Modelagem integrada de requisitos funcionais e estruturais em Sistemas Sócio-Técnicos Complexos: aplicação em uma Unidade de Terapia Intensiva

Healthcare systems are considered as Complex Socio-Technical Systems (CSS), in which clinical results can be classified as emergent phenomena of the Joint Cognitive System (JCS) formed by the interactions between social and technical agents. The built environment is a fundamental part of the technical dimension, as it encompasses the physical space, technologies and furniture that support the functions performed by the agents. However, interactions between the built environment and the activities performed in healthcare systems are generally modeled on work as imagined (WAI) through regulations, without considering work-as-done (WAD). In addition, the design of the built environment in healthcare services needs to meet the requirements of several users, which usually involves the management of trade-offs. The objective of this research work is to propose a method for the integrated management of functional and structural requirements in healthcare systems, considering the influence of meeting those requirements in JCS. Functional requirements are defined as the user needs related to the functions performed by them. Structural requirements are defined as the characteristics that a physical space must have for performing those functions. The interactions between requirements and between these and the functions were modeled by using the Functional Resonance Analysis Method (FRAM), considering WAD. The development of the FRAM model considered the functions from admission to discharge of patients in an Intensive Care Unit (ICU) from a hospital in Porto Alegre, Brasil. The aforementioned requirements were considered as preconditions for the functions in the FRAM model. Situations in which requirements are not met result in variability of the output of functions, triggering the need for system’s resilience. Building Information Modeling (BIM) was used to support the management of requirements for storing and connecting these with the three-dimensional model of spaces. The results of this study supported decision-making in the design of a new ICU, which is to be installed in the future.