The Role of Facilities Management in the Control of Healthcare Associated Infections (HAI)

A growing body of evidence now exist, which suggests that Healthcare Associated Infections (HAI) are a major cause of morbidity and mortality. There is, however, a paucity of empirical knowledge and evidence-base of the role of Facilities Management (FM) in the control of HAI. Therefore, the main aim of this research was to investigate the role of FM in the control of HAI. The focus of the study is on domestic services. The research methodology of the study employed both qualitative and quantitative approaches. Altogether, 81 interviews were carried out involving experts in the areas of FM and HAI in the National Health Service (NHS). The qualitative data collected was analysed using content analysis. The qualitative data sets were then augmented by 412 completed questionnaires. The quantitative data sets obtained were subjected to rigorous statistical analyses. The study concluded that FM has a major role to play in the control of HAI, mainly in terms of cleaning, catering, waste management and laundry and linen services. However, FM is yet to feature prominently in the ‘control of HAI agenda’ in the NHS. There is evidence and lack of clarity on the roles and clear lines of communication between the major players in the control of HAI in FM services. There is a relatively low level of integration between the clinical teams and FM teams in the control of HAI. The roles and benefits of knowledge management and performance management are yet to be fully exploited in FM services in the control of HAI. A Performance Management Framework (PMF) for the control of HAI in FM services (particularly in domestic services) have been developed, tested and validated. The study recommends, inter alia, that FM should be made integral to the core services in hospitals for effective control of HAI. A national training and education framework for FM teams should be developed in order to enable them to carry out their work to the highest standards. There is also a need to adhere to a Performance Management Framework (PMF), which allows FM services to monitor and measure the performances in the control of HAI. The research methodology employed in this study could be replicated in different countries, including developing countries. There is also scope to research the key motivational constructs associated with effective knowledge sharing between the domestics and ICT teams in the control of HAI

Renegotiation of public private partnership road contracts: Issues and outcomes

The renegotiation of road projects has been an important issue that has generated concerns in PPP procurement over the last decade. This has had serious policy implications for public procurement policy across countries because of its implications for the achievement of the objectives defined at the inception of PPP road contracts. This paper assesses the renegotiation of Public-Private Partnership (PPP) infrastructure projects in order to identify the issues involved in renegotiation and its outcomes. Data were collected through a literature review of selected studies on PPP infrastructure projects on a sectoral basis with particular emphasis on Latin America, Portugal and Spain. It was revealed that a high proportion of PPP contracts in the transport sector are renegotiated: Indeed, in the transport sector, more PPP road projects are renegotiated than other forms of transport projects. The main factors surrounding the renegotiation of road contracts are: lack of an adequate contract design, frequent opportunistic behaviour on the part of both public and private partners during the implementation of PPP road projects, changes in the conditions affecting revenue and costs beyond the reasonable assumptions accounted for in the original contract, corruption, and political and economic instability, all of which in most instances reduce the chance of the public partner achieving its objective of value for money (VfM). The paper concludes with a discussion of the need to develop a framework for integrating considerations of value for money into the renegotiation process of PPP road contracts

Collaborative Engagement Approaches For Delivering Sustainable Infrastructure Projects In The AEC Sector: A Review

The public sector has traditionally financed and operated infrastructure projects using resources from taxes and various levies (e.g. fuel taxes, road user charges). However, the rapid increase in human population growth coupled with extended globalisation complexities and associated social/political/economic challenges have placed new demands on the purveyors and operators of infrastructure projects. The importance of delivering quality infrastructure has been underlined by the United Nations declaration of the Millennium Development Goals; as has the provision of ‘adequate’ basic structures and facilities necessary for the well-being of urban populations in developing countries. Thus, in an effort to finance developing countries’ infrastructure needs, most countries have adopted some form of public-private collaboration strategy. This paper critically reviews these collaborative engagement approaches, identifies and highlights 10 critical themes that need to be appropriately captured and aligned to existing business models in order to successfully deliver sustainable infrastructure projects. Research findings show that infrastructure services can be delivered in many ways, and through various routes. For example, a purely public approach can cause problems such as slow and ineffective decision-making, inefficient organisational and institutional augmentation, and lack of competition and inefficiency (collectively known as government failure). On the other hand, adopting a purely private approach can cause problems such as inequalities in the distribution of infrastructure services (known as market failure). Thus, to overcome both government and market failures, a collaborative approach is advocated which incorporates the strengths of both of these polarised positions

