About this series

This series of tutorial articles is a joint project of the Association for the Healthcare Environment and Health Facilities Management.

Relationships impact every aspect of environmental services (ES) operations. The associations within a health care organization promote a structure for organizing, planning and implementing new standards. Internal and external partnerships are formed to successfully manage departments.


Collaboration is a process through which people constructively explore their ideas to form a solution that extends beyond one's own scope of work. Comprehensive strategies provide a resourceful approach to improving efficiencies and handling challenges in the industry. Forming collaborative relationships allows for successful integration into the infrastructure of an organization.

Collaborative partnerships also allow for synergy within an organization or between businesses. As each participant is defined, the shared vision will allow for a resolution, which positively impacts all participants.

The end result is a mutually beneficial relationship that allows each component to attain the goal. Organizations are as strong as their biggest challenge and collaborative partnerships allow front-line leaders to recognize opportunities for change.

Creative and efficient

Current health care trends dictate that all disciplines find creative and efficient solutions to produce a quiet, clean, professional and safe environment with a refined budget.

As health care organizations build, remodel and repurpose facilities to meet the demands of their markets, they must formulate constructive methods to minimize negative impact to the environment of care. Financial impact is critically important and it requires a multidisciplinary approach to achieve success.

When all operations departments are involved in the process, all aspects are reviewed and the impact of decisions is weighed from each perspective. The critical path to formulating a successful collaborative partnership involves:

• recognizing opportunity for change;
• creating a comprehensive team;
• developing a multidisciplinary vision;
• evaluating the position of each stakeholder;
• defining a solution for the entire scope;
• providing a model for systemic change.

Collaborative relationships unite diverse individuals to creatively explore and resolve concerns that affect the organization. This is advantageous for meeting the demands of all health care facilities because it allows for various departments to plan, organize and evaluate concerns from varying viewpoints.

Reviewing the entire scope of a challenge is critical to achieving success. Successful relationships promote cost and risk management, which enhance performance and improve competitiveness. As organizations strive to gain more market share, efficiencies are vital.

Personnel should be challenged to work efficiently, which will encourage them to give their best. Employees also should be educated on their value to the department and to the organization, which will empower them to deliver peak performance. A culture should be created that sets the standard to exceed expectations.

Leaders in the organization must correlate their efforts to realize the common goal of providing efficient, skilled and quality service to their patients with a streamlined budget. Collaboration is paramount to achieving the goal.

Ground rules

Current business trends require quick decisions with limited resources, so working as isolated departments renders an organization inefficient. Building collaborative relationships leads to developing innovative solutions and amassing resources. Ground rules that provide a framework to establish the team include:

Defining the boundaries. It is critical to determine the participants and their levels of participation. Selecting the people who understand the need allows for prudent discussion. Boundaries frame the parameters of operation. The parameters determine which metrics are involved and the impact to the organization.

Creating diversity. The diversity of collaboration is vital to success. A team comprising varying skill levels allows for different perspectives to explore alternative solutions.

Promoting innovation. Ideas should be allowed to flow freely. Creativity encourages combinations of thoughts, which foster a well-rounded resolution.

Building trust. Partnerships are defined by trust and it should be evident from the top down. If the C-suite trusts its leaders and the leaders trust the management team, the culture of trust trickles down to the front-line staff.

Encouraging networks. Relationships within the organization and the community reinforce the exchange of ideas and offer ways to study best practices in the industry. ES managers can learn from their competitors and create benchmarks within the industry.

A shared vision

To collaborate successfully, health facilities professionals must develop a shared vision. Creating the multidisciplinary vision requires identifying the concerns, creating the objectives, defining the goals and determining the rewards.

Hospital ES departments must work closely with health facility engineers, managers, directors and administration to evaluate the space requirements, the impact of change and the efficient use of the facility.

Multidisciplinary committees must work to resolve systemic concerns. Projects in health care benefit from this approach because of the impact of those involved. With all departments at the table, concerns of each are addressed and resolved in the process.

Defining solutions requires the staff to find creative processes to accomplish goals. As health facilities professionals evaluate processes, partnerships are formed to manage budgets, supplement staffing, provide additional services and meet various needs in the organization.

During one floor restoration project, for example, the staff members who usually provided floor sanding and refinishing services were on vacation and an opportunity presented itself to partner with a vendor who provides wood floor restoration. The incentive to collaborate was the value of retaining the restoration project and completing it in a timely manner. The exchange of service was beneficial to all involved.

Providing a model for systemic change requires cooperative individuals who are task- and relationship-oriented. Those who are task-oriented allow for structure and organization to accomplish defined goals with clear objectives. Relationship-oriented leaders are able to build rapport with the various team members to provide a platform for camaraderie when establishing accountabilities.

The tasks will require a relationship management process to fully disseminate the information throughout the organization and to monitor its success. Process improvement is imperative to successful implementation and adherence to the plan. Operations departments must evaluate the brand and redefine the necessary processes to remain competitive.

Success story

As the patient census grew at a 125,000-square-foot medical office building over a seven-year period, the facility's capacity expanded from 2,800 to 4,500 visits per day.

The growth of the facility dictated that all departments redefine their services to deliver excellent quality with limited space constraints with the same resources. A multidisciplinary team was constructed to evaluate how to manage the need. The goals were to reassign space, reduce wait times and provide faster service while maintaining the cleanliness of the facility and increasing patient satisfaction scores.

A team comprising the chief financial officer, director of nursing and nurse managers from the top three departments that make up 85 percent of the growth, the infection preventionist, architect, director of facilities, admissions supervisor and the ES provider met to create a critical path to proper space planning.

After several meetings and review of the budget, 8,000 square feet of area within the facility was reasssigned. This created 20 additional exam rooms, a secondary waiting area, offices for six additional providers, and an office for patient financial services. An additional 7,000 square feet was updated to coordinate with the new decor.

The budget was managed by outsourcing a portion of the remodel project to a small business contractor, and the facilities department completed the remaining portion. The process was streamlined with the architect present in the meetings to discuss which areas were critical to the redesign process.

The nursing, facilities and ES departments participated in the space evaluation and the impact of each stakeholder was expressed. ES was able to provide additional staff to meet the volume demands by redefining schedules and reallocating resources from the weekend to maintain the facility during times of peak volume.

Nursing was able to provide shorter wait times as patients were moved to the secondary waiting area, and efficiencies in preparing for the visits were accomplished. The patient's experience was more pleasant because the rooms were newly remodeled and wait times were significantly shorter.

Admissions personnel were pleased because of the decreased wait time and the lobby area was more manageable due to prompt service that moved the client into the department. Even more important, patient satisfaction scores increased by 10 percent. Successful resolutions shared by each department created a win for the partnership.

A mechanism

Collaborative partnerships provide a mechanism for diverse participants to explore creative solutions. They can form within the organization or through relationships outside the organization.

Strengthening an organization's capacity for collaborative relationships is a positive experience that yields broader opportunities for employee growth and development.

Successful partnerships are vital to the success of every organization and the benefits are efficiency in management, enhanced education, budget and risk management, increased competitiveness, expanded market share and value-added service to the client.

Monique Scott-Spaulding is an authorized franchise owner at Jani-King of Baton Rouge, La. She can be reached at janikingbatonrouge@bellsouth.net.