An exploratory study into the factors that influence patients' perceptions of cleanliness in an acute NHS trust hospital

Perceptions and experiences of patients attending an opioid substitution clinic in South Africa

Background

Opioid substitution therapy (OST) is endorsed as the recommended treatment for opioid use disorders. Opioid substitution therapy is not widely used in South Africa, so little is known about its perceived clinical utility in this setting. There is also a paucity of qualitative research that explores the subjective experiences of patients using OST.

Aim

To explore patients' perceptions and experiences attending a South African OST outpatient clinic (OST-OC).

Setting

The OST-OC at Stikland Psychiatric Hospital, Cape Town, South Africa.

Methods

We conducted a qualitative study using semi-structured interviews with eight participants who had been attending the OST-OC for at least 6 months. Transcripts were analysed using Atlas.ti software and thematic content analysis was used to identify themes.

Results

Patients stated that OST helped them to regain and maintain a stable lifestyle. Autonomy and agency, the therapeutic relationship and family support were perceived as contributing to successful patient outcomes. The preference for methadone and buprenorphine treatment depended on individual experiences. Patients valued kindness from staff members but reported that improved interactions with some nonclinical staff could better facilitate treatment. Challenges experienced included stigma and cost.

Conclusions

This study offers insights about OST that are pertinent to low- and middle-income countries. Reducing the cost of OST, collaborative decision-making between staff and patients, and a non-judgemental attitude by clinical staff were recognised as important factors for optimised service delivery.

Contribution

Understanding patients' experiences of OST in a South African setting will allow for future policy development for the treatment of opioid use disorders in similar settings locally and abroad.

Impact of environmental hygiene interventions on healthcare-associated infections and patient colonization: a systematic review

BACKGROUND

Healthcare-associated infections (HAI) are one of the gravest threats to patient safety worldwide. The importance of the hospital environment has recently been revalued in infection prevention and control. Though the literature is evolving rapidly, many institutions still do not consider healthcare environmental hygiene (HEH) very important for patient safety. The evidence for interventions in the healthcare environment on patient colonization and HAI with multidrug-resistant microorganisms (MDROs) or other epidemiologically relevant pathogens was reviewed.

METHODS

We performed a systematic review according to the PRISMA guidelines using the PubMed and Web of Science databases. All original studies were eligible if published before December 31, 2019, and if the effect of an HEH intervention on HAI or patient colonization was measured. Studies were not eligible if they were conducted in vitro, did not include patient colonization or HAI as an outcome, were bundled with hand hygiene interventions, included a complete structural rebuild of the healthcare facility or were implemented during an outbreak. The primary outcome was the comparison of the intervention on patient colonization or HAI compared to baseline or control. Interventions were categorized by mechanical, chemical, human factors, or bundles. Study quality was assessed using a specifically-designed tool that considered study design, sample size, control, confounders, and issues with reporting. The effect of HEH interventions on environmental bioburden was studied as a secondary outcome.

FINDINGS

After deduplication, 952 records were scrutinized, of which 44 were included for full text assessment. A total of 26 articles were included in the review and analyzed. Most studies demonstrated a reduction of patient colonization or HAI, and all that analyzed bioburden demonstrated a reduction following the HEH intervention. Studies tested mechanical interventions (n = 8), chemical interventions (n = 7), human factors interventions (n = 3), and bundled interventions (n = 8). The majority of studies (21/26, 81%) analyzed either S. aureus, C. difficile, and/or vancomycin-resistant enterococci. Most studies (23/26, 88%) reported a decrease of MDRO-colonization or HAI for at least one of the tested organisms, while 58% reported a significant decrease of MDRO-colonization or HAI for all tested microorganisms. Forty-two percent were of good quality according to the scoring system. The majority (21/26, 81%) of study interventions were recommended for application by the authors. Studies were often not powered adequately to measure statistically significant reductions.

INTERPRETATION

Improving HEH helps keep patients safe. Most studies demonstrated that interventions in the hospital environment were related with lower HAI and/or patient colonization. Most of the studies were not of high quality; additional adequately-powered, high-quality studies are needed. Systematic registration number: CRD42020204909.

