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By Bruno Lucet, ISQua Board Member Thursday. May 14, 2020

Resilience : landmarks and references Featured

In the current context of the pandemic that we are currently experiencing, it seemed interesting to me, not to comment on current events, but to offer some landmarks and references on the concept of resilience.

According to Boris Cyrulnik, French doctor, neurologist and psychiatrist, resilience is the art of sailing torrents; it is also the ability to live, to succeed, to develop despite adversity.

The work carried out by the WHO Department of Integrated Health Services (which has taken over the missions of the Service Delivery and Safety Department whose objective is help countries to “rethink health care”) is very instructive in this regard. We can cite the National Quality Policy and Strategy programme, which addresses resilience, according to the United Nations Office for Disaster Risk Reduction, as “the ability of a system, community or society exposed to hazards to resist, absorb, accommodate to and recover from the effects of a hazard in a timely and efficient manner, including through the preservation and restoration of its essential basic structures and functions”.


Similarly, the publication “WHO Community Engagement framework for Quality, people-centred and resilient health services” (WHO / HIS / SDS / 2017.15) draws lessons from the Ebola virus disease outbreak which teaches us how “to learn what did and did not work in terms of community engagement.” And how to learn from it for strengthening health systems and communities.


Finally, the work conducted by our excellent colleague, Professor Jeffrey Braithwaite, explains that resilience is a complex construct drawn initially from resilience engineering. Applied to patient safety in healthcare by Hollnagel, Wears, Braithwaite and colleagues, it describes the capacity of the system to adjust and sustain essential functions under expected and unexpected circumstances. Another way of describing resilient healthcare is it is the capacities to respond to internal and external pressures, monitor threats and risks, anticipate future occurrences, and learn (J Braithwaite, C Von Plessen, A Nicolaisen, R Clay-Williams, ISQUA17-2582 THE RELATIONSHIP BETWEEN QUALITY IMPROVEMENT AND RESILIENT HEALTHCARE; NUANCES, COMPLEXITIES AND TRADE-OFFS, International Journal for Quality in Health Care, Volume 29, Issue suppl_1, September 2017, Pages 46–47, and Jeffrey Braithwaite, Robert L. Wears, Erik Hollnagel, Resilient health care: turning patient safety on its head, International Journal for Quality in Health Care, Volume 27, Issue 5, October 2015, Pages 418–420,


There is no doubt that the concept of resilience can be usefully mobilized to, in the light of acquired experience, reconsider health systems and guarantee that the quality of care is effective, safe, people-centred, timely, equitable, efficient and integrated. 



Bruno Lucet

ISQua Board Member

Read 1937 times Last modified on Thursday, 14 May 2020 09:00