Chapter 16 Facility

Management
By Gobena Godama (CL.N, BSc.PH, MHA) FMoH Ethiopia
August 30, 2016
Adama
Chapter content
 Section 1. Introduction
 Section 2. Operational Standards for

Facilities Management
 Section 3. Implementation Guidance
 Section 4. Implementation Checklist and

Indicators
 Appendices
Section 1. Introduction
 The Purpose of Facility management is:-
to properly manage hospital buildings, grounds,
security and utilities
to ensure that the facility is maintained and in good
condition,
To provide safe environment for patients, visitors
and staff
To guarantee un interrupt delivery of clinical services
To create effective facilities management through
effective internal and external planning
to ensure adequately preparedness of Hospitals for
deal with facility events and minimize their impact.
Content of Facility management
Buildings Maintenance
layout renovation &
construction
Landscape
& Garden Utilities &
Organization
of Facilities Sewerage
Management
Function

Vehicle &
Major
Transport
Incidents
Services

Safety Security
Section 2. Operational Standards for
Facilities Management
 The hospital complies with relevant laws,
regulations, and facility inspection requirements.
 Designated hospital staff members are assigned
for facility maintenance functions.
 The hospital grounds are regularly inspected,
maintained, and, when appropriate, improved to
ensure cleanliness of grounds and safety of
patients, visitors and staff.
 Potable water is available 24 hours a day, seven
days a week through regular or alternate sources
to meet essential patient care.
Operational Standards continued…
 Electrical services are available 24 hours a day,
seven days a week through regular or alternate
sources to meet essential patient care.

 The hospital has a maintenance centre with

technical personnel, sufficient space and adequate
ventilation to conduct maintenance and repair work
on the facility operating systems (e.g., electrical,
water, sanitation, sewerage and ventilation) and
equipment. This includes proper hand washing
facilities, proper disinfection and cleaning of
equipment facilities, a storage area, and a library.
Operational Standards continued…
 The maintenance centre has appropriate tools and
testing equipment to perform repairs, as well as
procedures to ensure the routine calibration of the
testing equipment is performed as required.

 The hospital conducts regular preventive and corrective

maintenance for all facilities and operating systems (e.g.,
electrical, water, sanitation, sewerage and ventilation) to
ensure patient and staff safety and comfort.

 There is a notification and work order system for facility

and operating system (e.g., electrical, water, sanitation,
sewerage and ventilation) repairs.
Operational Standards continued…
 The hospital has a transport policy for the
use of and access to hospital vehicles.

 The hospital has a policy addressing access

to hospital premises.

 The hospital has a fire safety plan that

addresses both the prevention and response
to fires. A ‘Fire and Evacuation Drill’ is
conducted at least annually.
Operational Standards continued…
 The hospital has a plan for responding to likely
community or hospital emergencies, epidemics
and natural or other disasters.

 Staff members are trained and knowledgeable

about their roles in the plans for fire safety,
security, hazardous materials, and emergencies.

 The hospital has at least two Doors for vehicles,

customers and Ambulance, one door is dedicated
only ambulance entry and exit. New Standard ???
Section 3. Implementation Guidance
3.1 Organization of Facilities Management Services:-
 The hospital has a Finance and Property Case Team, led

by the Director of Finance

 The hospital should assign a Facilities Manager (or

equivalent) who is accountable to the Director of
Finance.

 The Facilities Manager should be supported by assigned

personnel, sufficient to fulfil the functions described
below.

 The facility management team members are responsible

to all activity of entire Hospital Facility management
Implementation Guidance cont…
 The Facilities Manager, together with support
staff, is responsible for:
 Buildings organization, layout, maintenance, construction
 Landscape and garden
 Utilities and sewerage
 Vehicle and transport services
 Security
 Safety
 Major incident planning and response
Implementation Guidance cont…
3.2 Buildings
 3.2.1 Buildings layout
 The buildings are the most fundamental

component of a hospital
 The Hospital Building layout and design are

contribute significantly to the smooth

operation of patient services and other
activities.
3.2.1 Buildings layout
 Well designed and organized buildings layout
is:
Minimize the travel distance between frequently
used spaces,
Streamline the movement of patients between
departments,
Allow patients to be easily visible by staff for
supervision,
Avoid unnecessary redundancies of clinical and non-
clinical areas and make efficient use of space,
 Provide an efficient system for the handling of food,
storage of supplies and the removal of waste, and
 Enhance the safety and security of patients, visitors,
staff and hospital assets.
3.2.1 Buildings layout
3.2.1.1. Layout of patient services
 The patient services should easily accessible and

located in close proximity to each other.

