The history of healthcare facilities management services: a UK perspective on infection control

Hospital-Acquired Infections Caused by Carbapenem-Resistant Enterobacteriaceae: An Observational Study

Worldwide, hospital-acquired infections (HAIs) are continuously rising within healthcare settings, leading to high mortality and morbidity rates. Many hospitals have reported the spread of carbapenemases globally, specifically within the E. coli and K. pneumoniae species. This study was aimed at analyzing the state of hospital-acquired, carbapenem-resistant E. coli and K. pneumoniae in the United Kingdom between 2009 and 2021. Moreover, the study analyzed the most efficacious approaches to patient management for controlling the carbapenem-resistant Enterobacteriaceae (CRE) spread. Initially, 1094 articles were identified as relevant for screening, and among them, 49 papers were eligible for full-text screening, with a total of 14 articles meeting the inclusion criteria. The information was recorded from published articles through PubMed, the Web of Science, Scopus, Science Direct, and the Cochrane library and was used to search for hospital-acquired carbapenem-resistant E. coli and K pneumoniae in the UK between 2009 and 2021, in order to evaluate the spread of CRE in hospitals. The total number of carbapenem-resistant E. coli was 1083 and this was 2053 for carbapenem-resistant K. pneumoniae in more than 63 UK hospitals. KPC was the dominant carbapenemase produced by K. pneumoniae. The results showed that the treatment options considered depended on the type of carbapenemase produced; K. pneumoniae showed more resistance to a treatment options, i.e., Colistin, than the other carbapenemase. The current state of the UK is at minimal risk for a CRE outbreak; however, appropriate treatment and infection control measures are highly required to prevent this CRE spread at the regional and global levels. The present study findings have an important message for physicians, healthcare workers, and policymakers about hospital-acquired carbapenem-resistant E. coli and K. pneumoniae spread and approaches to patient management.

Business environment as a determinant in the uptake of cyber-physical systems for facilities management – a Delphi study

Purpose

Incorporating digital technologies such cyber-physical systems (CPS) for facilities management (FM) functions is fast gaining attention. However, the rudiments for the effective espousal of such an innovative technology for the delivery of FM tasks have not received scholarly attention. In FM, the business environment is a vital component in achieving organisations’ stipulated objectives. Hence, this study aims to assess the influence of business environment factors in the adoption of CPS for FM activities.

Design/methodology/approach

A qualitative approach was adopted for the study using the Delphi technique. Experts were selected through a well-defined process that involved certain criteria. The opinions of the selected experts were gotten in two iterations that were subjected to analysis using statistics of measure for central tendency, and interquartile deviation to ascertain consensus among the experts, while Mann–Whitney U test was deployed in checking the difference in the views of the experts.

Findings

The results from the study indicated that eight business environment factors were of very high significance in determining the espousal of CPS for FM, while the other eight factors proved to be high significance. Also, there was no significant difference in the opinions of experts from academic institutions and professional practice.

Practical implications

The findings from the study would provide insight to organisations saddled with FM activities on the prevailing business environment factors that would be influential in adopting a digital technology such as CPS.

Originality/value

The study contributes immensely to the body of knowledge in the quest for digital transformation in FM delivery. It unveils the significant business environment factors that are influential in the drive for incorporating new innovations such as CPS for FM functions.

The relationship between facilities management service quality and patients’ health-care experience: the mediating effect of adequacy of health-care resource

Purpose

With challenges in health-care facilities management (FM) and adequacy of health-care resources constraints in most developing countries, improving patient’s health-care experience has become of strategic importance in public health-care delivery. This paper aims to investigate the mediating effect of adequacy of health-care resources on the relationship between the quality of health-care FM services and patient’s health-care experience.

Design/methodology/approach

This cross-sectional study adopts a quantitative approach based on a questionnaire survey conducted on 660 patients of three teaching hospitals in Ghana. In total, 622 valid questionnaires were used for data analysis using partial least squares structural equation modelling.

Findings

The mediating effect of adequacy of health-care resources on the relationship between responsiveness and tangibility and patients’ health-care experience were supported, while that of empathy, reliability and assurance were not supported. The relationship between and adequacy of health-care resources and patients’ health-care experience was also supported.

Research limitations/implications

The study limitation is that it was only the teaching hospitals that were surveyed. In future studies, a comparative analysis can be conducted between both public and private hospitals. Other constructs and relationships such as the mediating effect of the quality of health-care administrative process on the relationship between FM service quality and patients’ health-care experience as well as the moderation effect of adequacy of health-care resource on the relationship between FM service quality and patients’ health-care experience can also be tested. Future studies on the same subject can use health-care workers as the respondents of the study.

Practical implications

The result should inspire health-care managers to prioritize attention on health-care FM to create and sustain a decent health-care environment. Facilities managers should ensure standards are not compromised by keeping health-care resources in good condition through the organisation and management of resources.

Originality/value

To the best of the authors’ knowledge, this paper is one of the pioneer studies to test the mediating effect of adequacy of health-care resources on the relationship between patient’s health-care experience and health-care FM service quality. The proposed framework can be adapted to various sectors and countries as this empirical validation extends knowledge.

A review of facilities management interventions to mitigate respiratory infections in existing buildings

The Covid-19 pandemic reveals that the hazard of the respiratory virus was a secondary consideration in the design, development, construction, and management of public and commercial buildings. Retrofitting such buildings poses a significant challenge for building owners and facilities managers. This article reviews current research and practices in building operations interventions for indoor respiratory infection control from the perspective of facilities managers to assess the effectiveness of available solutions. This review systematically selects and synthesises eighty-six articles identified through the PRISMA process plus supplementary articles identified as part of the review process, that deal with facilities' operations and maintenance (O&M) interventions. The paper reviewed the context, interventions, mechanisms, and outcomes discussed in these articles, concluding that interventions for respiratory virus transmission in existing buildings fall into three categories under the Facilities Management (FM) discipline: Hard services (HVAC and drainage system controls) to prevent aerosol transmissions, Soft Services (cleaning and disinfection) to prevent fomite transmissions, and space management (space planning and occupancy controls) to eliminate droplet transmissions. Additionally, the research emphasised the need for FM intervention studies that examine occupant behaviours with integrated intervention results and guide FM intervention decision-making. This review expands the knowledge of FM for infection control and highlights future research opportunities.

A BIM-based space-oriented solution for hospital facilities management

Purpose

This paper aims to propose a space-oriented solution as an interface enabling the knowledge transfer between the building and the facilities management (FM) industry.

Design/methodology/approach

The research gap is explored based on practical investigations in six large-scale hospitals in China. The theory of engineering systems integration inspires the proposed solution. A practical scenario is demonstrated to explain the workflow of this solution.

Findings

It is founded that lagging information updates of FM systems in hospital project are one of the main reasons for inefficient and costly FM workflow. Building information modelling (BIM) model could provide accurate building information to the FM systems at the building handover stage. However, few researchers focus on the continuous information transfer solution from the BIM model to FM systems during the building in-use phase. An interface should be established for the “conversation” between the frequent changes of building and the FM systems in the post-construction period.

Practical implications

The information updates in three FM systems due to space changes in a hospital project is considered as a practical scenario in this paper. It is presented with the workflow and the data logic chain.

Originality/value

The originality of this paper is to propose a solution to integrate the space information provided by the BIM model with the parameters of particular FM systems. This solution deploys a BIM model for the FM industry. The solution could allow the FM personnel to ease operations and maintenance workflow by updating the space information in the BIM model.