Post-occupancy simulations and HFE framework to identify built environment hazards

The built environment (BE) lifecycle comprises the project design, construction, usage and demolition phases. The BE commissioning verifies the condition before the occupation, after which renovations and adaptations might occur. The conditions for the BE usage are of central concern for human factors and ergonomics (HFE) work. In healthcare, in-situ simulations of work have been adopted to proactively identify BE hazards and manage risks, mostly during BE design and commissioning phases. A previous work conducted by the authors (health system and HFE experts) analysed video-recorded in-situ simulations and debriefings of two emergency scenarios (i.e., ventricular fibrillation and acute myocardial infarction) in the resuscitation bay during the building commissioning of an Australian Emergency Department (ED). The HFE team proposed a data analysis methodology that combined the Hazard Assessment Remediation Tool (HART) and Functional Resonance Analysis Method (FRAM) to evaluate BE hazards influencing clinical performance and patient outcomes. Despite the utmost importance of identifying those BE hazards before use, post-occupancy in-situ simulations can also support BE evaluation and identification of new risks and mitigation strategies. Therefore, this study aimed to replicate the simulation and debriefing scripts within the same ED after 10 years of occupancy to identify current BE hazards and adaptations it has undergone during the COVID-19 pandemic. The study used the same HFE methodology, thus the FRAM models of each emergency scenario were displayed during debriefing sessions to present the functions performed by staff. The pre-occupancy simulations identified 45 BE hazards and 18 recommendations connected to the precondition aspects of FRAM functions as a strategy to mitigate output variabilities. The results were compared to the current ED environment in the post-occupancy simulation data. This work defends in-situ simulations and debriefing as valuable data to be analysed with HFE frameworks as a strategy to evaluate pre and post-occupancy BE conditions.