 The Emergency Department should be easily

accessed from the adjacent main road

 The Emergency & Outpatient Department (OPD)

entrance should labelled and visible from the street.

 The Outpatient Department (OPD) should have

enough space and seating for the expected number

of daily arrivals.
 Hospitals ensures at least two separate entrance

doors; one designated just for ambulances /other

vehicles with emergency cases.
3.2.1.1 Layout of patient services
 Central and emergency triages should be
clearly labelled and easily accessible.
 Inpatient wards should be easily accessible

from elevators, ramps and stairways.

 Sufficient seating space should be provided

for visitors, caregivers and other guests.

 Toilets and showers should be provided for

patients ideally at each ward but If not

possible clearly signposted and link the
Facility with walkway
3.2.1.1. Layout of patient services
 Medical records and payment offices should
be clearly labelled and easily accessible to
patients and visitors.
 Hospitals with more than one floor should

have either elevators or ramps to transport

wheelchair- or bed-bound patients.
 Elevators should be large enough to

accommodate patient beds.

 Stairs and corridors should be kept clear and

only used for its original purpose.

 Areas that are restricted to staff only should

be clearly marked with “No entry”

3.2.1.2. Layout of staff services
 The Hospital should ensure the Staff station is
organized in a way to provide easy access and
mobility.
 Toilets should be available within close proximity to all
staff working areas.
 The Hospital should ensure the staff changing rooms
with lockable lockers for (operating theatre, delivery
suite, laundry, kitchen, maintenance staff & security
personnel).
 Showers should be provided to workers who are
exposed to dirt, hazardous materials or body fluids
during their duty shift.
 A canteen or café and Drinking water should be
available for staff at all times
3.2.1.2. Layout of staff services
 Staff on ‘duty’ should have access to duty rooms
with beds that is located near regular work areas
for resting when not actively working.
 The staff duty rooms should be equipped with
landline telephones
 Facilities should be available for staff ‘on duty’ to
obtain meals/refreshments during duty hours.
 Health workers, residents and visiting students
should have access to a study area or library
equipped with various educational resources
including internet access.
3.2.2 Hospital site map
A map of the hospital campus should be
displayed at all entry points to provide clear,
easy navigation for patients and visitors.
 All hospital buildings should be clearly

labelled and signs should be used to guide

patients or visitors to each department.
3.2.3 Building maintenance
 Buildings are the largest investment in the
facility and should be well-maintained to
prolong their lifespan and minimize the need
for expensive repairs or renovation.
 appropriate workers should Inspect all

hospital buildings on a regular basis to

ensure that facilities are in good condition,
 The facility should avail appropriate

maintenance tools, equipment and machinery

3.2.3 Building maintenance
 Preventive maintenance and repairs should be
undertaken whenever necessary. In particular:
Windows should be replaced when cracked or
broken.
Windows should be able to open to allow for
ventilation.
Windows should have a functioning lock to prevent
theft or unwanted intruders.
Doors should be able to easily open and close.
Doors should have a functioning lock
The roof should not have any source of leakage into
the facility.
Walls should be repaired as necessary.
 Rain drainage systems should be working properly and efficiently. Water from drainage
systems should be diverted to a location that eliminates large flooding in locations
around the building, and
 Mould growth should be prevented, or removed if discovered to prevent damage to the
buildings.
 Sagging and broken beds should be fixed.
 Broken patient or visitor chairs, tables, etc should be repaired as soon as the problem
is reported.
 Regular walk through should be conducted to assess the condition of all the hospital
facilities. These should be done at least once a month.


 The hospital should ensure that reasonable stocks of building maintenance materials
are held at all times, and that these form part of recurrent budgets. Basic building
maintenance materials include cement, paint, metal, wood, glass, etc. There should
be a system in place that prompts for re-order when stocks of building maintenance
materials run low.


 A full construction plan for the buildings, including civil engineering drawings should
be available and kept within the office of the Facilities Manager and should be updated
when modifications are made.