Triple bottom line space: productivity paradoxes in FM

Purpose / Theory: To argue that the "productivity nut‟ means cracking FM thinking rather than external measurements. FM is not sexed-up building services engineering – it should return to its roots and consider how it impacts on particular businesses. "Nut‟ has an old European meaning of "profit‟ and FM's challenge is to recapture that sense. The FM "nut‟ is the advantage, or profit, a facility generates: the High German "nutzen‟. "Nut‟ is also colloquial English for "head‟. The process offered requires "doing in the current FM nut‟, i.e. finding new language and measures to express results. Design/methodology/approach: The argument is illustrated by reference to an ongoing action research project that challenges the conventional guidelines applied to the management of academic workspace in the UK. Findings: It illustrates the "cost of cheap‟; the downside of the search for building efficiency rather than business productivity. Originality/value: In a sense the case is not original in that it exemplifies what has been called for many times already. It does however demonstrate the startling combination of business benefits, cost saving and carbon reduction achievable when a workspace / place is approached from a business rather than a building perspective

Practical post-modernism: FM and socially constructed realities

The theme of the paper, with examples, is that strategic FM should engage not with elaborate structural functional models of building service supply but with the socially constructed realities of organisations and their results. Several, evidence based, examples of FM creating different conversations will be provided, viz: • The creation of excellent patient environments in English Hospitals is not a function of structure (whether or not there is an integrated FM Directorate), sourcing (in house or outsourced) or a particular business process. It is a function of leadership exercised through context specific conversations. • The creation of effective new ‘knowledge’ environments is not a function of a particular design or project structure. It is a reflection of FMs ability to create conversations for changes in business results. • The failure of FM to capture strategic attention deriving from an obsession with considerations of unit costs and building condition rather than overall costs and business outcomes. • The role of perceptions and assertions in creating or blocking effective business relationships between FM providers and clients In the process the paper will challenge academic FM, whether research or education, to stop being in thrall to ‘practice’ to a degree that is arguably greater than is found in other areas of business and management, let alone other established disciplines. FM has too many models, too little theory and too little empirical evidence of specific business contributions. It is too concerned with supplying facilities rather than considering the purpose for which a given facility is managed.</p

Space, conversations and place: lessons and questions from organisational development

Physical workspace is distinguished from workplace. The latter embodies culture and should become the greater concern of FM. In the field of individual and group development spaces can add an extra gear to stimulate cognitive processes. We provide various examples and suggest modern workplaces, with their emphasis on interaction need to also focus on environments and spaces for individual and collective reflection

Lean healthcare assets challenge FM performance measurement conventions

Purpose; To show how Lean Asset thinking can be applied to health care facilities using different measures to compare the estates contribution to the business of health care providers. The challenge to conventional wisdom matches that posed by Lean Production to Mass Manufacturing. Methodology; Data Envelope Analysis examines the income generated and patient occupied area as outputs from the Gross Area of a Trust’s estate. Findings; The approach yield strategic comparisons that conventional FM measures of cost per m2 hide. The annual cost of an excess estate is conservatively estimated at £600,000,000(in England alone) Research limitations/implications; Further research to understand the causes of the excess is needed and is in hand. Meanwhile the research illustrates the power of an alternative way of assessing facilities performance. Practical implications Have already been demonstrated in two trusts who have used such an analysis to define strategic estates targets, Originality. The author’s are not aware of the Lean Asset perspective previously being applied to healthcare facilities. The research shows the underlying fallacy of relying on cost per m2 as the primary measure of asset performance.</p

Open plan and academe: pre- and post-hoc conversations

There now exists a strong body of evidence that creative workplaces can, in certain circumstances, exert beneficial influences on organisational cultures and outputs. Academia tends to resist such spaces and faculty buildings. The reasons are explored but the reactions of staff are not found to be different from those reported in the literature on general creative spaces. The success or failure of team oriented workspaces is in large part a socially constructed perception influenced by the manner of implementation and management. As elsewhere new workplaces are about new conversations. The cases studied lead to a model of the tensions inherent in workplace redesign.</p

