Modeling the interdependencies of critical factors in hospital facility management: a system dynamics framework

Hospitals are mission-critical facilities where operational integrity is crucial for ensuring patient safety and delivering adequate healthcare. Reactive, fragmented approaches often undermine effective hospital facility management (FM). This study addresses this gap by developing and validating a system dynamics (SD) model to analyze the causal relationships and feedback loops among key performance factors. A multi-phase methodology was employed, integrating expert surveys using the Relative Importance Index (RII), the Analytic Hierarchy Process (AHP), and the DEMATEL technique to structure and quantify the model. The developed SD model was validated through sensitivity analysis. Study findings revealed that cumulative impacts hinder the system, resulting in a significant 26.38% budget overrun over twelve months. The model identifies ’Design Errors’ and ’System and Selection of Materials’ as the most destructive factors, causing severe performance degradation across the system. The implications are significant, providing a strategic blueprint for hospital managers to shift towards proactive interventions by focusing on these high-leverage points.