Institutions, resilience, and intrapreneurship in healthcare: a critical literature review

Abstract In this paper, we investigate how institutional conditions shape individual-level resilience in healthcare organizations which in turn facilitates the intrapreneurial behavior of healthcare professionals. Using a critical literature review methodology, we identify that the current literature centers around three dominant clusters defined by intrapreneurial outcomes: organizational performance, innovation and knowledge creation, and intrapreneurial agency. Across these clusters, both formal and informal institutions play a complementary role in shaping resilience. This resilience, enables professionals to navigate uncertainty, cope with institutional barriers, and drive bottom-up change within hierarchical healthcare organizations, fostering intrapreneurship predominantly related to internal innovation and organizational improvement. Based on these insights, we propose a conceptual model illustrating how institutions jointly foster resilience, which acts as a mediating mechanism between institutional conditions and intrapreneurial behavior in healthcare. The study offers theoretical contributions to research on intrapreneurship and resilience, as well as managerial implications for healthcare leaders and policymakers.