A revised approach to performance measurement for health-care estates

The purpose of the research was to show how lean asset thinking can be applied to UK health-care facilities using different measures to compare the estates contribution to the business of health-care providers. The challenge to conventional wisdom matches that posed by ‘Lean Production’ to ‘Mass Manufacturing’. Data envelope analysis examined the income generated and patient-occupied area as outputs from the gross area of a NHS Trust’s estate. The approach yielded strategic comparisons that conventional facilities management measures of cost per square metre hide. The annual cost of an excess estate is conservatively estimated at £600,000,000 (in England alone). Further research to understand the causes of the excess is needed. Meanwhile the research illustrates the power of an alternative way of assessing facilities performance. The authors are not aware of the lean asset perspective previously being applied to health-care facilities. The research shows the underlying fallacy of relying on cost per square metre as the primary measure of asset performance. The results and discussion will be particularly useful to senior estates and facilities managers wishing to use new measures to define strategic estates targets

Leadership conversations: the impact on patient environments

Purpose – The aim of this study is to examine 15 NHS acute trusts in England that achieved high scores at all their hospitals in the first four national Patient Environment audits. No common external explanations were discernible. This paper seeks to examine whether the facilities managers responsible for the Patient Environment displayed a consistent leadership style. Design/methodology/approach – Overall, six of the 15 trusts gave permission for the research to take place and a series of unstructured interviews and observations were arranged with 22 facilities managers in these trusts. Responses were transcribed and categorised through multiple iteration. Findings – The research found common leadership and managerial behaviours, many of which could be identified from other literature. The research also identified managers deliberately devoting energy and time to creating networks of conversations. This creation of networks through managing conversation is behaviour less evident in mainstream leadership literature or in the current Department of Health and NHS leadership models. Practical implications – The findings of this study offer managers (particularly those in FM and managers across NHS) a unique insight into the potential impact of leaders giving an opportunity to re-model thinking on management and leadership and the related managerial development opportunities. It provides the leverage to move facilities management from the role of a commodity or support service, to a position as a true enabler of business. Originality/value – Original research is presented in a previously under-examined area. The paper illuminates how facilities management within trusts achieving high Patient Environment Action Team (PEAT) scores is led.</p

Welcome to Journal of Ethnobiology and Ethnomedicine

Ethnobiology is a multidisciplinary field of study that draws on approaches and methods from both the social and biological sciences. Ethnobiology aims at investigating culturally based biological and environmental knowledge, cultural perception and cognition of the natural world, and associated behaviours and practices. Ethnomedicine is concerned with the cultural interpretations of health, disease and illness and also addresses the health care seeking process and healing practices. Research interest and activities in the areas of ethnobiology and ethnomedicine have increased tremendously in the last decade. Since the inception of the disciplines, scientific research in ethnobiology and ethnomedicine has made important contributions to understanding traditional subsistence and medical knowledge and practice. The Journal of Ethnobiology and Ethnomedicine (JEE) invites manuscripts and reviews based on original interdisciplinary research from around the world on the inextricable relationships between human cultures and nature, on Traditional Environmental Knowledge (TEK), folk and traditional medical knowledge, as well as on the relevance of the above for Primary Health Care (PHC) policies in developing countries

Nudging the FDA

[Excerpt] The FDA’s regulation of drugs is frequently the subject of policy debate, with arguments falling into two camps. On the one hand, a libertarian view of patients and the health care system holds high the value of consumer choice. Patients should get all the information and the drugs they want; the FDA should do what it can to enforce some basic standards but should otherwise get out of the way. On the other hand, a paternalist view values the FDA’s role as an expert agency standing between patients and a set of potentially dangerous drugs and potentially unscrupulous or at least insufficiently careful drug companies. We lay out here some of the ways the FDA regulates drugs, including some normally left out of the debate, and suggest a middle ground between libertarian and paternalistic approaches focused on correcting information asymmetry and aligning incentives.