Training the next generation of facilities managers

Managers should encourage dialogue and information sharing on facility walks to capture knowledge related to system conditions that can be unique for a specific installation.

Image by Getty Images

With so many areas of health care facilities management scrambling for attention, time is scarcely available to develop beneficial training programs on equipment and spaces that will engage staff. The entire facilities labor market has had unprecedented retirement and turnover, creating a void of competent, educated and knowledgeable teams to ensure reliable operations of health care facilities.

Before looking outside an organization, health care facilities managers should take time to develop internal team members for success. Developing internal talent creates a pipeline for future facilities leaders by improving continuity. Managers should dedicate time not only to program development but also to consistent implementation.

A basic outline of topics and areas must be developed as a guide to a repeatable program. Facilities managers should use available resources to structure an organization-specific training program that includes standardized elements and receives support from team members by rewarding success through various methods.

A successful training program can be achieved through the process described below.

Training topics

An outline of training topics is key to program consistency. Major systems, equipment, utility distribution and isolation points must be identified and documented. Facilities can no longer rely on one technician who knows where to tap the boiler when it does not fire. Generators, boilers, chillers, fire alarms, medical gas, pneumatic tube systems and similar equipment should be included not only for familiarity but also to provide facility-specific information that adds depth to the program.

Facilities managers should include code-required procedures or documentation steps for accurate regulatory compliance. Understanding how electrical and mechanical systems are distributed is a key function of facilities operations. For each of these systems, proper identification through labeling, as-built documentation and recording changes through technician knowledge is crucial for long-term staff development.

Every member of the facilities team needs to know utility shutdown locations in an emergency. Seconds are crucial to prevent further damage, particularly during water-based events such as a water line breach or activated fire sprinkler.

Drawings, project files and equipment manuals must be organized and easily accessible for all technicians. Many facilities have extensive libraries that contain invalid information due to renovations or equipment change-outs. Facilities managers should be sure time is allowed to purge out-of-date files (especially electronic ones) to remove non-essential records, so training content is current and relevant.

Not all training is classroom-based, but it requires a formal structure to remain consistent for each student. One good method is to establish a facility tour upon initial hire and annually for all team members that covers major infrastructure components and equipment locations. Facilities managers should encourage dialogue and information sharing on these walks to capture knowledge related to system conditions that can be unique for a specific installation and is not always found in manuals.

During one such walk, for instance, a technician once shared that staff should be careful not to overfill diesel once the gauge indicates full or constant alarms will go off on the tank monitor, even though there is room in the belly tank on the generator.

Examples from such experiences require documentation to ensure everyone knows crucial information. Facilities managers should be sure to update the data sheet for each system as comments are discussed. Individuals have different memory capacities and recall abilities, so facilities managers should include administrative or clerical staff on these tours to take notes and ensure follow-through in recording information. Knowledge shared across roles and responsibilities can be invaluable in emergency situations.

To simplify sections, many training opportunities can be recorded as job action sheets or methods of procedure for complicated tasks that can be equipment-specific. Often, these are found in equipment operation and maintenance manuals provided by manufacturers or other performance standards and guidelines.

Dividing equipment training into multiple sections based upon inspection, testing or maintenance procedures also can quickly identify skill levels and knowledge from competence to mastery. Keeping information current is another crucial step. Engaging senior technicians to act as mentors as a standard part of their role is imperative to continuity and staff development.

Many free resources exist through professional associations and manufacturers to assist with processes or equipment procedures. Facilities managers can utilize online resources and search engines to provide links to these resources for their teams if copies do not exist on-site.

General topic training around standard system operation is the basis of any education program before moving into site-specific installations or operations. Technicians need to understand the basic concepts of processes to be able to diagnose and troubleshoot issues. Other training materials can provide an overview of requirements, such as the American Society for Health Care Engineering’s (ASHE’s) Health Care Facilities Management Essentials Series of handbooks and education courses that lead to qualifications and, eventually, certifications.

Understanding how every system and component combines to form the physical environment will aid technicians in applying their knowledge. Training programs developed with continual growth opportunities for each trainee to reach their individual level of success will outlast the creator and provide pathways for future careers.

Building knowledge

A baseline of systems, equipment, distribution, specific arrangements and institutional knowledge must be captured and included in training plans. A health care facilities technician may be extremely proficient at one site’s generator equipment and not know where to begin on another unit.

Controls sequencing knowledge can be invaluable when troubleshooting an incident. Ensuring site-specific information is documented, posted and available to staff is essential. For complex written procedures, facilities managers should ensure the steps are proven through a trial sequence and revised when not exact and easy to follow.

