Beyond the operating room: built environment design knowledge supportive of resilient surgical services

Natália Ransolin*, Tarcisio Abreu Saurin, Robyn Clay-Williams, Carlos Torres Formoso, Frances Rapport, John Cartmill

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: Surgical services are settings where resilient performance (RP) is necessary to cope with a wide range of variabilities. Although RP can benefit from a supportive built environment (BE), prior studies have focused on the operating room, giving scant attention to support areas. This study takes a broader perspective, aiming at developing BE design knowledge supportive of RP at the surgical service as a whole. Design/methodology/approach: Seven BE design prescriptions developed in a previous work in the context of internal logistics of hospitals, and thus addressing interactions between workspaces, were used as a point of departure. The prescriptions were used as a data analysis framework in a case study of the surgical service of a medium-sized private hospital. The scope of the study included surgical and support areas, in addition to workflows involving patients and family members, staff, equipment, sterile instruments and materials, supplies, and waste. Data collection included document analysis, observations, interviews, and meetings with hospital staff. Findings: Results identified 60 examples of using the prescriptions, 77% of which were related to areas other than the operating rooms. The developed design knowledge is framed as a set of prescriptions, examples, and their association to workflows and areas, indicating where it should be applied. Originality/value: The design knowledge is new in surgical services and offers guidance to both BE and logistics designers.

Original languageEnglish
Number of pages28
JournalEngineering, Construction and Architectural Management
Early online date12 Mar 2024
Publication statusE-pub ahead of print - 12 Mar 2024


  • Built environment
  • Design
  • Resilience
  • Surgical services


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