Browsing by Author "Kruger, Inge Christine"
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- ItemA layout design decision-support framework and concept demonstrator for rural hospitals using mixed methods(2017-03) Kruger, Inge Christine; Bam, Louzanne; Stellenbosch University. Faculty of Engineering. Dept. of Industrial EngineeringENGLISH ABSTRACT: Layout design is an ever-present problem that has a significant effect on the operations of an organisation, especially in the context of healthcare which deals with the lives of patients. It is a complex problem that has long-term consequences and oftentimes competing objectives. Literature has focused almost exclusively on using either quantitative or qualitative layout design methods for designing layouts. This study develops a generic framework using both quantitative and qualitative layout design methods that will guide the user to design a near optimal layout for a rural hospital while taking into consideration the relevant laws and standards as well as the health outcomes of the surrounding rural community. Rural and urban lifestyles, health, and illnesses differ in many ways. General hospital design methods are therefore not necessarily appropriate for hospitals in these areas. There is thus a need for a framework to be tailored for a rural community. Following a mixed methods methodology, a systematic literature review of quantitative and qualitative layout design methods along with hospital design considerations were conducted in order to determine the most adequate methods for designing a hospital layout at the block diagram level of detail. Furthermore, the commonalities and differences between rural and urban hospitals were investigated including laws and standards relevant to hospital layouts. The qualitative layout design methods involved different layout procedures and Muther’s Systematic Layout Planning Procedure was found to be most adequate. Furthermore, hospital design considerations such as patient-centeredness, efficiency, flexibility and expandability, sustainability, and therapeutic environment were identified and linked with the quantitative layout methods. It was also found that rural communities have different needs to urban ones with regard to access to medical care, prominent illnesses, and attitudes towards health. The healthcare personnel shortages are particularly problematic for rural communities. The quantitative layout design methods involved layout models, solution methods (exact methods, metaheuristics, and hybrid metaheuristics), and layout software. Using criteria of objectives, assumptions, inputs, outputs, and hospital design considerations, the Quadratic Set Covering Problem was determined to be the most appropriate model for designing a rural hospital block diagram layout. It was deemed possible to integrate the quantitative and qualitative methods by embedding the qualitative data into this quantitative model. The rural hospital design framework was developed using Excel VBA and RStudio. The framework was validated via two routes. Firstly, semi-structured interviews were conducted with experts in the field, i.e. expert analyses. Secondly a case study of the Semonkong Hospital Project was employed wherein the framework was applied successfully. The framework was deemed valid according to both the expert analyses and the case study.