A Constructivist BPMN Framework for Strategic Management of Hospital Medical Assets: Toward Patient-Centered and Risk-Informed Governance

This paper proposes a constructivist Business Process Model and Notation (BPMN) framework tailored to the strategic management of hospital medical assets. Hospitals increasingly depend on complex devices and integrated infrastructure whose availability and safe functioning are fundamental for effective clinical care. Traditional asset management approaches, often adapted from industry, emphasize technical maintenance and cost-containment but may overlook the socio-organizational and clinical dimensions that drive outcomes in healthcare. By integrating BPMN with constructivist participatory methods, the proposed framework seeks to align procurement, operation, maintenance, and renewal processes with patient safety, clinical needs, and organizational governance. Drawing on a structured literature review of BPMN applications, constructivist organizational methods, and asset life-cycle management, the article synthesizes empirical evidence and methodological guidance and presents a stepwise approach for model development, validation, and implementation. Key components include stakeholder engagement and co-design workshops, layered BPMN modeling (strategic, operational, and exception layers), embedding of safety-oriented gateways and simulation-ready constructs, pilot validation with integrated KPIs, and governance feedback loops for continuous improvement. We also discuss challenges in deployment, especially in resource-constrained settings, and recommend a research agenda to evaluate clinical and economic impacts. The framework aims to offer healthcare managers a pragmatic, context-sensitive toolkit for operationalizing ISO 55000 principles in hospital environments.