Subconscious influences on perceived cleanliness in hospitality settings

Due to the COVID-19 pandemic, now and for years to come, guests at hospitality venues will have heightened awareness with regard to formulating their perceptions of cleanliness. While perceived cleanliness has received attention in our existing body of literature, this conceptual paper integrates potential subconscious influencers on cleanliness perceptions into our understanding. Specifically, findings contained in various streams of research suggest that a number of factors can have subconscious influences on individuals' perceptions of cleanliness in service environments. Such factors include the degree of lighting, the presence of plants / greenery, the shininess of surfaces, the use of ambient scents, the use of white bedding, and the presence of cleaning staff. Evidently, the sooner hospitality venues (particularly airlines, lodging operations, restaurants, and cruise ships) are perceived as clean and safe, the faster they will recover from the pandemic. As such, this paper is rich with both practical and research implications.

The Development of a Public Bathroom Perception Scale

Public bathrooms are sensible locations in which individuals confront an intimate environment outside the comfort of their own home. The assessment of public bathrooms is especially problematic for people whose illnesses make them more prone to needing this service. Unfortunately, there is a lack in the evaluation of the elements that are relevant to the user’s perspective. For that reason, we propose a new scale to assess these elements of evaluation of public bathrooms. We developed a scale of 14 items and three domains: privacy, ease of use and cleanliness. We tested the factor validity of this three-factor solution (n = 654) on a sample of healthy individuals and 155 respondents with a bowel illness or other affection that reported to be bathroom-dependent. We found that bathroom-dependent people value more privacy and cleanliness more than their healthy counterparts. We additionally found a gender effect on the scale: female participants scored higher in every domain. This study provides the first scale to assess value concerning public bathrooms and to highlight the relevance of different bathrooms’ aspects to users.

Perceived barriers to healthcare utilization among Jordanian families: A family centered approach

AIM

This study aimed to understand the barriers to health services utilization by Jordanian families.

BACKGROUND

Access to quality healthcare services is a significant issue facing healthcare systems. Healthcare systems must identify and apply measures to overcome barriers that face utilizing health services and thus increase clients' satisfaction.

METHODS

A cross-sectional qualitative research design was used in this study. Semi-structured interviews were conducted with twenty-five families to elicit the model of health services barriers.

RESULTS

The analysis of the family interviews led to four main themes related to health services barriers: service system, structural/physical barriers, equipment and medication, and staff competency. This study would increase awareness about underserved populations that avoid seeking medical care.

CONCLUSION

Public health efforts are required to increase awareness about the importance of contacting the healthcare system as early as possible. However, public health policy may require developing new initiatives that reduce these perceived barriers, such as enhancing communication skills among healthcare workers, increasing supervision and inspection of healthcare quality, and enhancing patient engagement by using phone calls and messages as appointment reminders and careful follow-up.

Women's experiences of midwifery care immediately before and after caesarean section deliveries at a public Hospital in the Western Region of Ghana

Background

Childbirth remains a uniquely multifaceted, mental-cognitive and a major life experience to women. It is composed of a variety of psycho social and emotional aspects and creates memories, sometimes bad experiences and unmet expectations which leaves the mother with lasting scars. Therefore, this study aimed at exploring post-caesarean section delivered mothers experiences of midwifery care in a public hospital in Ghana.

Methods

This descriptive exploratory qualitative research used an interpretative approach to explore mothers’ experiences of midwifery care immediately before and after caesarean section (CS). The study employed a purposive sampling technique in recruiting 22 participants who had knowledge of the phenomenon under study. Data collection was guided by an interview guide, which involved face to face individual interviews and focus group discussion at the postnatal ward and clinic. All interviews were audio-recorded and lasted 30–40 min. Audio recordings were transcribed verbatim and inductive thematic data analysis employed.

Results

Four major themes emerged from the analysis of participants’ transcripts: Support by Midwives (physical and psychological, and attitude towards patients’ pain management); Protection of mothers (provision of privacy, confidentiality and physical environment); Provision of information/communication (before caesarean section, and before a minor task) and midwives’ attitude (attitude towards delivery care).

Conclusion

Mothers delivered by caesarean section had varied experiences of midwifery care which were both positive and negative ones. Provision of psychological support and adequate pain management were positive experiences. The challenges experienced were related to provision of information, privacy, and physical support. Participants, who underwent emergency CS in particular, were dissatisfied with the provision of information concerning the surgical procedure. Provision of privacy and physical support were also issues of great concern. We therefore, recommend supportive and sensitive midwifery care particularly for mothers undergoing emergency CS. Documenting women’s diverse experiences of midwifery care before and after CS delivery is important to healthcare providers, hospital managers and policy makers as the feedback garnered can be used to improve maternity services and inform decisions on midwifery care.

