TY - JOUR
T1 - Factors impeding flexible inpatient unit design
AU - Pati, Debajyoti
AU - Evans, Jennie
AU - Harvey, Thomas E.
AU - Bazuin, Doug
PY - 2012/10
Y1 - 2012/10
N2 - Objective: To identify and examine factors extraneous to the design decision-making process that could impede the optimization of flexibility on inpatient units. Background: A 2006 empirical study to identify domains of design decisions that affect flexibility on inpatient units found some indication in the context of the acuity-adaptable operational model that factors extraneous to the design process could have negatively influenced the successful implementation of the model. This raised questions regarding extraneous factors that might influence the successful optimization of flexibility. Method: An exploratory, qualitative method was adopted to examine the question. Stakeholders from five recently built acute care inpatient units participated in the study, which involved three types of data collection: (1) verbal protocol data from a gaming session; (2) in-depth semi-structured interviews; and (3) shadowing frontline personnel. Data collection was conducted between June 2009 and November 2010. Results: The study revealed at least nine factors extraneous to the design process that have the potential to hinder the optimization of flexibility in four domains: (1) systemic; (2) cultural; (3) human; and (4) financial. Conclusions: Flexibility is critical to hospital operations in the new healthcare climate, where cost reduction constitutes a vital target. From this perspective, flexibility and efficiency strategies can be influenced by (1) return on investment, (2) communication, (3) culture change, and (4) problem definition. Extraneous factors identified in this study could also affect flexibility in other care settings; therefore, these findings may be viewed from the overall context of hospital design.
AB - Objective: To identify and examine factors extraneous to the design decision-making process that could impede the optimization of flexibility on inpatient units. Background: A 2006 empirical study to identify domains of design decisions that affect flexibility on inpatient units found some indication in the context of the acuity-adaptable operational model that factors extraneous to the design process could have negatively influenced the successful implementation of the model. This raised questions regarding extraneous factors that might influence the successful optimization of flexibility. Method: An exploratory, qualitative method was adopted to examine the question. Stakeholders from five recently built acute care inpatient units participated in the study, which involved three types of data collection: (1) verbal protocol data from a gaming session; (2) in-depth semi-structured interviews; and (3) shadowing frontline personnel. Data collection was conducted between June 2009 and November 2010. Results: The study revealed at least nine factors extraneous to the design process that have the potential to hinder the optimization of flexibility in four domains: (1) systemic; (2) cultural; (3) human; and (4) financial. Conclusions: Flexibility is critical to hospital operations in the new healthcare climate, where cost reduction constitutes a vital target. From this perspective, flexibility and efficiency strategies can be influenced by (1) return on investment, (2) communication, (3) culture change, and (4) problem definition. Extraneous factors identified in this study could also affect flexibility in other care settings; therefore, these findings may be viewed from the overall context of hospital design.
KW - Evidence-based design
KW - Flexibility
KW - Healthcare design
UR - http://www.scopus.com/inward/record.url?scp=84878182449&partnerID=8YFLogxK
U2 - 10.1177/193758671200600105
DO - 10.1177/193758671200600105
M3 - Article
C2 - 23224844
AN - SCOPUS:84878182449
VL - 6
SP - 83
EP - 103
JO - Health Environments Research and Design Journal
JF - Health Environments Research and Design Journal
SN - 1937-5867
IS - 1
ER -