A mobile methods pilot study of surgical spaces: ‘fit for purpose? Organisational productivity and workforce wellbeing in workspaces in hospital’ (FLOURISH)

Abstract

Background: Good workspace design is key to the quality of work, safety, and wellbeing for workers, yet we lack vital knowledge about optimal hospital design to meet healthcare workforce needs. This study used novel mobile methods to examine the concept of Work-as-Done and the effect of workspace-use on healthcare professional practice, productivity, health and safety in an Australian university hospital. Methods: This pilot study took place in one gastroenterological surgical unit between 2018 and 2019. Data collection involved 50 h of observations and informal conversations, followed by interpretation of five architectural plans and 45 photographs. Fieldnotes were thematically analysed and corroborated by analysis of visual data using a predefined taxonomy.Results: Six themes were identified, revealing spaces that both support and hinder Work-as-Done. Fit-for-purpose spaces facilitated effective communication between staff, patients and families, conferred relative comfort and privacy, and supported effective teamwork. Unfit-for-purpose spaces were characterised by disruptions to work practices, disharmony among team members, and physical discomfort for staff. Staff employed workarounds to manage unfit-for-purpose spaces. Conclusion: The results identified negative impacts of negotiating unfit-for-purpose workspaces on the work and wellbeing of staff. While the use of workarounds and adaptations enable staff to maintain everyday working practices, they can also lead to unexpected consequences. Results indicated the need to identify and support fitfor-purpose spaces and minimize the detrimental qualities of unfit-for-purpose spaces. This study showed that mobile methods were suitable for examining Work-as-Done in a fast-moving, adaptive hospital setting.

The complexities, coordination, culture and capacities that characterise the delivery of oncology services in the common areas of ambulatory settings

“…While we observed a degree of fluidity in team membership, this represents one of many possible models of team care that have been described [ 1 – 4 ]. As observed in other hospital settings [ 44 ], features of the design and layout played a role in shaping OPCs, including co-location of departments and professionals. Purpose-designed standalone treatment spaces may increase efficiency and safety, but reduce the opportunity for incidental inter-departmental interactions which provide opportunities for communication about patients and may provide a foundation for care-enhancing social networks; such spaces may need to create artificial mechanisms for building collaborative relationships.…”

The Built Environment Influence on Resilient Healthcare: A Systematic Literature Review of Design Knowledge

“…An analysis of the theoretical background adopted by the papers was also conducted. Besides referring to EBD, papers addressed patient-and-family-centered care (16) (Choi & Bosch, 2013; France et al, 2009), the complexity of health services (11) (Rapport et al, 2020; Ransolin et al, 2020), safety science (seven) (Pati et al, 2016; Sundberg et al, 2020a), human factors and ergonomics (six) (Battisto et al, 2009; Platt et al, 2017), and lean healthcare (three) (Copeland & Chambers, 2017; Karvonen et al, 2017). Postoccupancy evaluation was a methodological approach (10 papers) common to several of those theoretical backgrounds.…”

“…However, BE design solutions are often based on WAI models that do not properly account for the reality of WAD (Rapport et al, 2020). As a result of this disconnection, staff adjusts their performance during the use of facilities (Borsci et al, 2018; Braithwaite, 2018).…”

Developing a novel psychographic-behavioral qualitative mapping method for exergames

“…Proformas differ from structured interviews or closed question surveys [46,47] which are highly formalized and can be rigid. Instead, the proforma is a qualitative data collection tool taking the form of an open-ended, text-box survey, containing several specific open-ended questions [48,49]. Proformas are designed to encourage expansive answers from participants.…”