Comparative case study on the implementation of the multi- space concept in a healthcare facility: study protocol.

BACKGROUND: Modern healthcare organizations face increasing psychosocial and organizational demands driven by digitalization, flexible work models, and rising workload. In large university hospitals such as the Medical Center - University of Freiburg, administrative and clinical staff work in highly complex, interdisciplinary environments where well-being, performance, and patient care are closely linked. The physical office environment plays a crucial role in shaping employees' well-being, motivation, and health. To meet the high cooperative demands in medical centers, multi-space offices are introduced to support collaboration, flexibility, and efficiency. However, their effects in clinical settings remain unclear. The scarce existing research shows inconsistent findings regarding productivity, satisfaction, privacy, and health outcomes. Thus, there is a need for systematic, empirical studies that investigate how office design influences work processes, well-being, and long-term psychosomatic health outcomes among hospital employees.

METHODS: The presented study applies a mixed-methods comparative case design. Two office types are compared: Multi-space offices with activity-based workspaces and traditional closed offices with assigned individual or shared rooms. Participants are employees from different professional groups (e.g., physicians, administrative staff) working in these offices (N ≥ 40). Data collection combines (1) an electronic questionnaire, (2) an e-diary with repeated daily assessments, and (3) semi-structured interviews with purposive sampling. Validated instruments assess fatigue, psychosomatic complaints, job satisfaction, commitment, work climate, and social stressors. Quantitative data are analyzed using state-of-the-art exploratory and multivariate methods. Qualitative interview data are analyzed using qualitative content analysis according to Mayring, supported by MAXQDA. Methodological triangulation integrates quantitative and qualitative findings to explore relationships between office design, work processes, and employee well-being.

CONCLUSION: This study addresses a key gap in healthcare research by systematically examining how multi-space office concepts influence work processes, psychosocial risk and protective factors, as well as employees' well-being in clinical settings. By linking spatial design with organizational and individual factors, it contributes evidence needed to improve workplace conditions in highly demanding healthcare environments. The use of multiple data sources and analytical strategies allows for the examination of complex relationships between variables. These insights can guide evidence-based decisions on office design and preventive measures to enhance sustainable work environments in healthcare.

CLINICAL TRIAL REGISTRATION: https://drks.de/search/de/trial/DRKS00037660/details, identifier DRKS00037660.