251 General Discussion 7.4 Framework considerations and future research In using Duchek’s organizational resilience framework in this dissertation, and in her encouragement for studies to carefully assess the framework, a suggestion would be to add an arrow from “power and responsibility” to affect the second stage of coping (see Figure 7.2, added arrow in gray). Power and responsibility are credited to be the main drivers underlying the third stage of adaptation but our studies found that Sanquin’s management was a key player in supporting successful coping. As “coping with crises builds the foundation for [adaptation]” (Duchek, p. 202)48 it seems logical that the same driver contributes towards both stages. This connects with literature, for example, in Vakilzadeh and Haase’s systematic review59 that lists aspects of leadership within each stage of resilience, Kim54 and Kaltenbrunner’s53 frameworks that outline the role of leaders upon multiple stages of resilience, and studies that examine the influence of power upon improvisation.60,62 While learning should occur in each stage of resilience,59,75 it may be most necessary in the last stage of adaptation.70 This is already in line with the framework as each stage is interdependent upon one another and any learning in each phase would be stored into the organization’s “prior knowledge base.” As previously discussed, this would benefit the entire organization and would increase both “resilience potential and the ability to realize and enhance this potential” (Duchek, p. 233)48. Currently, the latest studies on resilience propose an integrated model that shows the interactions between attributes, processes, in a multi-level manner (i.e., individual, team, leadership/management, operational/organizational) and over time.54,76 Additionally, as resilience research is a very diffuse and diverse field, a taxonomy of the major resilience themes (i.e., developmental, proactive, and reactive) is proposed for clearer differentiation and better alignment across disciplines.76 Thus, future work may explore and adopt these perspectives. As this thesis is one of the first to assess organizational resilience and leadership within BEs, many questions remain. Future research can build and improve upon the work presented here as briefly described above. Overall, as there is a scarcity of research on management, organization, and leadership in Transfusion Medicine, opportunities remain to find sustainable and contextually appropriate ways to improve and strengthen organizational resilience.
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