Pitfall benchmarking of cleaning costs in hospitals

Purpose

It is typical of public real estate benchmarking reports to show only highly aggregated benchmarks based on buildings’ floor areas. They hardly provide disaggregated benchmarks for usage clusters. The aim of this study is to show the caveats from highly aggregated benchmarking without consideration of cluster-specific characteristics.

Design/methodology/approach

Based on the parameters of the German facility management association 812 standards, cleaning costs and costs for the surfaces of seven hospitals have been collected and allocated to specific room clusters. Using these basic data, a calculation and simulation conducted with the aim of simulating facilities that are comparable in the sum of costs yet feature varying sub-clusters as cost drivers. In particular, during this simulation, area ratios were varied randomly and the average cleaning costs per cluster were held constant for all hospitals. Therefore, the costs per square meter in the clusters of all simulated hospitals are identical and the full costs only depend on the area ratios.

Findings

The simulation shows that highly aggregated cleaning costs lead to large spans, and thus, to misinterpretations in the field of action. In the case, the aggregate benchmark ranges from 40.6 to 66.5 EUR/m², although, for all hospitals the same costs per square meter had been used. Thus, the bias results only from varying the share of area across the clusters. This finding is caused by a well-known statistical problem: the Simpson’s paradoxon, which currently receives little attention in real estate benchmarking.

Practical implications

The results show, that the regular benchmarking with high aggregated data, often used in practice, cannot be recommended. The author consider using a detailed benchmarking as meaningful and purposeful. To be able to make a detailed benchmarking, it is essential to identify and collect the influencing factors. Only if all important factors, in this case, the clusters will be regarded in the benchmarking, a reasonable benchmarking and useful interpretation can be given. Using a simple benchmarking to get a rough overview is refused steadfastly.

Originality/value

The study highlights that a comparison with public benchmarking reports (operation costs) must be taken with great caution. The author has quantified the bias from the aggregated benchmarking and have shown, that the Simpson’s paradox fully explains the consequences.

Field testing of a prototype mechanical dry toilet flush

A prototype of a non-fluid based mechanical toilet flush was tested in a semi-public, institutional setting and in selected peri-urban households in eThekwini municipality, Republic of South Africa. The mechanism's functionality and users' perception of the flush were assessed. User perception varied depending on background: Users accustomed to porcelain water flush toilets were open to, yet reserved about the idea of using a waterless flush in their homes. Those who commonly use Urine Diversion Dehydration Toilets were far more receptive. The user-centred field trials were complemented by a controlled laboratory experiment, using synthetic urine, -faeces, and -menstrual blood, to systematically assess the efficiency of three swipe materials to clean the rotating bowl of the flush. A silicone rubber with oil-bleed-effect was found to be the best performing material for the swipe. Lubrication of the bowl prior to use further reduced fouling. A mechanical waterless flush that does not require consumables, like plastic wrappers, is a novelty and could - implemented in existing dry toilet systems - improve acceptance and thus the success of waterless sanitation.

Into the light: effects of the presence of cleaning staff on customer experience

Purpose

The purpose of this paper is to determine how the presence of cleaning staff affects perceptions and satisfaction of train passengers. Day-time cleaning is becoming increasingly popular in (public) service environments. It is however unknown how the presence of cleaning staff in the service environment affects perceptions and satisfaction of end-users.

Design/methodology/approach

Two experimental field studies were performed. Data for the first study were collected on the trajectory between the train station of Assen and the station of Groningen (N= 506) in the northern part of the Netherlands. Data for the second study were collected on the trajectory between train station “Amsterdam Amstel” and train station “Utrecht Centraal” (N= 1,113) in the central part of the Netherlands. In the experimental condition, two cleaners collected waste and performed minor cleaning activities (i.e. empty trash bins, cleaning doors and tables) during the journey. After the first study, cleaners received hospitality training and corporate uniforms.

Findings

The presence of cleaning staff positively influenced train passengers’ perceptions and satisfaction. Effects were stronger in the second study, after the second consecutive intervention (i.e. hospitality training, corporate uniforms). In both studies, the presence of cleaners positively influenced passengers’ perceptions of staff, cleanliness and comfort. The perception of atmosphere was only significant after the intervention.

Practical implications

The findings of this study allow in-house and corporate facility managers to better understand the possible effects of the presence of their cleaning staff on end-user perceptions and satisfaction.

Originality/value

The study’s value lies in its human centred approach by demonstrating the importance of day-time cleaning. This area of research has been largely neglected in the field of facilities and (public) services management research.

