Developing a whole life cycle automated system for measuring the performance of mobile cabin hospital projects

Abstract

The world faces the threat of various major emergencies, such as public health crises, natural disasters, and military conflicts, which put countless lives at risk. In such urgent circumstances, traditional healthcare facilities often struggle to meet the rapidly increasing medical demands. Mobile cabin hospitals (MCHs) play a crucial role in reducing the pressure on traditional healthcare systems. These facilities are designed with modularity and mobility in mind, allowing them to be constructed swiftly to address urgent medical needs and relieve the burden on conventional healthcare facilities. This enables an efficient and effective response to major emergencies. However, the implementation of mobile cabin hospital projects (MCHPs) encounters many challenges, including stringent time constraints, limited resources, the need for extreme cleanliness, and sustainability issues post-emergency. These challenges significantly impact the performance of MCHPs, hindering their success. Focusing on the performance of MCHPs is essential because it involves the ability to efficiently establish functional healthcare facilities, operate them effectively during major emergencies, and deconstruct them sustainably afterward. While previous studies have generally addressed broader aspects of healthcare infrastructure or emergency response, they have not adequately addressed the specific challenges and performance metrics unique to MCHPs. Additionally, although there is considerable research in the field of performance measurement, most of it focuses on general construction or other infrastructure projects, with few studies evaluating the performance of MCHPs. Given their temporary nature, requirements of rapid deployment, unique operational challenges, and sustainability issues, MCHPs necessitate a distinct approach to performance evaluation. This study aims to develop a comprehensive, reliable, objective, accurate, and practical system to automatically measure the performance of MCHPs in China throughout their entire lifecycle. The specific objectives include: (1) investigating key performance indicators (KPIs) most appropriate for MCHPs throughout the entire lifecycle; (2) assessing the most suitable quantitative metrics (QMs) for those KPIs identified; (3) proposing a composite performance measurement model for MCHPs; (4) automating the performance measurement process using a computerized system; (5) validating the system developed. To achieve these objectives, this study identified the KPIs most appropriate for MCHPs, a series of QMs for each determined KPI, and their quantitative ranges (QRs) through literature review, Delphi surveys, and expert interviews. Then the weights of KPIs and QMs were computed using the Bayesian Best-Worst Method and the combination ordered weighted averaging (C-OWA) operator. Based on these weights of different dimensions and the QRs, a cloud matter element model (CMEM) was utilized to establish a performance measurement model for MCHPs. Subsequently, the study developed an automated system using MATLAB Graphical User Interface (GUI) technology on the basis of this model. Finally, the case study was used to validate the practicability of this system developed. In this study, a total of 52 potential KPIs throughout the entire lifecycle were identified through literature review. Through Delphi surveys conducted in China, ten KPIs were deemed most appropriate for MCHPs. These KPIs comprise (1) construction quality performance; (2) construction cost performance; (3) construction time performance; (4) functional suitability; (5) stakeholder/user satisfaction; (6) functional capacity and utilization; (7) demolition environmental performance; (8) demolition resource utilization efficiency;(9) demolition safety performance; and (10) demolition cost performance. Subsequently, twenty QMs most suitable for the ten weighted KPIs were determined using expert interviews and further Delphi surveys. The QRs for these metrics were clearly defined using a combination of Delphi research, empirical research conducted in China, and non-linear regression analysis. By employing the CMEM, the performance grade for each dimension of MCHPs can be computed. Through programming the model, a computerized system was developed using the GUI technology to automate the process and visualize the results. This system has demonstrated robustness, practicality, and accuracy in a case study. This study provides a systematic and holistic framework for performance evaluation for MCHPs in China, significantly contributing to the field of performance measurement and MCH-related research. This framework can serve as a valuable reference for the performance assessment of different projects or similar project in various contexts. Also, it assists practitioners in measuring and monitoring the performance of MCHPs throughout their lifecycle and enables benchmarking within the MCH industry to facilitate continuous improvement.