Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Macquarie University Hospital, Macquarie Park, Australia.
BMC Health Serv Res. 2020 Feb 3;20(1):78. doi: 10.1186/s12913-020-4938-8.
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.
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.
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.
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 fit-for-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.
良好的工作空间设计是提高工作质量、保障工人安全与健康的关键，但我们缺乏满足医疗保健劳动力需求的最佳医院设计的重要知识。本研究采用新颖的移动方法，研究了澳大利亚一所大学医院中工作完成情况的概念以及工作空间使用对医疗保健专业人员实践、生产力、健康和安全的影响。
该试点研究于 2018 年至 2019 年在一个胃肠外科病房进行。数据收集包括 50 小时的观察和非正式对话，随后对五个建筑平面图和 45 张照片进行解释。对现场记录进行了主题分析，并通过使用预定义分类法对视觉数据进行分析来加以佐证。
确定了六个主题，揭示了支持和阻碍工作完成情况的空间。合适的空间促进了工作人员、患者和家属之间的有效沟通，提供了相对的舒适和隐私，并支持了有效的团队合作。不合适的空间的特点是工作实践中断、团队成员之间不和谐以及工作人员身体不适。工作人员采用了权宜之计来管理不合适的工作空间。
研究结果表明，协商不合适的工作空间会对工作人员的工作和健康产生负面影响。虽然权宜之计和适应措施使工作人员能够维持日常工作实践，但也可能导致意想不到的后果。结果表明，需要确定和支持合适的工作空间，并尽量减少不合适工作空间的不利因素。本研究表明，移动方法适合在快速变化的适应性医院环境中研究工作完成情况。
