;20(2):74-82. doi:10.1177/1355819614561537\u003c/li\u003e\n\u003cli\u003eKruk ME, Ling EJ, Cammett M, et al. Building resilient health systems: a proposal for a resilience index. \u003cem\u003eBMJ-Br Med J\u003c/em\u003e. 2017;357. doi:10.1136/bmj.j2323\u003c/li\u003e\n\u003cli\u003ePilevari N, Shiva MV. Country-Wide Resilience Model for the Health System: A Case Study on Iran, under Coronavirus Outbreak. \u003cem\u003eIran J Public Health\u003c/em\u003e. 2021;50(4):806-815. doi:10.18502/ijph.v50i4.6007\u003c/li\u003e\n\u003cli\u003eKruk ME, Myers M, Varpilah ST, Dahn BT. What is a resilient health system? Lessons from Ebola. \u003cem\u003eThe Lancet\u003c/em\u003e. 2015;385(9980):1910-1912. doi:10.1016/S0140-6736(15)60755-3\u003c/li\u003e\n\u003cli\u003eGrimm PY, Oliver S, Merten S, Han WW, Wyss K. Enhancing the Understanding of Resilience in Health Systems of Low- and Middle-Income Countries: A Qualitative Evidence Synthesis. \u003cem\u003eInt J Health Policy Manag\u003c/em\u003e. 2021;11(7):899-911. doi:10.34172/ijhpm.2020.261\u003c/li\u003e\n\u003cli\u003eForoughi Z, Ebrahimi P, Aryankhesal A, Maleki M, Yazdani S. 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Keeping health facilities safe: one way of strengthening the interaction between disease-specific programmes and health systems. \u003cem\u003eTrop Med Int Health TM IH\u003c/em\u003e. 2010;15(12):1407-1412. doi:10.1111/j.1365-3156.2010.02662.x\u003c/li\u003e\n\u003cli\u003ePathmanathan I, O\u0026rsquo;Connor KA, Adams ML, et al. Rapid Assessment of Ebola Infection Prevention and Control Needs \u0026mdash; Six Districts, Sierra Leone, October 2014. \u003cem\u003eMorb Mortal Wkly Rep\u003c/em\u003e. 2014;63(49):1172-1174.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Organizational, resilience, adoption, nursing, concept analysis","lastPublishedDoi":"10.21203/rs.3.rs-3410621/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3410621/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eAim\u003c/h2\u003e \u003cp\u003eTo differentiate, clarify, and identify the development, concept, attributes, types, prerequisites, and consequences of organizational resilience, ultimately to contribute improve strategies.\u003c/p\u003e\u003ch2\u003eDesign:\u003c/h2\u003e \u003cp\u003eRodgers and Knafl\u0026rsquo;s evolutionary concept was applied.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eFive databases (MEDLINE, CINAHL, Web of Science, PubMed, Embase) were searched from 1973 to 2023 to identify relevant sources. Thematic analysis was used to form the conceptual connotation of organizational resilience.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 45 articles were included for synthesis. Six antecedents of organizational resilience were identified, that is robustness, redundancy, rapidity, and resourcefulness. Nine attributes of organizational resilience include robustness, redundancy, rapidity, resourcefulness, diversity, adaption, self-regulation, flexibility, and recoverability, and the consequence was explored.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe overall direction for what Organizational resilience involves and its overall qualities could assist an organization with focusing on its activities and systems inside its unique circumstance and arrive at its strength objective, accordingly healthcare system to continue to adapt and evolve in the face of stress and change. Our conceptual analysis of organizational resilience gives a complete comprehension of this phenomenon and a rationale for instrument development, future research and intervention.\u003c/p\u003e\u003ch2\u003eImpact:\u003c/h2\u003e \u003cp\u003eThis study defines the concept, antecedents, attributes and consequences of organizational resilience. Strengthening resilience could improve the overall adaptability and sustainability of organizations. This study helps to provide guidance and recommendations for health organizations to enhance their resilience and meet future challenges.\u003c/p\u003e","manuscriptTitle":"Organizational Resilience in Nursing: A Concept Analysis Using Rodgers' Evolutionary Approach","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-10-11 17:04:36","doi":"10.21203/rs.3.rs-3410621/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f3152864-0b4e-46f0-bddc-df58a65a5d81","owner":[],"postedDate":"October 11th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-10-18T07:29:24+00:00","versionOfRecord":[],"versionCreatedAt":"2023-10-11 17:04:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3410621","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3410621","identity":"rs-3410621","version":["v1"]},"buildId":"FbvkV6FR0MCFSLy54lSbu","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}