Agilience: Bridging Agility and Resilience for Safer Healthcare—A Conceptual Commentary

Healthcare systems operate in safety-critical environments where rapid adaptation and sustained functioning must occur simultaneously, yet existing safety frameworks tend to conceptualise agility and resilience as separate, sequential, or retrospective capabilities. This conceptual separation limits understanding of how safety is enacted during disruption, when healthcare workers and organisations must respond in real time without temporal or structural buffers. This paper introduces agilience as an emerging conceptual construct that captures the concurrent enactment of agility (rapid adaptation) and resilience (sustained functioning, recovery, and learning) under conditions of uncertainty. Drawing on safety science, resilience engineering, organisational theory, and comparative industry literature, this conceptual commentary clarifies how agilience extends existing Safety-I and Safety-II paradigms by addressing the temporal gap between prevention-focused and learning-focused approaches. Agilience is positioned as both an explanatory lens and an aspirational organisational state, highlighting the alignment required between individual adaptive capability and organisational structures to support safe, sustainable care delivery. The paper outlines the defining features, boundaries, and system conditions under which agilience becomes visible, and illustrates its relevance through healthcare examples. By articulating agilience as a distinct conceptual contribution, this work provides a foundation for future empirical investigation, measurement development, and application in healthcare safety management.