A review of computerized hospital layout modelling techniques and their ethical implications

Purpose: This paper reviews an area of interdisciplinary collaboration in the design of healthcare facilities that attempts to optimize hospital space-planning using automated statistical techniques from the discipline of Operations Research (OR). This review articulates Facility Layout Problems (FLPs) as a general class of OR problems. Furthermore, the review highlights limitations of these techniques, which necessitate an ethical and participatory engagement with computerized processes of healthcare architecture. Design/methodology/approach: An in-depth critical review was carried out, which revealed a number of common themes, collectively theorized as metamodeling processes, or models of models, through which various FLP modelling techniques can be challenged and debated in terms of their architectural viability, and ethical ramifications. Findings: This review provides a methodological basis for the further evaluation of computational models. It was found that most of the reviewed studies are functionally focused on flow efficiency and, in general, do not consider broader contextual, relational, social, or salutogenic design values. Originality/value: This review is the first on the subject written from an architectural perspective. It can be used by a broad range of readers as its critical review of past and present hospital layout modelling techniques discusses their capabilities and limitations. As such, it also enables them to consider ethical values while critiquing the epistemology of computational processes hidden beneath algorithmic outputs.