Beyond the meso level
A multilevel analysis of hospital resilience to floods
Bibliographic Data
| ID | 22025327 |
|---|---|
| Authors | Stela Xavier Terra (0000-0002-5395-9667, Universidade Federal do Rio Grande do Sul), Tarcísio Abreu Saurin (0000-0003-2929-5888, Universidade Federal do Rio Grande do Sul, corresponding author) |
| Year | 2026 |
| Volume | 143 |
| Pages | 106297 |
| Publication date | 2026-09-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | International Journal of Disaster Risk Reduction (JOURNAL) |
| Journal identifiers | ISSN: 2212-4209 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.ijdrr.2026.106297 |
| OpenAlex | W7167592566 |
| Language | EN |
| References cited | 51 |
Hospital resilience to extreme weather events is usually investigated at the meso level, taking the entire hospital as the unit of analysis. This overlooks the multilevel nature of resilience, regarding interactions with the micro and macro levels. This article develops an analytical framework informed by the Resilience Engineering perspective, considering cross-level interactions and informal practices neglected by studies focused on the robustness of physical infrastructures. To this end, a study of hospital resilience to a flooding event was conducted, encompassing triggers, manifestations, and impacts of resilience across the micro, meso, and macro levels. Data collection involved observations, meetings, document analysis, and questerviews with healthcare professionals from four hospitals affected by the floods. Results indicated 31 triggers, 40 manifestations, and 44 impacts. Three propositions synthesise emergent patterns arising from these results. Altogether, the themes that guided data collection and analysis (triggers, manifestations, and impacts), a schematic model of their relationships, and the propositions, make up a framework for the multilevel analysis of hospital resilience to floods. This framework advances Resilience Engineering by moving beyond the conceptual recognition of multilevel resilience and offering a basis for its empirical analysis. It also contributes to the assessment of hospital resilience to floods by highlighting the limitations of an overemphasis on the meso level and formal organisational structures
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| Highly cited | No |
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