Purpose: Health systems are periodically confronted by crises – think of Severe Acute Respiratory Syndrome, H1N1, and Ebola – during which they are called upon to manage exceptional situations without interrupting essential services to the population. The ability to accomplish this dual mandate is at the heart of resilience strategies, which in healthcare systems involve developing surge capacity to manage a sudden influx of patients. The paper aims to discuss these issues. Design/methodology/approach: This paper relates insights from resilience research to the four “S” of surge capacity (staff, stuff, structures and systems) and proposes a framework based on complexity theory to better understand and assess resilience factors that enable the development of surge capacity in complex health systems. Findings: Detailed and dynamic complexities manifest in different challenges during a crisis. Resilience factors are classified according to these types of complexity and along their temporal dimensions: proactive factors that improve preparedness to confront both usual and exceptional requirements, and passive factors that enable response to unexpected demands as they arise during a crisis. The framework is completed by further categorizing resilience factors according to their stabilizing or destabilizing impact, drawing on feedback processes described in complexity theory. Favorable order resilience factors create consistency and act as stabilizing forces in systems, while favorable disorder factors such as diversity and complementarity act as destabilizing forces. Originality/value: The framework suggests a balanced and innovative process to integrate these factors in a pragmatic approach built around the fours “S” of surge capacity to increase health system resilience.

Although inter-organisational collaborative structures play a vital role in determining the level of collaboration among organisations, the identification of required organisational structural types and their features to facilitate fruitful collaboration is not satisfactorily discussed in existing studies. In addition, the connection between inter-organisational structural types and features, and their influence on collaboration, is not well understood. This systematised literature review study explores the available inter-organisational collaborative structural types, features, and their suitability to facilitate collaboration among organisations. Our findings underscore the importance of adopting a hybrid form of hierarchy and network arrangements to facilitate effective collaboration among organisations. Furthermore, this study developed a framework that presents how collaboration depends on inter-organisational structures and their features in facilitating vertical and horizontal integration. This framework can be used to identify the inter-organisational collaboration structures that are required to move towards a desired inter-organisational collaboration level.