Exploring cleanliness in the Dutch facilities management industry: a Delphi approach

Purpose

This paper aims to identify antecedents that influence perceived cleanliness by consulting experts and end-users in the field of facilities management (facility service providers, clients of facility service providers and consultants). Business models were evaluated to understand why some antecedents are adopted by practitioners and others are not.

Design/methodology/approach

A qualitative study, with end-users (n = 7) and experts (n = 24) in the field of facilities management, was carried out to identify antecedents of perceived cleanliness. Following the Delphi approach, different research methods including interviews, group discussions and surveys were applied.

Findings

Actual cleanliness, cleaning staff behaviour and the appearance of the environment were identified as the three main antecedents of perceived cleanliness. Client organisations tend to have a stronger focus on antecedents that are not related to the cleaning process compared to facility service providers.

Practical implications

More (visible) cleaning, maintenance, toilets, scent, architecture and use of materials offer interesting starting points for practitioners to positively influence perceived cleanliness. These antecedents may also be used for the development of a standard for perceived cleanliness.

Originality/value

A basis was created for the development of an instrument that measures perceived cleanliness and includes antecedents that are typically not included in most of the current standards of actual cleanliness (e.g. NEN 2075, ISSA).

Cleanliness unravelled: a review and integration of literature

Purpose

The purpose of this paper is to present a systematic literature review on stimulus, organism and response variables related to actual and perceived cleanliness and develop a conceptual framework to encourage future research on cleanliness.

Design/methodology/approach

The PRISMA statement methodology for systematic literature review was applied. After analysing 926 articles, 46 articles were included and reviewed.

Findings

Stimulus, organism and response variables related to cleanliness were identified and integrated in a conceptual framework. A distinction was made between articles evaluating the relationship between stimulus and organism variables; stimulus and response variables; and organism and response variables. First, actual cleanliness, staff behaviour, condition of the environment, scent and the appearance of the physical environment were identified as stimuli variables influencing perceived cleanliness and service quality. Second, the presence of litter, behaviour and presence of others, scent, disorder, availability of trash cans and informational strategies were identified as stimuli affecting littering and other kinds of unethical behaviour. Third, the effect of perceived cleanliness (and other organism variables) on satisfaction, approach behaviours, physical activity and pro-social behaviour was registered.

Practical implications

The findings of this review allow in-house and corporate facility managers to better understand and identify most effective interventions positively influencing actual and perceived cleanliness.

Originality/value

No systematic literature review on antecedents and consequences of a clean environment has previously been conducted.

Patient choice modelling: how do patients choose their hospitals?

As an aid to predicting future hospital admissions, we compare use of the Multinomial Logit and the Utility Maximising Nested Logit models to describe how patients choose their hospitals. The models are fitted to real data from Derbyshire, United Kingdom, which lists the postcodes of more than 200,000 admissions to six different local hospitals. Both elective and emergency admissions are analysed for this mixed urban/rural area. For characteristics that may affect a patient's choice of hospital, we consider the distance of the patient from the hospital, the number of beds at the hospital and the number of car parking spaces available at the hospital, as well as several statistics publicly available on National Health Service (NHS) websites: an average waiting time, the patient survey score for ward cleanliness, the patient safety score and the inpatient survey score for overall care. The Multinomial Logit model is successfully fitted to the data. Results obtained with the Utility Maximising Nested Logit model show that nesting according to city or town may be invalid for these data; in other words, the choice of hospital does not appear to be preceded by choice of city. In all of the analysis carried out, distance appears to be one of the main influences on a patient's choice of hospital rather than statistics available on the Internet.

Evidence-based design and transformative service research for the healthcare in hospitals

Purpose

The purpose of this study is to combine the two fields of transformative service research (TSR) and evidence-based design (EBD) to improve the healthcare service provided in hospitals. TSR and EBD are two separate research fields that aim to improve the well-being of consumers within the service sector. Research propositions for making changes in the hospital physical environment to improve the patient well-being are developed to link the two fields.

Design/methodology/approach

This work takes a theoretical approach to develop research propositions based on the literature. The research propositions guide the development of the framework developed for future studies under TSR and EBD.

Findings

The research propositions should be tested empirically in future studies to develop a methodology for transforming a hospital physical environment. The implementation of these propositions would allow hospitals to reach a new and more sustainable competitive advantage.

