Toward Hospital Resilience: a Qualitative Study on the identification of Hospital Shocks during Disruption era in Indonesia

Abstract Background: Hospital resilience has been well recognized among healthcare managers and providers as disruption of hospital services threatens their business environment. However, the shocks identified in the recent hospital resilience concept are mainly related to disaster situations. This study aims to identify potential shocks the hospitals face during the disruption in Indonesia. Method:This qualitative study is conducted in Makassar, Indonesia in August-November 2022. Data was collected through in-depth interviews with hospital managers and resilience experts using a semi-structured interview guide. Overall 20 key informants were interviewed. Data were analyzed by thematic analysis. Results: The study identified seven shocks to hospitals during the disruption era: policy, politics, economics, hospital management shifting paradigm, market and consumer behavior change, disaster, and conflicts. It also identified barriers to making hospitals resilient, such as inappropriate organizational culture, weak cooperation across sectors, the traditional approach of hospital management, inadequate managerial and leadership skills, and human resources capabilities, a lack of business mindset and resistance to change. Conclusion: This study provides a comprehensive understanding of hospital shocks during disruptions. This would serve as a guide to redesigning the instruments and capabilities needed for a resilient hospital.