Tocchetto Natália Maciel, Saurin Tarcisio Abreu, Dos Santos Helena Barreto
Industrial Engineering Post-Graduate Program, Universidade Federal Do Rio Grande Do Sul, Av. Osvaldo Aranha, 99, Porto Alegre, CEP, 90035-190, Brazil.
Hospital de Clinicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, Porto Alegre, CEP, 90035-903, Brazil.
BMC Health Serv Res. 2025 Mar 20;25(1):414. doi: 10.1186/s12913-025-12339-y.
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.
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.
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.
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.
医院科室的搬迁是一个复杂的过程，既需要进行正式规划，也需要现场进行非正式的自我组织，以便在时间压力下应对突发事件。然而，支持这一过程的指南零散且隐匿于文献之中。本文通过运用组织韧性的复杂性视角，呈现医院设施搬迁指南，以填补这一空白。
这些指南基于对一个外科科室搬迁的研究，新设施面积约为原设施的四倍。数据收集包括对搬迁项目中担任领导职务的专业人员进行访谈、对搬迁项目委员会会议进行非参与式观察，以及对新旧设施进行实地参观。首先进行演绎主题分析，以识别韧性和脆弱性的实例。然后，通过归纳推理得出搬迁指南。
提出了17条医院设施韧性搬迁指南。所有指南均适用于变革前阶段，凸显了其前瞻性。它们还将韧性绩效设计的七条原则付诸实践，主要涉及提供冗余资源和创造学习机会。
这些指南包含新的规范性知识，与韧性视角明确相关。它们对领导搬迁过程的医院管理者尤为重要。