Originality/value

The relationship between the domains of TSR and EBD has not been explored before in the literature. This study presents an unprecedented work that is needed to improve patient well-being. It contributes to TSR and EBD by providing a research agenda for healthcare practitioners and researchers to pave the way for achieving improved healthcare services focusing on patient well-being and sustainability.

Re-conceiving building design quality: A review of building users in their social context

Considerable overlap exists between post-occupancy research evaluating building design quality and the concept of 'social value', popularised by its recent application to issues of the public realm. To outline this potential research agenda, the paper reviews design quality research on buildings in relation to users and their social context where the term 'social context' refers to building user group dynamics, a combination of organisational cultures, management strategies, and social norms and practices. The review is conducted across five key building types, namely housing, workplaces, healthcare, education, and the retail/service sector. Research commonalities and gaps are identified in order to build a more comprehensive picture of the design quality literature and its handling of users in their social context. The key findings concerning each building type are presented visually. It is concluded that the design quality field comprises a patchwork of relatively isolated studies of various building types, with significant potential for theoretical and empirical development through interdisciplinary collaboration. Users tend to be conceived as anonymous and autonomous individuals with little analysis of user identity or interaction. Further, the contextual impact of user group dynamics on the relationship between building design and building user is rarely addressed in the literature. Producing a more nuanced understanding of users in situ is proposed as an important area for future design quality research.

Nurses’ perceptions of dirt and contagion: Does the work environment pose a greater threat than one’s own home?

The aim of this study was to understand nurses’ infection prevention behaviours in the acute hospital setting by eliciting their explanations of observed behaviour. It sought to identify perceptions of risk from infection within their work environment and their homes, the practices carried out to avoid these risks, and the factors that influence behaviour. Twenty semi-structured interviews, using a topic guide and vignettes, were conducted with Registered Nurses. Interviews were audio recorded and transcribed verbatim. Three main themes of ‘Rationalising dirt related behaviour’, ‘Protection from dirt’ and ‘Transitions and journeys: no place like home’ emerged following data analysis using a framework method. This paper presents the theme ‘Transitions and journeys: no place like home’, which has two components: ‘Where is the dirt?’ and ‘Practice and rituals’. The findings demonstrate that dirt and germs present in hospitals represent a higher risk than those in the home. Healthcare workers can take measures to mitigate this risk; however, on leaving the workplace perception of self does not change significantly until they arrive home. At this point a transition occurs; they now recognise the risk they may pose and practices and rituals are required in order to protect the home . The findings demonstrate the multifaceted nature of infection prevention beliefs and behaviours. Behaviour is influenced by knowledge, belief systems and the circumstances of the situation. People see themselves positioned differently within the environment depending on the context of the risk; they can either be at risk or be the cause of the risk.

Patient satisfaction questionnaires in surgery: inpatients' perceptions and experiences of surgical wards in general surgery

The NHS continually promotes patient-centred care. One way of assessing this is by looking at inpatient satisfaction rates as this is a central aspect of patient care. A patient's experience during their surgical admission can impact their perception of the care they receive, their treatment, recovery and follow-up. Currently NHS questionnaires are often posted out following patient discharge to assess patient satisfaction rates. However, it is important to assess inpatient satisfaction as this can change following discharge. Our survey highlighted areas for improvement when delivering care.

An empirical study on hospital selection in India

PURPOSE

The purpose of this paper is to understand the different factors patients consider in choosing a hospital in a major city in India, prior to admission.

DESIGN/METHODOLOGY/APPROACH

A 20-item scale to identify various factors a patient considers in choosing a hospital was developed. A field survey was conducted on patients who were discharged in the recent past from a public or a private hospital. The data collected were analysed using multivariate techniques.

FINDINGS

The data analysis highlighted several factors in the hospital choice selection process, namely quality of treatment, referral, transport convenience, cost, and safety and services.

RESEARCH LIMITATIONS/IMPLICATIONS

This research study was carried out in one of the four major metropolitan cities of India. Nonetheless, the study provides valuable insights into the hospital selection process in a developing country like India.

PRACTICAL IMPLICATIONS

Hospital managers, in general, can use the study findings to improve the operating performance of their hospitals so that they are able to attract more patients in the future. Additionally, the information can be useful to the marketing managers for developing appropriate marketing strategies for their hospitals.

ORIGINALITY/VALUE

Majority of the empirical research on hospital choice process has been conducted in Europe and North America. Limited knowledge exists on the same in a developing nation like India. This research illustrates a comprehensive study to address that concern.

