Relocation of hospital facilities: guidelines for resilient performance.

Abstract

Background: The relocation of a hospital unit is a complex process that demands both formal planning and informal self-organization on the spot to cope with unexpected events under time pressure. However, guidelines to support this process are fragmented and concealed in the literature. This article addresses this gap by presenting guidelines for the relocation of hospital facilities, using the complexity-informed lens of organizational resilience.

Methods: The guidelines were based on the study of relocating a surgical unit, in which the new facilities were approximately 400% larger. Data collection involved interviews with professionals holding leadership positions in the relocation project, non-participant observations of the meetings of the relocation project committee, and guided tours at the old and new facilities. An initial deductive thematic analysis was conducted to identify instances of resilience and brittleness. Then, inductive reasoning gave rise to the relocation guidelines.

Results: Seventeen guidelines for resilient relocation of hospital facilities are proposed. All guidelines are applicable to the period before the change, highlighting their proactive nature. They also operationalize seven principles of designing for resilient performance, mainly those related to the provision of slack resources and creation of opportunities for learning.

Conclusions: The guidelines consist of new prescriptive knowledge, explicitly connected to the resilience perspective. They are particularly relevant to hospital managers that lead the relocation process.