Organizational resilience in nursing: a concept analysis using Rodgers’ evolutionary approach

Peng et al. Health Research Policy and Systems (2025) 23:129 https://doi.org/10.1186/s12961-025-01407-8 Health Research Policy and Systems Open Access RESEARCH Organizational resilience in nursing: a concept analysis using Rodgers’ evolutionary approach Ying Peng1,2†, Yangli Ou3†, Xin Luo1,2, Chunni Wang1,2, Mingzhao Xiao2, Huanhuan Huang1,2* and Qinghua Zhao1,2* Abstract Aim We sought to distinguish, clarify and define the development process, concepts, attributes, types, prerequisites and consequences of organizational resilience, ultimately with the aim of improving relevant nursing strategies. Design Rodgers and Knafl’s evolutionary concept was applied to the concept analysis. Methods Five databases (MEDLINE, CINAHL, Web of Science, PubMed and 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. Alternative and related terms (mentioned in the literature) that share attributes with organizational resilience include crisis management and change management. Six antecedents of organizational resilience were identified: Resource, Communication, Social Networks, Infrastructure, Organizational Structure and People. Nine attributes of organizational resilience include: robustness, redundancy, rapidity, resourcefulness, diversity, adaption, self-regulation, flexibility and recoverability. Consequences of organizational resilience were separated into three themes: organization, employee and customer. Conclusions Organizational resilience delineates a coherent set of antecedents, attributes and consequences that can guide healthcare systems in calibrating their structures, processes and resources to context-specific demands. By internationalizing these qualities, organizations can systematically pursue resilience objectives, thereby sustaining adaptive capacity under conditions 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. By strengthening these elements, organizations can enhance their adaptability and long-term sustainability. The findings offer evidence-based guidance that healthcare organizations can apply to build resilience and effectively respond to future challenges. Keywords Organizational, Resilience, Adoption, Nursing, Concept analysis † Ying Peng and Yangli Ou share first authorship. *Correspondence: Huanhuan Huang Qinghua Zhao Full list of author information is available at the end of the article © The Author(s) 2025. 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To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. Peng et al. Health Research Policy and Systems (2025) 23:129 Introduction In recent years, pandemics, climate change, armed conflict and public health emergencies have converged, generating systemic risks with profound social and economic consequences [1, 2]. Accelerating globalization and an evolving geopolitical order are rendering the environments in which organizations operate increasingly volatile. Crises and disasters have become recurrent phenomena that organizations must anticipate and navigate. To survive and develop under such conditions—especially during major shocks – organizations must cultivate greater adaptive capacity [3, 4]. In 2020, the World Health Organization re-issued Strengthening the resilience of health systems: key concepts and strategies, asserting that the resilience of health systems is pivotal to managing catastrophic events [5]. In addition, the 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. Coronavirus disease 2019 (COVID-19) has again exposed organizations’ capacity to absorb health shocks while sustaining core functions, prompting intensified interest – among both governments and institutions – in cultivating organizational resilience [7]. Although scholarship and policy initiatives have proliferated, definitional and analytical consensus remains elusive; competing conceptualizations continue to circulate. In nursing, in particular, the construct remains notably under-theorized. Background Resilience – originally denoting toughness, elasticity and the ability to recover – refers to the capacity of a material to return rapidly to its initial state after deformation by external forces [8]. It first appeared in the field of materials science. The construct emerged in materials science and has since evolved through three principal developmental phases. The first phase began in 1973, when C.S. Holling applied complex adaptive systems theory to ecological contexts, demonstrating that ecosystems reorganize in response to shifting environmental imperatives [9, 10]. Holling developed the concept of ecological resilience, defined as the magnitude of disturbance a system can absorb before shifting to an alternative stability domain. The concept has been applied to all fields of complex systems science (economics, politics, etc.) and featured prominently in the Resilience Alliance series [11, 12], which sought to elucidate how systems reconfigure in response to perturbations. Since then, the concept of resilience has been widely used and popularized. Later, to adapt to sudden disasters and environmental changes, a combination of social, managerial, economic, Page 2 of 12 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 fierce competition (...truncated)