The type, level, and distribution of microorganisms within the ward environment: a zonal analysis of an intensive care unit and a gastrointestinal surgical ward

OBJECTIVE. To investigate the distribution of hospital pathogens within general and critical care ward environments and to determine the most significant bacterial reservoirs within each ward type. DESIGN. Prospective 4-month microbiological survey. SETTING. The intensive care unit (ICU) and gastrointestinal (GI) surgical ward of a London teaching hospital. PATIENTS. Sampling was conducted in and around the bed space of 166 different patients (99 in the ICU and 67 in the GI ward). METHODS. Conventional agar contact methodology was used to sample 123 predetermined sites twice a week for 17 weeks. Sixty-one surfaces were located within the ICU, and 62 were located within the GI ward. Each surface was located within a theoretical zone of increasing distance from the patient. Aerobic colony counts were determined, and confirmatory testing was conducted on all presumptive pathogens. RESULTS. Regardless of ward type, surfaces located closest to the patient, specifically those associated with the bed (side rails, bed control, and call button), were the most heavily contaminated. Elsewhere, the type of surfaces contaminated differed with ward type. In the ICU, bacteria were most likely to be on surfaces that were regularly touched by healthcare workers (e.g., telephones and computer keyboards). In the GI ward, where the patients were mobile, the highest numbers of bacteria (including potential nosocomial pathogens) were on surfaces that were mainly touched by patients, particularly their toilet and shower facilities. CONCLUSIONS. In terms of cleaning, a hospital should not be considered a single entity. Different ward types should be treated as separate environments, and cleaning protocols should be adjusted accordingly.

Improving public perceptions around cleanliness and health care associated infection in hospitals (service improvement)

A qualitative study was undertaken to understand public perceptions of hospital cleanliness and how this might be improved following national initiatives to reduce infection rates and invest in domestic services. Eleven focus groups were held across the West Midlands.

Results demonstrated that perceptions are attained from a variety of sources. For patients and visitors the things they see, hear, smell and taste in hospitals and health services shaped their perceptions of cleanliness. For the public the media, friends and family are important. Key factors for attention include: ensuring hospital floors, walls, ceilings, doors and toilets are kept clean, tidy, and unstained; an absence of strong odours; patients have the opportunity for regular baths/showers; staff have clean hands and uniforms, have short, clean finger nails and hair tied back; and eye-catching material on why cleanliness is important as well as what people need to do. Participants were generally unaware of the symptoms of MRSA, Clostridium difficile or Norovirus.

The results of the study suggest that attention needs to be focussed on developing effective communication strategies. This will only be possible by adopting a multifaceted approach and enabling collaborative working between infection control staff, communications teams and other frontline staff.

Operating cost analyses of long‐term care facilities

Purpose

After salary and wages, facility and real estate expenditure are the largest cost items in the semi‐public sector. Especially, for long‐term care facilities, there is high‐saving potential from more efficient and effective use of property. The main purpose of this paper is an exploratory research study in order to analyse the operating costs of long‐term care facilities.

Design/methodology/approach

The survey is based on empirical data questionnaires, data generation and semi‐structured interviews at 18 long‐term care facilities in Tyrol, Austria carried out during Summer 2007. In order to determine the volume and to prioritize the cost drivers computer‐aided real‐estate benchmarking software was used, which was developed by the Institute of Real Estate Benchmarking at the University of Applied Sciences KufsteinTirol, Austria. Statistic analyses were conducted to investigate saving potential, determine the best case of the sample and submit recommendations to the decision makers.

Findings

The main findings are the investigation and visualization of saving potential of long‐term care facilities and identification of the volume and structure of the cost drivers and illuminated current best practices in effective building upkeep and operating costs of long‐term care facilities in Tyrol. Furthermore, the study reveals the immense saving potential in the costs of various services.

Research limitations/implications

This survey is based on the operating costs of long‐term care facilities. Other running costs such as costs for healthcare personnel as well as quality indicators are not considered in this survey. Further research activities will be necessary regarding the identification of these cost drivers by the application of regression models.

Practical implications

Professional property management of long‐term care facilities will be shown to decrease the cost share in the healthcare sector. The results should help to establish cost benchmarking increasingly and develop it as a strategic planning tool in order to support management in the healthcare sector in the decision‐making process.

Originality/value

The paper presents a new measuring method, which allows an holistic view of three influencing factors, namely the amount of beds, occupancy and the space consumption, to investigate weak points in cost efficiency on one chart.