Hospital Resilience to the COVID-19 Pandemic in Five Countries: A Multiple Case Study

Abstract

ABSTRACT Since the beginning of the pandemic, hospitals have been central to the COVID-19response, often experiencing severe financial, material, and human constraints. In thisspecial issue, we present some of the findings of the HoSPiCOVID research project.One of its main objectives was to compare hospital responses to the first and secondwaves of the COVID-19 pandemic in Brazil, Canada, France, Japan, and Mali.Studying and comparing how nine different hospitals coped with the pandemic in termsof preparedness and response allowed us to: 1) identify strengths and weaknesses oftheir responses, including challenges for hospital professionals; and 2) producelessons learned, using a systematic approach to reflect and analyze their potential ofresilience to the crisis. In the five countries, research teams conducted in-depthqualitative studies focused on nine large hospitals, using observation sessions, semistructuredinterviews with hospital professionals, and lessons learned workshops. Theempirical work was supported by an original analytical framework on hospital resilienceand a heuristic tool focused on configurations. The studies demonstrate that thehospitals were able to absorb and/or adapt to the crisis by deploying different copingmechanisms, which often required extensive involvement of hospital professionals.More extended study periods would be needed to assess the sustainability of thesecoping mechanisms and discern whether they have transformative potential. Theseinternational comparisons of hospital resilience, based on studies of contrastingcontexts and epidemiological situations, allowed researchers to identify lessonslearned to support hospital decision-makers in thinking more deeply about managingfuture health crises.