Literature study from a social ecological perspective on how to create flexibility in healthcare organisations

Aim:
To examine (1) how flexibility is defined and described in healthcare literature and (2) which interventions are used at what organisational level to influence flexibility.
Background:
Flexibility is necessary in healthcare for continuous adaptation to the dynamic environment. In accordance with Social Ecological Theory, it takes the combination of all organisational levels to achieve flexibility (individual, interpersonal, organisational, community, and macro-policy). However, managing this is complex.
Evaluation:
Using Psychinfo and Web of Science, a systematic search was performed on flexibility in health care organisations. The 19 studies that met the selection criteria were analysed from a social ecological perspective. Eight publications described flexibility as a result of interventions, but provided little information about their evidence base.
Key issues:
It is difficult to achieve flexibility: a pro-active attitude and capability to adapt internal processes to the changing environment. Interventions promoting flexibility in healthcare need all organisational levels, since they mutually influence each other.
Conclusion:
This study shows that there is too little evidence on how to create flexibility in healthcare organisations.
Implications for management: Change in healthcare is continuous. Therefore, flexibility should be a permanent pro-active attitude of both managers and professionals and should take all organisational levels into account.