Bianca Beersma is a professor in Organizational Behaviour in the Department of Organization Sciences at VU University, Amsterdam (the Netherlands). She received her Ph.D. in Organizational Psychology from the University of Amsterdam in 2002. Her research focuses on cooperation and competition in and between organizations. Specific research topics are teamwork, negotiation, conflict management, resilience in healthcare and gossip and voice in organizations. Bianca currently works on an ERC consolidator grant project on the functional and dysfunctional effects of gossip in organizations. She is the scientific director of the Talma Institute, which focuses on contributing to the quality, accessibility, and affordability of healthcare through research and other knowledge products, and theme leader of the Care and Welfare theme for the Institute for Societal Resilience.



A multilevel negotiation perspective on organizational resilience – healthcare as a case in point

The term resilience generally refers to an entity’s capacity to “bounce back from a setback” (Stoverink et al., 2020, p. 397). In the context of healthcare, resilience is a central theme (Wiig & O’Hara, 2021; Turenne et al. 2019) because at its core, healthcare is about coping with and anticipating physical and mental setbacks in the lives of individuals (Huber et al., 2011). Moreover, the healthcare sector as a whole is dealing with a variety of (external) setbacks. Examples are the COVID-19 pandemic, the challenges associated with an ageing and an increasingly diverse population, and staff shortages.

In this contribution, we use insights from our research in the Research Group on Care Organization and Policy (with, among others, colleagues Kim van Erp, Marieke van Wieringen, Karin Kee, Ludo Glimmerveen and Henk Nies), in the context of healthcare, to develop a perspective on resilience in the context of organizations. Similar to other organizational fields, in healthcare, several interdependent levels of analysis can be distinguished: 1) the individual level that includes patients/clients, informal caregivers, and care professionals; 2) the team level, referring to the unit of organization where a group of (interdependent) individuals work together towards a goal; 3) the organizational level, which constitutes the care organization(s), and 4) the care system as a whole involving for instance also governments and institutions (cf. Valentijn et al, 2013).

Despite calls to develop an integrative, multilevel framework on resilience in the context of organizations (Hartmann et al., 2020), research has tended to focus on single levels of analysis (Baggio et al. 2015). This limits our understanding of resilience, as entities’ responses to setbacks on one particular level of analysis may both affect and reflect what happens on a different level.  In this contribution, we address this shortcoming, and propose the following:

  1. Understanding resilience requires a multilevel, relational perspective. We conceptualize the ability to employ internal resources and negotiate external resources as central to resilience. External resources may be available at other levels of analysis than the focal level. Therefore, we need to understand resilience as a multilevel, relational concept.
  2. The question of what “resilience” is has diverse answers that are – at least to a certain extent – determined normatively. (Successfully) coping with a setback may result in developmental or learning processes in which entities re-invent their “essential condition” or adapt their “desired state”. In such processes, different entities (at different levels of analysis) may have different perspectives on what is “desired”. Therefore, in contrast to the conventional view idea of “bouncing back”, we prefer the term “bouncing forward”. That is, a resilient response may imply that actors bounce forward to a different “desired state”, whereby a setback can be an experience that potentially changes the entity under consideration.
  3. Because the resilience of one entity is interdependent with the resilience of other entities (at the same or at another level of analysis, see proposition 1), and because what “resilience” is, is determined normatively (see proposition 2), the resilience of one entity may (partly) conflict with the resilience of other entities (at the same or at other levels of analysis).
  4. A constructive approach to fostering organizational resilience requires integrative negotiation, that is, negotiation that aims to optimally integrate the outcomes of the involved entities in order to arrive at mutually beneficial solutions (Pruitt & Lewis, 195). Different perspectives on the ‘desired states’ of entities (see propositions 2 and 3) and their inherent interdependence (see proposition 1) require a problem-solving approach in which the focus is on integrating outcomes of the involved parties.

We use examples from the field of healthcare to illustrate the above propositions, arguing that the perspective discussed here is also applicable to other organizational fields.

Answers to the questions with regards to Theme III. Transforming Communities, Organizations and Norms

- How do you define the resilience of communities and organizations vis-à-vis their needed transformations? - Do communities need to be resilient, and what does it mean? Do they need to undergo transitions, and why?

As described in the abstract, in our perspective, the integrative negotiation of resources between organizational entities at different levels of analysis is crucial.

- What is the role of organizations/communities in the current crises (socio-ecological, geopolitical, cultural and socio-economical)?

Obviously, in the healthcare examples that are central in our contribution to the conference, the role of organizations is very important. Whether or not individuals and teams are able to respond to setbacks in a resilient way is determined in large part on whether they are able to successfully negotiate resources at the organizational level. In turn, to respond in a resilient way to setbacks at the organizational level, organizations depend on negotiating resources with the lower levels (teams and individuals) and the higher level (healthcare system). It is important to emphasize the importance of an integrative approach, aimed at mutually beneficial solutions, for these negotiations. 

- What norms, values, processes and policies are beneficial in this context, and how can they be implemented?

Norms, values, processes and policies should all motivate integrative negotiation, in which entities are clear about their own interests and combine this with an aim to also foster the interests of the other parties they are negotiating with. This means that it is important to critically review which norms and values are explicitly and implicitly stimulated by the systems and policies in place.