Impact of microgeography on communication dynamics in a healthcare environment.

Abstract

Background: For growing healthcare organisations, anchored resources-assets that are not easily movable-may complicate expansion and distort workflow patterns. We examine work patterns at a radiation oncology department of a major Canadian hospital. As this department doubled its size, healthcare providers remained bound to treatment planning rooms and radiation machines at the original site. This study examines workplace communication and interactions before and after the expansion.

Methods: We conducted regression analyses using a unique dataset merging email communications, badge swipes, office locations and organisation charts for individuals that routinely use the treatment planning room (n=232). We use a difference-in-differences framework to compare individuals' behaviours before and after the expansion. Our dependent variables were how often individuals accessed the treatment planning room and email volumes between two individuals.

Findings: We find an overall decrease in the use of the treatment planning room, though the effect was larger for those that moved away from it. Further, we find an increase in email communication for dyads of individuals separated in the move, but only if they belonged to different departments.

Practical implications: Our research points to complex interdependencies among healthcare providers, shedding light on how hospital expansion may have unintended consequences. Healthcare leaders should acknowledge that interaction patterns will be affected when healthcare providers are separated from each other or from anchored resources. Shifting to remote interactions may be adequate in some instances; in others, it may negatively affect work outcomes as well as the engagement and satisfaction of providers and patients.