Burnout and network centrality as proxies for assessing the human cost of resilient performance

Workspace Layout for Resilient Performance using Social Network Analysis: A Case Study

Purpose: To present the social network analysis-based approach used to create a new workspace layout for three hospital services as part of a campus expansion at a large tertiary care public hospital. Objective: To analyze the relationships among service members across four healthcare resilience abilities (monitor, anticipate, respond, and learn) and utilize network metrics to indicate the suitability of a shared workspace layout for the services. Background: The hospital expanded by 70%, providing space for relocating key services-the rapid response team, medical on-call team, and nursing supervision. Initial observations suggested a shared workspace layout based on anecdotal evidence. Method: Stakeholders have reached a consensus on a three-stage process to assess the suitability of a shared workspace layout for these services: first, collecting data on social interactions with a focus on resilience abilities; second, presenting layout alternatives based on sociograms; and third, evaluating these alternatives and devising a strategy for allocating personnel to shifts based on a resilience score derived from social network metrics. Case Study: The examination of social network metrics allowed identifying key individuals contributing to the overall resilience of the three services. Sociograms provided visual representations of how these individuals were spatially distributed within the shared layout. Discussion: The process was designed to shape a resilient layout and incorporated initial data, preferences, and constraints into layout proposals. Additionally, it utilized a resilience score from existing literature to formulate a strategy for staff allocation to shifts, ensuring consistent collective resilience ability across all shifts.

A knowledge framework for the design of built environment supportive of resilient internal logistics in hospitals

Internal logistics is crucial for hospitals, occurring within facilities that pose constraints and opportunities, demanding resilient performance (RP) to adapt to dynamic conditions and balance safety and efficiency pressures. However, the role of the built environment (BE) to support RP is not explicitly analysed in the hospital logistics literature, which is usually limited to discuss BE in terms of layout and routing issues. To address this gap, this study presents a knowledge framework of BE supportive of RP in internal hospital logistics. The framework was developed based on a study in a large teaching hospital, encompassing 11 service flows of people and supplies between an intensive care unit and other units. Data collection was based on 38 interviews, documents such as floor plans, and observations of logistics activities. Seven BE design principles developed in a previous study, concerned with RP in general but not focused on logistics, were adopted as initial themes for data analysis. Results of the thematic analysis gave rise to a knowledge framework composed of seven design prescriptions and 63 practical examples of BE supportive of RP in hospital internal logistics. The paper discusses how these prescriptions and examples are connected to resilience management. The framework is new in the context of internal hospital logistics and offers guidance to both BE and logistics designers.

Principles and practices of designing for resilient performance: An assessment framework

Although resilient performance is intrinsic to socio-technical systems it might be supported by design, an idea known as Design for Resilient Performance (DfRP). Considering that such design is usually a re-design, learning from existing systems is crucial. This article introduces a framework for assessing the extent to which a system uses practices and principles of DfRP. The framework allows for the assessment of 24 attributes of the principles, the analysis of their relationships (a model was devised based on a survey with experts), and the investigation of practices that operationalize the principles. A scoring system sheds light on the effectiveness of using the principles. The framework application is exemplified based on the study of an emergency department in which daily huddles stood out as a practice of DfRP. This study involved interviews, observations, and documentary analysis. Based on this, a knowledge structure of DfRP is presented, comprised of concepts, principles, and practices. Six propositions to guide the framework application are set out, addressing themes such as the need for cost-effective DfRP, short control cycles, and customized designs that meet preferences of designers. The study contributes to DfRP theory and offers a new approach for resilience assessment.