Compliance management is often associated with risk management and has an inherent reactive nature, prompting significant effort to ensure scope coverage of regulatory, performance or institutional requirements, when a potential gap is identified. It is, however, a critical part and key success factor in managing the complexity of safety and quality of service in healthcare facilities.
Healthcare activities are driven by excellence in clinical care, performance standards, efficient and effective operational outcomes. Similarly, the systems and processes required to maintain a building’s infrastructure are required to respond, ensuring the appropriate environment for activities in the context of regulatory compliance for buildings and their services.
Managing the information from building systems is a process driven activity aiming to convert data into actionable results, while delivering cause and effect scenarios on most critical issues affecting the environment of care. This process is based on robust and structured monitoring, seeking to continually measure and validate potential infrastructure inefficiencies, failure scenarios or significant improvements.
A proactive infrastructure compliance program becomes the catalyst of efficiency and effectiveness in continual improvement. And analysing and predicting patterns of building services behaviour creates a visible and auditable path to evidence-based proof of performance. It can balance the challenges of governing compliance requirements, gaining a stronger commitment from a broader stakeholder group towards proactive risk mitigation, shared accountability and support in improving operational performance.
Healthcare compliance management – a complex multidisciplinary process
Facility management in healthcare does not exist for the sole purpose of maintaining or optimising plant and equipment operation; it exists for supporting clinical care, the care of those in need of a safe, secure and resilient environment. Therefore, building infrastructure regulatory compliance or institutional requirements are significantly embedded in the organisation-wide strategy and practice for meeting and governing compliance of the health service.
The multitude of government regulations is stimulating the realignment of rules, standards and regulation for healthcare service compliance with the changing landscape of healthcare in Australia collectively governed by health reform initiatives. The effort devoted to meeting and achieving compliance across multidisciplinary domains aims to ultimately contribute to improvements in activities, process outcomes, healthcare delivery and saving lives.
An enabling element for achieving and effectively managing compliance across healthcare activity areas and with specific focus on infrastructure and building services is the application and implementation of intelligent technology. The adoption of technology in healthcare facilities has experienced a sequentially progressive development pattern, mainly driven by critically important factors of safety, security and compliance, and building services control technology allows the integrated system building blocks to leverage on its own and overall capabilities.
The meaning of control systems, deployed as tools for managing complexity in healthcare compliance management, is extended to become the decision-support mechanism in the areas of operations, maintenance, performance, risk and cost-effective optimisation of resource allocation.
The control systems implemented to assist the operations of complex building services have emerged to incorporate technology innovation alongside its applicability in the healthcare dynamic environment. The need for interoperability and interface between control systems triggers the requirement for integration of such, under a platform facilitating the exchange of information, process enabling inputs and outputs between the systems.
The analysis of infrastructure data and its contribution to decision-making will result in better understanding of cause and effect scenarios affecting the environment of care, and hence enables change management initiatives, people efficiency and productivity gains.
Understanding the risk on non-compliance and its implications
Compliance management for infrastructure and building services has been traditionally associated with risk management. It is inherently risk-based and incident driven. One of the most significant challenges is the assessment of risk to which an organisation is being exposed, from non-compliance of infrastructure assets or their management.
The methods and techniques applied to managing the compliance of healthcare assets in the different stages of their life cycle have a common objective to optimise the delivery of value by ensuring operational continuity, minimising cost of operation and mitigating risk of underperformance or failure.
This will assist the healthcare facility manager to navigate the many challenges and opportunities of complying with standards, regulations or performance requirements and driving value through those efforts. Healthcare organisations need to stay in front of both existing and emerging risks in order to define and implement optimum strategies for compliance.
Focusing on prediction prevention and early intervention
An agile facility management practice requires consolidated information and analysis of infrastructure and services performance. The facts and records accumulated in the integrated monitoring and control systems can become the evidence behind robust strategic planning for an efficient and sustainable service operation.
The strength of information from building systems can be leveraged beyond its traditional use in daily operations and used to provide visibility into physical infrastructure performance. By managing the information and analysing its critical impact to core operational activities, this results in awareness building, ownership and accountability of risk, opportunities or sustainability drivers in strong connection to healthcare service continuity, regulatory compliance and financial performance.
Balancing the risk of downtime from infrastructure failures, raising cost of maintenance for ageing plant and equipment, resources and budget constraints with an increased demand for performance and efficiency is extremely challenging. The healthcare facility management profession is also facing the performance test from service criticality, considering that asset failure can potentially have a direct or indirect impact on patient care outcomes. Systematically achieving efficiency in process, people and technology domains eliminates waste, while maintaining or improving the quality and continuity of service, hence compliance management. The benefits are mostly visible in cost and quality measures, which allow dynamic readjustments in processes and systems, controlling operating cost and reducing errors.
Through robust and structured information management, facility managers can understand how to take advantage of the building services data, find hidden cost and inefficiencies, mitigate risk of asset failure or service downtime, to optimise the operational performance of the facility.
The transparency into buildings’ behaviour created from analysed data enables fact-based decisions and confidence in capital and sustainment investments allowing a result driven and proactive approach. The business value of information management for healthcare buildings is translated in measurable results in green-star rating and energy management, operational efficiency and regulatory compliance, meaningful spending on operational activities and sustained savings from proactive building management.
Leadership – key attribute for success in managing compliance
With the role of healthcare facility manager transitioning from technical focus to strategic and operational performance driven, there is additional pressure and responsibility to enhance the perspective on compliance management and actively participate in the effort to guide continual improvement of processes related to infrastructure management.
The impact from technology advances and their adoption in healthcare operations, along with the challenges from ageing infrastructure, demands that the facility manager adapts and leads change practices, building internal capabilities to recognise the importance of infrastructure compliance management.
For a dynamic and continually changing healthcare landscape, the mission of facility managers is to embrace a culture of excellence and address compliance management with professional pride, as a duty of care. Effectively, they become a change agent and a driver for quality in the built environment.
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The author, Irina Lindquist, is Schneider Electric’s healthcare solution architect. This is an abridged version of a white paper from her titled: ‘Navigating the maze of healthcare compliance requirements and the role of the facility manager’.