Healthcare built environment impacts, construction projects and organisational change

Understanding the links between a building and outcome measures relevant to the purpose of the building should be an important issue for those commissioning, designing, delivering and operating facilities. In project teams that concern is often tacit and understanding is limited. The links are complex, under-researched and hard to demonstrate. Progress has been made in the context of healthcare infrastructure - an influential body of literature has demonstrated the role of the built environment in achieving good healthcare outcomes. However, applying such knowledge often requires new building or adaptation of existing buildings. These are process of change undertaken by healthcare organisations and others. Building change and organisational change happen together and influence each other. And both can be expected to subsequently influence organisational and healthcare outcomes. These relationships are explored using the findings from a mixed-method, longitudinal case study of the design, construction and operation of a new day surgery ward. The analysis draws on built healing environment, health management, organisational research and value management to propose ways in which the impact of the built environment can be mediated through construction/organisational change projects and potential implications for construction practice.