Organisational Resilience in Medical Rehabilitation During Pandemics and Comparable Crises: A Nationwide Survey of Facility Managers in Germany

Maintaining rehabilitation services during pandemics is an international preparedness challenge. This study examines organisational responses and support needs in Germany as a national case example. A nationwide cross-sectional survey of outpatient and inpatient rehabilitation facility managers was conducted online and by post between June and September 2021. Of 599 returned questionnaires, 535 were included in the analysis. Closed-ended responses were analysed descriptively, and open-ended responses using qualitative content analysis. Overall, 13.6% of facilities reported poor or very poor preparedness, while 38.8% reported good or very good preparedness. Establishing separate staff teams was particularly challenging, with 50.8% rating implementation as problematic or very problematic. Managers reported that information sharing, consistent communication, adapted workflows, testing and hygiene measures had worked well. Clear and nationally consistent requirements were the most frequently mentioned need when reflecting on support that would have helped during the pandemic. Financial support and clear guidance remained important at the time of the survey. The findings highlight organisational, communication and resource-related factors in maintaining rehabilitation care. This German case offers context-specific lessons for integrating rehabilitation into broader pandemic preparedness and crisis planning.