Table 4 Instances of brittleness in the surgical unit relocation
From: Relocation of hospital facilities: guidelines for resilient performance
Code | Instances of brittleness (B) | Principles |
|---|---|---|
B1 | It was not possible to change some key architectural decisions that hindered service flows and had been made several years earlier | 1 |
B2 | Low engagement of the sterile unit´s staff in the relocation, reflected in their low attendance to relocation training and low proactiveness to share improvement opportunities | 6, 7 |
B3 | Insufficient staffing of the new facilities | 4 |
B4 | The suspension of elective surgeries created a backlog for the future | 4, 5 |
B5 | No monitoring of clinical and process indicators (e.g., patient length of stay) before and after changing to the new facilities | 2 |
B6 | Low detailing and attention to flows of materials in the new facilities, with problems surfacing after the relocation had occurred | 1, 3 |
B7 | Revision of the surgical trays´ composition did not involve representatives from the surgical unit | 6 |
B8 | Not all employees followed the planned routes for the transport of patients, materials, furniture, and equipment to the new facility. Staff often preferred their traditional routing despite of the risk of disturbing other units | 3, 4 |