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Towards Process-Oriented Hospital Structures; Drivers behind the Development of Hospital Designs

Hospitals have been encouraged to develop more process-oriented designs, structured around patient needs, to better deal with patients suffering from multi-morbidity. However, most hospitals still have traditional designs built around medical specialties. We aimed to understand how hospital designs...

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Detalles Bibliográficos
Autores principales: van Wijngaarden, Jeroen D. H., Braam, Anoek, Buljac-Samardžić, Martina, Hilders, Carina G. J. M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9916222/
https://www.ncbi.nlm.nih.gov/pubmed/36767360
http://dx.doi.org/10.3390/ijerph20031993
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author van Wijngaarden, Jeroen D. H.
Braam, Anoek
Buljac-Samardžić, Martina
Hilders, Carina G. J. M.
author_facet van Wijngaarden, Jeroen D. H.
Braam, Anoek
Buljac-Samardžić, Martina
Hilders, Carina G. J. M.
author_sort van Wijngaarden, Jeroen D. H.
collection PubMed
description Hospitals have been encouraged to develop more process-oriented designs, structured around patient needs, to better deal with patients suffering from multi-morbidity. However, most hospitals still have traditional designs built around medical specialties. We aimed to understand how hospital designs are currently developing and what the important drivers are. We built a typology to categorize all Dutch general hospitals (61), and we interviewed hospital managers and staff. The inventory showed three types of hospital building blocks: units built around specific medical specialties, clusters housing different medical specialty units, and centers; multi-specialty entities provide the most suitable structure for a process-oriented approach. Only some Dutch hospitals (5) are mainly designed around centers. However, most hospitals are slowly developing towards hybrid designs. Competitive drivers are not important for stimulating these redesigns. Institutional pressures from within the health care sector and institutional ‘mimicking’ are the main drivers, but the specific path they take is dependent on their ‘heritage’. We found that hospital structures are more the result of incremental, path-dependent choices than ‘grand-designs’. Although the majority of the Dutch general hospitals still have a general design built around medical specialties, most hospitals are moving towards a more process-oriented design.
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spelling pubmed-99162222023-02-11 Towards Process-Oriented Hospital Structures; Drivers behind the Development of Hospital Designs van Wijngaarden, Jeroen D. H. Braam, Anoek Buljac-Samardžić, Martina Hilders, Carina G. J. M. Int J Environ Res Public Health Article Hospitals have been encouraged to develop more process-oriented designs, structured around patient needs, to better deal with patients suffering from multi-morbidity. However, most hospitals still have traditional designs built around medical specialties. We aimed to understand how hospital designs are currently developing and what the important drivers are. We built a typology to categorize all Dutch general hospitals (61), and we interviewed hospital managers and staff. The inventory showed three types of hospital building blocks: units built around specific medical specialties, clusters housing different medical specialty units, and centers; multi-specialty entities provide the most suitable structure for a process-oriented approach. Only some Dutch hospitals (5) are mainly designed around centers. However, most hospitals are slowly developing towards hybrid designs. Competitive drivers are not important for stimulating these redesigns. Institutional pressures from within the health care sector and institutional ‘mimicking’ are the main drivers, but the specific path they take is dependent on their ‘heritage’. We found that hospital structures are more the result of incremental, path-dependent choices than ‘grand-designs’. Although the majority of the Dutch general hospitals still have a general design built around medical specialties, most hospitals are moving towards a more process-oriented design. MDPI 2023-01-21 /pmc/articles/PMC9916222/ /pubmed/36767360 http://dx.doi.org/10.3390/ijerph20031993 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
van Wijngaarden, Jeroen D. H.
Braam, Anoek
Buljac-Samardžić, Martina
Hilders, Carina G. J. M.
Towards Process-Oriented Hospital Structures; Drivers behind the Development of Hospital Designs
title Towards Process-Oriented Hospital Structures; Drivers behind the Development of Hospital Designs
title_full Towards Process-Oriented Hospital Structures; Drivers behind the Development of Hospital Designs
title_fullStr Towards Process-Oriented Hospital Structures; Drivers behind the Development of Hospital Designs
title_full_unstemmed Towards Process-Oriented Hospital Structures; Drivers behind the Development of Hospital Designs
title_short Towards Process-Oriented Hospital Structures; Drivers behind the Development of Hospital Designs
title_sort towards process-oriented hospital structures; drivers behind the development of hospital designs
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9916222/
https://www.ncbi.nlm.nih.gov/pubmed/36767360
http://dx.doi.org/10.3390/ijerph20031993
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