Key Takeaways:
Hospitals are more than just buildings. They are places where people turn during their most vulnerable moments.
But hospitals and other healthcare facilities face a growing range of threats that extend well beyond keeping buildings operational.
Jonathan Flannery, senior associate director of ASHE Regulatory Affairs, says the National Health System in the United Kingdom offers a warning of what can happen when problems are allowed to accumulate.
"They have facilities that are crumbling around them," he says. "They let the complexity get to them. They didn't address what needed to be, and now they are in a state of emergency."
Avoiding the same outcome requires that healthcare facilities managers understand the way risks interact and act before vulnerabilities lead to irreversible damage.
Aging infrastructure is a threat not simply because individual components become old but because healthcare buildings are highly interconnected. Flannery says this situation is "synergistic degradation."
"The more load you're putting on increases the degradation of the system as a whole," he says. "When the chiller is not working right, it impacts the HVAC, which now impacts the electrical system because it's warmer in the electrical closet."
Facility managers can reduce this threat by moving beyond reactive maintenance toward reliability-centered maintenance.
"Reliability-centered maintenance is when you're actually starting to analyze things and identify patterns before they become failures," Flannery says. "At a previous facility, my team was able to identify air handlers needing upgrades by tracking and analyzing the hot calls."
Managers should also maintain a facility condition assessment and translate its findings into an active, continuously reviewed plan.
"The type of five-year plan that works is one that is used consistently and is part of the whole program," Flannery says, adding that a plan that sits on a shelf cannot guide capital decisions or maintenance priorities.
Flannery says two human tendencies can make things more difficult. The first tendency is stationary bias, which occurs when facility staff become so accustomed to their surroundings that they stop noticing changes or deficiencies.
"You become so used to where you are and what you are doing that you lose the perspective to see things outside of that," he says. "Always bring someone else in to look at your building and help you."
The second tendency is the glamour effect, which refers to the fact that capital projects that are attractive and revenue-generating often receive more attention than essential infrastructure work.
"When you're doing capital projects, you want something shiny that brings in revenue," Flannery says. "Infrastructure doesn't do that, and if you don't have infrastructure that functions properly, it doesn't work."
Managers should bundle infrastructure improvements with more visible projects to make the business case stronger. At his previous facility, Flannery says he combined construction of a new energy plant with a hospital expansion. The energy project generated enough savings to support adding 60 beds.
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.