Application of the Delphi technique in healthcare maintenance

Purpose The purpose of this paper is to examine the research design, issues and considerations in the application of the Delphi technique to identify, refine and rate the critical success factors and performance measures in maintenance-associated infections. Design/methodology/approach In-depth literature review through the application of open and axial coding were applied to formulate the interview and research questions. These were used to conduct an exploratory case study of two healthcare maintenance managers, randomly selected from two National Health Service Foundation Trusts in England. The results of exploratory case study provided the rationale for the application of the Delphi technique in this research. The different processes in the application of the Delphi technique in healthcare research are examined thoroughly. Findings This research demonstrates the need to apply and integrate different research methods to enhance the validity of the Delphi technique. The rationale for the application of the Delphi technique in this research is because some healthcare maintenance managers lack knowledge about basic infection control (IC) principles to make hospitals safe for patient care. The result of first round of the Delphi exercise is a useful contribution in its own rights. It identified a number of salient issues and differences in the opinions of the Delphi participants, noticeably between healthcare maintenance managers and members of the infection control team. It also resulted in useful suggestions and comments to improve the quality and presentation of the second- and third-round Delphi instruments. Practical implications This research provides a research methodology that can be adopted by researchers investigating new and emerging issues in the healthcare sector. As this research demonstrates, the Delphi technique is relevant in soliciting expert knowledge and opinion to identify performance measures to control maintenance-associated infections in hospitals. The methodology provided here could be applied by other researchers elsewhere to probe, investigate and generate rich information about new and emerging healthcare research topics. Originality/value The authors demonstrate how different research methods can be integrated to enhance the validity of the Delphi technique. For example, the results of an exploratory case study provided the rationale for the application of the Delphi technique investigating the key performance measures in maintenance-associated infections. The different processes involved in the application of the Delphi technique are also carefully explored and discussed in depth

Facilities Management Approach For Achieving Sustainability in Commercial Buildings in Nigeria

The purpose of this research is to determine the extent of sustainable facilities management (FM) practice in the management of commercial buildings in Nigeria and identify barriers to it, in order to develop a solution model that will proffer ways of overcoming these barriers and ultimately determine sustainable methods by which facility managers in Nigeria can effectively manage commercial properties. This study is a work in progress and it presents a theoretical review on the extent of sustainable FM in developed countries, especially the United Kingdom (UK), and comparing it with the development of sustainable FM in developing countries and Nigeria in particular. Nigeria has a history of unsustainable building practices, mismanagement of buildings and poor maintenance culture with no consideration for its impact on the environment. Findings reveal the three main barriers to sustainable FM practice in corporate organisations in Nigeria, as lack of training and tools, lack of relevant laws and regulation, and lack of knowledge and awareness. Nevertheless, there remains the urgent need to investigate barriers of sustainable FM practice in the management of commercial buildings in Nigeria

Implications of the use of different payment models: The context of PPP Road Projects in the UK

Purpose – The purpose of this paper is to illustrate the payment models and financing structures used for road Infrastructure projects under public private partnerships (PPPs) in the UK. Comparison of funding and financial structures in the selected case studies exposes the risks and values of the models of payment utilised. This research also aims to identify relationships with payment certainty and financing debt restructuring. Design/methodology/approach – The paper compares several case studies representing the evolution of private finance initiative road infrastructure in the UK context. Templates were completed using semi- structured interviews during data collection; and a qualitative content analysis approach was employed for case study analysis. Findings – Lessons learned from using different payment methods show the benefit and limitations of adopting different forms of PPP in road development. Refinancing of projects presents substantial risks to the viability of a project, and benefits gained by the private sector. Further, refinancing brings no significant benefits to the public sector as well. Practical implications – Performance of selected case studies highlights emerging issues that need to be considered when adopting a PPP procurement route in roads projects. Financial markets have supported these projects under different risk profiles and payment models. They also have the potential to play a greater part in capitalising long-term investment in road projects and increase private sector participation in infrastructure development, generating more competition and innovation. Originality/value – This paper provides case study comparison and practical implications of recent PPP developments in road provision in the UK and the evolution of public policy in the subject

A critique of post‑occupancy evaluation in the UK

Architects are trained to design buildings and the subjective perception of building users may not be easy to translate into a designer’s language. In the UK, the design profession has not fully appreciated the significance of returning to the erected structure to appraise how well it was, and remained, fit for purpose. This paper presents a critique of the state of the art of post-occupancy evaluation (POE) in the UK building procurement process. It is established that despite the known benefits of POE, the culture of evaluating the perfor-mance of a building, after it has been built and occupied by users for a while, has not been successfully embedded in the design and procurement process. The authors advocate for a ‘forward feeding’ POE, which embraces early collaboration between end users and designers in the building procurement process, in order to co-create a liveable built environment

Disaster Risk Reduction Compliance Framework for Public Private Partnership (PPP) Port Projects

Purpose: The paper aims to identify success factors and resilience measures that contribute to Disaster Risk Reduction (DRR) in Public Private Partnerships (PPP) port projects in Asia.vSignificant losses have been associated with large-scale natural hazards, such asvearthquakes, tsunami, cyclones, and other extreme weather events and thus, ports needvto evaluate their resilience level and adopt relevant DRR strategies to improve it. Methodology: A Step-by-step methodology, based on literature review, port cases analysis,vquestionnaire survey and expert opinions, was followed.vFindings: The paper provides a research instrument extracted from a large list of measures and factors after a combined screening process was carried out. This instrument offer policy makers and researchers a tool applicable to PPP port projects in Asian countries to evaluate the level of resilience. Limitations: Relevant resilience measures for some specific projects may have not been considered in order to obtain a standardised instrument. Originality /value: This paper fulfils an identified need to evaluate resilient port infrastructures and the output is a resilience framework to be used in PPP port projects in Asia