Isolation or interaction: healthcare provider experience of design change

Abstract

Recent studies have drawn attention to the relationship between healthcare environments and patient outcomes. Yet, it remains unclear how changes in the design of healthcare facilities are experienced by providers. To understand this relationship, this study employs an inhabited institutionalist theoretical frame to assess longitudinal ethnographic and interview data collected at a neonatal intensive care unit (NICU) as it transformed from an open‐bay unit, to one with single‐patient rooms. Findings show that changing the structure of the NICU interfered with the original local organisational culture of collaboration. While providers actively worked to maintain the original culture, their success in doing so was mediated by the built environment. Responding to the new space, practitioners developed new practices. Some of the practices (such as doorway discussions and increased individual assessments) directly undermined the original organisational culture, whereas others (hallway hangouts and calling out) worked to transpose the original culture into the new space. These findings call for greater attention to the effect of physical space on organisational culture.

Benefits of GP care in outreach settings for people experiencing homelessness: a qualitative study

“…While these are positive steps forward, findings from the current study suggest that therapeutic relationships do not develop in a vacuum but are shaped by the physical and organisational environment of the service. As VanHeuvelen states, 27 ‘the physical environment operates as a dynamic force that influences organisational members’ local cultural practices’. In order for local cultural practices and relationship dynamics between GPs and PEH to change, attention needs to focus on the local organisational environment.…”

“…It should also be noted that just altering the physical structure of an organisation does not equate to altering the rules, culture, or policies of that organisation. 27 …”

“…2 0 2 0 . 0 7 4 9 organisation does not equate to altering the rules, culture or policies of that organisation [27].…”

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Healing architecture and psychiatric practice: (re)ordering work and space in an in‐patient ward in Denmark

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