The Expansive Hospital is a board game that helps to understand the challenges of collaboration among construction and healthcare experts. The elements of the game are based on a set of interviews conducted with construction and healthcare professionals in the Region of Twente, Netherlands.

1. The Expansive Hospital Game
Frederick van Amstel, PhD Researcher
Construction Management & Engineering Dept.
BIM Werkplaats
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2. This is not how healthcare construction projects do organize
Top-down hierarchy
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3. Healthcare construction projects emerge
amidst the boundaries of many organizations
Sub-contractor
Contractor
Structural
engineering
counseling
Building
Engineering
company
Construction
management
Engineering
company
Architecture studio
Architectural
design
Structural
engineering
Model
management
Engineering
company
Electrical
engineering
Engineering
company
Hydraulic
engineering
Information
technology
company
Elderly care
Facility
management
Elderly housing
Elderly housing project studied in Enschede
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4. Collaboration across organizations is not easy
Architecture
studio
Engineering
company
Structural
engineering
Contractor
Northwestern
Hospital
Architectural
design
Dialysis
Concurrent
engineering
Facility
management
Engineering
company
Electrical
engineering
Engineering
company
Advisory
Hydraulic
engineering
Client’s
consultant
Pathology
Microbiology
Medical device
development
Technology
manufacturer
Hospital lab project studied in Hengelo
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5. How to learn collaboration in
multi-organization projects?
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6. Welcome to the Expansive Hospital Board Game!
• Fun and safe way to try
• Simulate long processes
(25 years in 2 hours)
• Highlight the
consequences of
player’s actions
Second workshop for a new Medical Imaging Center.
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7. Game plot: constant hospital expansion
Ziekenhuis Ziekenzorg Enschede, 1955
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8. Game plot: constant hospital expansion
Medisch Spectrum Twente, 2013
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9. Game components
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10. Game roles
The Architect
The Director
The Engineer
The Facility Manager
The Builder
The Nurse
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11. Succesfully treated patient
Money flow
Players must balance
between competing and
collaborating for money.
Insurance bank
Hospital Account
Player’s accounts
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12. Building rules
Building block
Requirements
Service layer
Clashes
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13. Operating rules
Patient card
Patient pawn
Income
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14. Information strategies
Players must keep information,
since it gets easily lost.
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15. Contract types
Moderating the construction guys.
Traditional
Fast-track
Integrated
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16. Playtesting results
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17. Organization performance
Builder
Nurse
Director
Builder
Engineer
Director
Engineer
Facility manager
Architect
Architect
Facility manager
$ 1784
Nurse
$ 9905
Builder
Director
Nurse
Engineer
Architect Facility manager
$ 1860
Experiment with Civil Engineering Students, 2013
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18. Learning outcomes
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Contracts have a great impact on collaboration
Collaboration is a free choice
Tendency to egoisthic behavior when the stakes are high
Players begin to collaborate when they realize the big picture
Information models help seeing the big picture
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19. The fun test
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20. My Research Interests
 Participatory Design
 Activity Theory
 Cultural Studies
 Frederick van Amstel f.vanamstel@utwente.nl
 Twitter @fredvanamstel
 http://fredvanamstel.com
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