Background: Health Organizations (HOs) worldwide are vital to any nation's capacity to withstand crises. The heightened focus on organizational resilience (OR) can be largely attributed to the global COVID-19 pandemic. The terror attack on Israel on October 7, 2023, underscored the essential nature of resilience in healthcare settings. By emphasizing OR's components, HOs can enhance their ability to anticipate, respond to, and recover from disruptions. This research hypothesized that the terror attack would serve as a catalyst for enhancing organizational resilience within healthcare organizations. This study aims to compare levels of organizational resilience among healthcare organizations before and after a mega-mass casualty incident and to identify the key predictors of resilience across various healthcare settings.
Methods: A quasi-longitudinal study. Three HOs were assessed pre-7.10.23 and six HOs were assessed following this incident, in the midst of an ongoing conflict (two hospitals, two district health bureaus, and two Emergency medical services regions). An organizational resilience assessment tool, developed through literature review, expert validation, pilot testing, and a Delphi process to rank the importance of each category, included 29 items across seven categories. Data were collected anonymously via an online survey and results were analyzed both separately and in aggregate to assess resilience levels.
Results: A total of 1,035 participants completed the survey across three healthcare organization types: general hospitals (N = 345), district health bureaus (N = 300), and emergency medical service regions (N = 390). Organizational resilience (OR) was measured separately for each organization type at two timepoints: before and after the October 7, 2023 events. No statistically significant changes in OR were observed post-event. Multiple linear regression identified six predictors that explained 81.4% of the variance in OR (Adjusted R² = 0.814), with transformational leadership emerging as the strongest predictor.
Conclusions: The study stresses the importance of improving organizational resilience in healthcare organizations facing extreme events. Managers in healthcare organizations should prioritize investment in transformational leadership, technological advancement, and employee well-being to enhance organizational resilience. Due to the differing levels of organizational resilience across disciplines within healthcare organizations, it is recommended to concentrate efforts and resources on sectors with lower resilience levels. This approach will enhance targeted interventions, save resources, and establish an effective timeline for strengthening organizational resilience. By enhancing their resilience, organizations can more effectively manage unforeseen emergencies, mitigate their impact on the overall health system, and contribute to saving lives.
Keywords: Conflict; Healthcare organizations; Organizational resilience.
© 2025. The Author(s).