International Journal of Health Policy and Management

International Journal of Health Policy and Management

Learning Health Systems Are Resilient Health Systems Comment on “Re-evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons From the First Two Years of the Pandemic”

Document Type : Commentary

Authors
Rachel Neill
Michael A. Peters
Health Systems Program, International Health Department, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
10.34172/ijhpm.8676
Abstract
Saulnier’s review, “Re-evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons From the First Two Years of the Pandemic,” analyzes health systems resilience in the first two years of the COVID-19 pandemic. A key finding was the importance of learning. In this commentary, we argue that strengthening systems-level learning capabilities could build resilient health systems. Drawing on learning theories and evidence from organizational resilience and management scholarship, we link the concept of learning loops with Blanchet’s resilience capacities framework, demonstrating the importance of higher levels of learning to build adaptive and transformative resilience capacities. We also argue for an increased focus on power analysis to analyze what is learned, who learns it, and who responds as determining factors to adaptation and transformation. Future research should empirically investigate the extent to which different types of learning supports – or impedes – the building of resilient health systems.
Keywords
Learning Health Systems
Resilience
COVID-19
Health Policy
Pandemic Preparedness
  1. Blanchet K, Nam SL, Ramalingam B, Pozo-Martin F. Governance and capacity to manage resilience of health systems: towards a new conceptual framework. Int J Health Policy Manag. 2017;6(8):431-435. doi:15171/ijhpm.2017.36
  2. Saulnier DD, Duchenko A, Ottilie-Kovelman S, Tediosi F, Blanchet K. Re-evaluating our knowledge of health system resilience during COVID-19: lessons from the first two years of the pandemic. Int J Health Policy Manag. 2023;12:6659. doi:34172/ijhpm.2022.6659
  3. Witter S, Thomas S, Topp SM, et al. Health system resilience: a critical review and reconceptualisation. Lancet Glob Health. 2023;11(9):e1454-e1458. doi:1016/s2214-109x(23)00279-6
  4. Fridell M, Edwin S, von Schreeb J, Saulnier DD. Health system resilience: what are we talking about? A scoping review mapping characteristics and keywords. Int J Health Policy Manag. 2020;9(1):6-16. doi:15171/ijhpm.2019.71
  5. Sheikh K, Peters D, Agyepong IA, Abimbola S, Ghaffar A, Swaminathan S. Learning is a means to progress and empowerment for health systems. BMJ Glob Health. 2022;7(Suppl 7):e010572. doi:1136/bmjgh-2022-010572
  6. Argyris C. Double loop learning in organizations. Cambridge: Harvard University; 1977.
  7. Tosey P, Visser M, Saunders MN. The origins and conceptualizations of ‘triple-loop’ learning: a critical review. Manag Learn. 2012;43(3):291-307. doi:1177/1350507611426239
  8. Easterling D, Perry AC, Woodside R, Patel T, Gesell SB. Clarifying the concept of a learning health system for healthcare delivery organizations: implications from a qualitative analysis of the scientific literature. Learn Health Syst. 2022;6(2):e10287. doi:1002/lrh2.10287
  9. Bishai D, Saleh BM, Huda M, et al. Practical strategies to achieve resilient health systems: results from a scoping review. BMC Health Serv Res. 2024;24(1):297. doi:1186/s12913-024-10650-8
  10. Millimouno TM, Meessen B, Put WV, et al. How has Guinea learnt from the response to outbreaks? A learning health system analysis. BMJ Glob Health. 2023;8(2):e010996. doi:1136/bmjgh-2022-010996
  11. Saulnier DD, Topp SM. We need to talk about 'bad' resilience. BMJ Glob Health. 2024;9(2):e014041. doi:1136/bmjgh-2023-014041
  12. van de Bovenkamp H, de Graaff B, Kalthoff K, Bal R. The patient representation struggle during the COVID-19 pandemic: missed opportunities for resilient healthcare systems. Health Expect. 2024;27(1):e13877. doi:1111/hex.13877
  13. Witter S, Sheikh K, Schleiff M. Learning health systems in low-income and middle-income countries: exploring evidence and expert insights. BMJ Glob Health. 2022;7(Suppl 7):e008115. doi:1136/bmjgh-2021-008115
  14. Orth D, Schuldis PM. Organizational learning and unlearning capabilities for resilience during COVID-19. Learn Organ. 2021;28(6):509-522. doi:1108/tlo-07-2020-0130
International Journal of Health Policy and Management
Volume 13, Issue 1
2024
Pages 1-4

  • Received Date 30 June 2024
  • Revised Date 11 August 2024
  • Accepted Date 12 August 2024
  • First Published Date 14 August 2024
  • Published Date 01 December 2024