Key Takeaways:
Staffing shortages create a second major threat because healthcare facilities cannot operate safely without enough qualified people.
"When you have minimum staffing, you get minimum service," says Jonathan Flannery, senior associate director of ASHE Regulatory Affairs. He recommends that facility managers clearly document their teams' activities, including which services are required for compliance, and be prepared to show executives the impact of a reduction in staffing.
Facility managers should also track service calls, routine work, regulatory requirements, special projects and nonessential requests so executives can see the full scope of the department's workload.
This approach allows facility managers to explain exactly where a cut will land. Flannery says he was able to protect staffing during multiple budget cuts because he could show executives how resources were being used.
"You don't become a CEO or CFO without a brain," he says. "It's easy for them to understand when you lay it all out."
On the other hand, employee retention depends on more than defending head count. Facility managers must also create a workplace where employees want to stay.
"Nobody gets into healthcare facilities management for the money," Flannery says. "I could have made a whole lot more managing banks or data centers. My ambition has been to help save lives, and I think everyone else in this field is in the same boat."
Employees who understand the way their work contributes to patient care are more likely to view their jobs as meaningful and to remain engaged during difficult periods.
Workplace culture is another major retention factor.
"When you address the negative energizers, you elevate everybody," Flannery says. "If high performers believe they are carrying employees who are not contributing, morale and retention can suffer."
Partnerships with local schools, technical colleges and professional chapters can create pipelines.
"You have to grow your own program," he says. "You have to bring people in, train them (and) help them gain skills they need to move up in your organization.
"We had internships at my former hospital because of the STEM program at the local high schools. We had one student who became a respiratory therapist after working with ventilators as an intern."
Resilience means more than preparing for emergencies a facility has already experienced. Threats vary by geography and community, so facility managers need to continually reassess vulnerabilities and plan measures to return the facility to operation as quickly as possible.
Flannery says using an annual hazard vulnerability assessment gives managers an opportunity to evaluate infrastructure. The assessment can identify the hazards most likely to affect the facility, determine systems and services those hazards could disrupt and assign specific mitigation projects to responsible departments.
"Always involve the people that are working on this stuff every day because they know far more than you ever will," Flannery says. "Bringing those perspectives together can reveal problems that would not be transparent from drawings or administrative reports alone."
Understanding interdependencies is another important step toward resilience. For example, a facility might have backup power but still be vulnerable if a critical electrical panel or fuel system fails.
"The only way to truly understand the interconnectedness of your systems is to get out there and walk the system," Flannery says. "Put your hands on it. Know what it's doing."
Regular walkthroughs can also help managers identify conditions that are easy to overlook, such as blocked access to shutoff valves, missing labels, water intrusion and equipment stored in inappropriate locations.
Once a vulnerability is identified, managers should develop a mitigation plan. Flannery says vulnerabilities cannot always be eliminated but can be managed. Plans can include adding redundancy, increasing inspection frequency, establishing alternate procedures and coordinating with outside agencies.
A hospital's greatest vulnerabilities often become part of the background. These risks accumulate quietly until the facility is forced to respond under pressure.
For this reason, the facility manager's role is so critical. They can see what others miss and help the organization act while there is time to choose the solution.
“This is what we do,” Flannery says. “We understand the complexity, where the vulnerabilities are and how to manage those vulnerabilities. This is the job.”
Elaina Myers is the assistant editor of the facilities market. She has covered various topics from pest management to resilience to sustainability and covers all holidays and special days in the facilities field. She also manages the FacilitiesNet social media accounts.
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