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

Area of Science:

• Healthcare Management
• Hospital Design
• Organizational Studies

Background:

• Hospitals traditionally designed around medical specialties struggle with multi-morbidity care.
• A shift towards patient-centered, process-oriented hospital designs is encouraged.
• Current hospital designs often do not align with patient needs for complex conditions.

Purpose of the Study:

• To investigate the current development of hospital designs in the Netherlands.
• To identify the key drivers influencing hospital redesigns.
• To understand the transition from traditional to process-oriented hospital structures.

Main Methods:

• Development of a typology to classify Dutch general hospitals (n=61).
• Interviews with hospital managers and staff to gather insights.
• Analysis of hospital building blocks: specialty units, clusters, and centers.

Main Results:

• Three hospital building block types identified: specialty units, clusters, and centers.
• Centers (multi-specialty entities) are most suitable for process-oriented approaches.
• Only 5 Dutch hospitals are primarily center-based; most are developing hybrid designs.
• Redesigns are driven by institutional pressures and 'mimicking,' not competitive factors.
• Hospital structural changes are incremental and path-dependent, influenced by organizational heritage.

Conclusions:

• Dutch hospitals are gradually moving towards more process-oriented designs.
• The transition is characterized by incremental, path-dependent choices rather than radical redesigns.
• Institutional factors and organizational history significantly shape hospital design evolution.