CBPM Conference 2026 · Vol. 2026, Issue 1

Improving Hospital Facilities Management through a Human-Centred Complexity Management Approach in Tehran

Niyoosha Beirami

Keywords: Complexity Management, Facilities Management, Healthcare Infrastructure, Hospital Performance, Socio-Technical Systems

Abstract

Hospital facilities management (FM) operates within a complex socio-technical environment where infrastructure, organisational routines, professional roles and human decision-making continuously interact. In high-density metropolitan contexts such as Tehran, this complexity is intensified by increasing service demand, ageing infrastructure, financial constraints and fragmented governance. This exploratory mixed-methods study investigates human-centred drivers of operational complexity in hospital FM and proposes a Human-Centred Complexity Management Framework. Quantitative data were collected through structured questionnaires completed by 40 hospital FM professionals selected through purposive sampling. The instrument included 18 fivepoint Likert-scale items measuring communication effectiveness, interdepartmental coordination, leadership engagement, role clarity and cultural adaptability. Data were analysed descriptively in SPSS, and reliability testing produced a Cronbach's alpha of 0.82. Qualitative insights from semi-structured interviews and on-site observations were analysed thematically to contextualise the questionnaire findings. Results indicate that communication gaps recorded the highest perceived influence, followed by coordination failures, role ambiguity and cultural resistance. The proposed framework integrates structured communication, cross-functional coordination, role clarification, adaptive leadership and behavioural governance alignment. The study contributes to complexity-informed FM by showing that hospital resilience depends not only on technical maintenance capacity, but also on the alignment of human, organisational and governance mechanisms.