(2/20/2017)
The healthcare terrain has shifted dramatically over the past few years, and evolving regulation and market behavior continue to bring new challenges you didn’t have to worry about just a few years ago. In facilities management, four obstacles can cause costs and safety violations to mount, unless hospital leaders are aware and equipped to tackle them effectively.
Below are four challenges you’ll want to plan for, to guard your facility against violations and unforeseen expenses:
1. Increased regulatory scrutiny over the physical environment
In the past, CMS and their Accreditation Organizations focused heavily on the clinical side through regulatory surveys. But the next time your facility undergoes a survey, surveyors will take a much deeper review of your hospital’s infrastructure and physical environment as it pertains to compliance with the Life Safety Code©.
So much so, that The Joint Commission (TJC) is utilizing Life Safety Specialists to perform the life safety portion of the survey. With their extensive knowledge of these codes, requirements and hospital facility operations, it is important that your facility is kept up to date with these requirements. In fact, there may be two Life Safety Code Specialists depending on the size of your facility as well as increasing the time on-site, (It’s also worth noting the Environment of Care tends to be the most heavily cited portion of Comprehensive Accreditation Manual (CAM).)
This shift will require specialty skills—professionals trained in the physical environment—to pinpoint issues and solutions prior to a survey that would otherwise elude an untrained eye.
2. Shrunken timeline (60 days) for correcting violations
Also in our recent past, TJC’s program called the Statement of Conditions, allowed healthcare facilities their self-identified and survey identified deficiencies to manage their deficiencies over a period of time up to and during a survey. Many also counted on the generous grace periods and extensions granted by TJC and other Accreditation Organizations for fixing deficiencies, which could be stretched over a year, two, maybe three.
That ended earlier this year, when the TJC moved to no longer consider the Plans For Improvement (PFI) portion of the Statement of Conditions and adopted the same
“We find it, you fix it in 60 days” methodology as CMS. Any exceptions to that timeframe will be exceedingly hard to obtain.
The solution is to integrate your Accredited Organization’s requirements into your daily practices, and plan for necessary investments & improvement plans across the presumed two to three-year cycle between surveys. It’s really a matter of “pay now or pay later”—except the “pay later” option, when a surveyor catches the issue and demands resolution within 60 days, is going to be far more expensive, and a much bigger headache.
3. Aging workforce & loss of knowledge
As the workforce ages and retires from healthcare facilities management, there’s a real risk that key knowledge and skilled trades required to maintain your facility will go out the door with them. Compounding the issue is that industry-wide, there has been a loss of formal succession planning for skilled trades, many facilities fail to invest in adequate training or development of their staff. This could lead a healthcare facility to fall into a greater dependency on external service contracts that cost them far more than it would cost to build the same service capabilities in-house.
Your greatest opportunity for long-term sustainable savings is ultimately reducing your reliance on external contracts. Building a strong succession plan that includes a holistic approach to what your healthcare facility requires to build an in-house team to perform those highly technical skilled trades. And that can only happen with data-driven, generous and ongoing investment in your internal facilities team.
4. Lack of solid performance baseline or standards
It’s tough to discern how your facilities should be operating without a solid baseline or performance standards. Even more so when you have limited visibility and understanding of how you’re performing today.
Traditionally, most facilities tend to have some form of computerized maintenance management system in place. They have good visibility into work orders, budget, and some kind of benchmark to measure themselves against.
The challenge is that they also tend to be easily manipulated to present whatever picture someone might want to portray of your facilities operations. Hence, the importance of basing decisions on unbiased, comprehensive, and evidence-based intel on your entire facilities inventory—how it performs and what it costs you to maintain all those assets over the years. (Not just the cost in hard dollars, but also the impact of downtime, glitches, productivity lapses, and more.)
In order to enable an evidence-driven, high-performing facilities program, it requires the consolidation and standardization of processes, procedures, systems and more. At a minimum, that consolidation and standardization ensures everyone caring for your facilities speaks the same language, works toward the same goals, and can easily access information and resources as needed. (It is also a great benefit in ongoing compliance and survey experiences).
Facilities management is a complex job, but one that has the potential to make your own job easier, and your patients’ experience better. General awareness of the challenges addressed in this article is an important first step that puts you ahead of the pack. Solidify that advantage by learning more when you download our free white paper:
Tools for the In-House Model.