Photo by Rebecca Lomax
As the American Society for Healthcare Engineering enters its 51st year, senior executive director Dale Woodin assesses present and future challenges for facilities managers.
What will the major content focus be for the ASHE Annual Conference in August?
One main focus will be on bringing value and, therefore, building trust capital with the C-suite. Now more than ever, facility design, construction and operational issues are vitally important to a health care organization's future success. But all too often, ASHE members are not part of the C-suite team and, therefore, not included in the initial conversations regarding space utilization needs. Without a person in the C-suite who understands the capabilities of the current infrastructure, whether it be utility, technology or regulatory, there is a high potential to suboptimize facility assets leading to undesirable results.
By improving our ability to communicate in business terms, and think broadly to find solutions to reduce operating costs while improving performance, ASHE members can generate trust capital. Once that trust capital is established and enhanced over time, I believe that members of the C-suite will see their facilities director or facilities vice president as someone who understands the big picture and is able to fulfill the organization's current needs and overall mission through thoughtful facility planning.
Does this include being part of the discussion of how to reshape facilities in this new era of care delivery?
Absolutely. In the recent construction survey conducted by Health Facilities Management and ASHE, the data identified the impact of health care reform on facilities and showed that organizations are now having these conversations.
It all cascades from visioning what health care delivery will look like in the future. There are already many rapidly changing variables, such as physicians' moving back into hospitals, curbing overutilization of hospital services and more patient care moving out of the acute care setting into the community. ASHE members are looking at how to address issues such as real estate management and renovating stranded assets — buildings whose core services have moved away from the acute care setting.
ASHE members have the opportunity to and can play a significant role in renewing the infrastructure of these incredibly expensive assets that are pillars of the community — not just the power plant, but the building itself, so that it becomes a useful, viable asset for the future.
What's being done to develop the next generation of facilities managers?
Within our strategic plan, we've identified three strategic imperatives. One imperative is focused on succession planning. Studies on the intergenerational workforce and the aging workforce show that we have many people on the cusp of retiring, and there's going to be a huge talent void when they leave.
We have to look at where their replacements will come from. We've identified three pathways. One is upward lift — people who have worked in the organization a number of years and now need further education and opportunity to move from a technical role to more of a managerial, director or leadership role.
The second pathway includes people who are migrating from other industries — traditionally, those who have worked in manufacturing or served in the military. They have skills and technical expertise, and working within health care is attractive to them.
These first two pathways are incredibly important, but the group we're focusing most of our attention on is university graduates. We've been working with a number of universities to develop programs and offer internship opportunities to establish a pipeline for that next generation of health facilities professionals. Often these university programs are not degree programs in health care facilities management, but rather engineering, property management or construction degrees with an emphasis in health care facilities management.
Where is the regulatory environment of health facilities headed? Will we see more uniformity in codes?
Yes. Another of our strategic imperatives is moving toward a unified code. We've really worked to identify the disparity in codes that affect both the construction and operations of buildings from national, state and often local levels and work to reduce that disparity.
When you step back and ask why standards aren't uniform at different levels, it often comes down to not having good science as the basis of the standard. We've had success in promoting that codes need to be based on good science, supported by defensible economics and developed through informed decision-making. The authorities who promulgate and enforce these codes and standards have been open to better understanding the unique applications and needs of a patient care environment. As we've promoted these three pillars, we're seeing more code uniformity and standardization.
But because of our focus on reducing unnecessary regulatory burden, some people may have a misperception that ASHE is not supportive of codes; to the contrary. We absolutely need to have regulation in health care. Patients and families come to hospitals at their most vulnerable time and we have a solemn responsibility to protect them from harm. We need well-thought-out standards to keep patients safe and we have to be ever diligent about meeting those standards.
We're focusing on addressing issues such as when we have conflicting standards, standards that address hazards that don't exist anymore and the unintended consequences of codes that actually get in the way of good medical practices.
Where does sustainability rate today as a priority?
Sustainability is incredibly important. On the most basic level, sustainability is about how we extend the useful life of and get greater value out of our facilities. That's part and parcel of what ASHE members do. For years, we've been able to take systems that were rated for a 10-year life and get 30 years out of them. Now we have to take that to a health system- or multihospital-level approach.
Our focus on sustainability will help hospitals to reduce costs, whether they are electrical costs or water usage or reducing waste streams. To help facilities, we've put a lot of energy into the Sustainability Roadmap for Hospitals (www.sustainabilityroadmap.org), which is a series of performance improvement measures — starting with low cost/no capital projects — that facilities can implement from an operational standpoint to reduce costs and consumption as well as revitalize infrastructure.
The website has a large number of case studies and success stories. The University of Arkansas for Medical Sciences, which has added 1 million square feet of space but not one dollar to the utility bill, is a good example. They've done this by negotiating utility rates, reducing consumption and by commissioning and retrocommissioning buildings to make sure they're getting every possible ounce out of the system. Many other success stories like this can be found on the website. Hospitals can look at what they've done and follow their path.
Bob Kehoe is associate publisher of Health Facilities Management.
The Woodin File
• Executive director of the American Society for Healthcare Engineering (ASHE)
• Provides senior leadership to ASHE's public policy initiatives, research agenda, education programs, publications and sustainability programs
• Frequently represents ASHE's 11,000 members on codes and standards formation, revision and interpretation
• More than 30 years of health care experience, including 18 years in hospital facilities management
Bachelor of science degree in biomedical engineering from the University of Illinois
ASHE's most significant accomplishment
"ASHE has professionalized our profession. Today, we look at what kind of design we need so form will follow function. We look at the role we can play in environmental infection prevention and how to make our buildings highly reliable."