Managers should have someone unfamiliar with the procedure verbally perform the steps under the supervision of the system expert to identify any additional details needed in the document. They should then edit the steps to be clearer and improve the documentation through repeated attempts.

When developing equipment-specific procedures, managers should remember to include safety information. Safety steps for lockout/tagout procedures for all utilities, including electricity, water, steam, fuel or any other active source, can prevent workplace injuries and additional damage to equipment. Proper startup, shutdown and safety procedures must be followed for everyone’s protection.

Facilities managers should dedicate time to identify and educate staff about any unique spaces in the facility that may have coded nicknames, such as the “dungeon,” “tunnel,” “pit” or “oasis,” when, for instance, the oasis will actually be an unfinished shell space with a dirt floor where the ferns grow. Spaces with special nicknames often have a hidden meaning that may require specific training to access.

Some health care facilities expect technicians to be jacks-of-all-trades, while others are very specialized. It is crucial for technicians to understand expectations and scopes of their responsibilities. Often the lines between clinical engineering, facilities, construction and safety are blurred depending on a facility’s organizational structure. For some departments, equipment like patient beds, stretchers, surgical tables, scales, exam lights or trash carts may be serviced by different teams with different procedures.

Each organization can have a different separation of duties as equipment responsibility is not standardized across the field. Understanding how all the equipment in a hospital is connected and separated is a necessary step to facility orientation. Items as simple as the casters on a cart can be extremely disruptive to patient care if they are noisy when moving across hard floors, even if they are functioning as designed.

Measuring staff success can be done in many ways. One method is to utilize a suitable baseline exam or questionnaire for each technician prior to beginning the program. Just as an energy program has a starting point to measure success, so should a training program.

A pretest format is a solid choice in a training program for internal education. Facilities managers should explain to teams the importance of a baseline to identify areas for individual improvement and demonstrate success. Low scores on a pretest can be a source of anxiety for many facilities teams, but growth cannot occur without a known starting point. It is acceptable for some topics to be scored as beginner, intermediate or advanced instead of numerically.

Specific training goals also can be added to annual reviews with mid-cycle checkpoints to ensure progress.

Training framework

The list of key components and systems can tailor a recognized framework for training. Health care facilities managers should not struggle developing the outline when there is a ready-made start available to anyone.

ASHE’s Mechanic Evaluation and Certification for Health Care (MECH) and Sr. MECH candidate handbook, has nine categories for training that can be expanded to include facility-specific topics. They include plumbing/pipefitting; carpentry; life safety/physical environment; electrical services; general facility maintenance; grounds; heating, ventilating and air-conditioning systems; steam and hydronic boiler systems; and safety support.

Expanding technician knowledge benefits the team, organization and field in many ways. Ensuring facility-specific educational program content aligns with training, qualifications and certifications provides a pathway that individuals can follow for career development to support future leaders.

While most of this discussion is about technical development, facilities managers should remember to encourage staff to grow beyond their roles for personal development. Increasing numbers of organizations are using qualifications, certifications and licenses as minimum requirements on job documents and postings.

The next level of staff training is to define site-specific technical training under maintenance and operations, one of the eight elements of the ASHE Core Competency Framework™. This can then be used to create development pathways in the Core Competency Framework’s seven remaining elements: compliance, sustainability, finance, energy management, project management, managing risk and administration. 

There are numerous opportunities along this pathway to achieve qualifications and certifications that will open doors for new career opportunities. As regulatory authorities increase expectations and reviews of staff competence during surveys, the need to show proper training has never been greater. Many systems and codes require individuals to be qualified to perform inspection, testing or maintenance activities. Facilities managers also should consider local and state requirements that may apply to their organization, such as environmental or energy regulations (including the management of refrigerants or underground storage tanks).

One of the most effective forms of motivation is the recognition of staff contributions, for which financial incentives are not always the primary driver. Formal and informal acknowledgment at the departmental, organizational, community or professional level can foster a strong sense of satisfaction and reinforce engagement.

Facilities managers should not wait until the end of a journey to recognize success. Each step along the way should be celebrated to encourage continued development. They also should be cautious as some people shy away from recognition and will stall before completion to prevent it. Managers should check with each person that rewards and recognition are desired before sharing.

Any training program will have hurdles and need continuous refinement. Health care facilities managers should be receptive to suggestions from staff as knowledge increases. New equipment and consistent renovations keep buildings modernized and ready to support the latest methods of care.

Maintenance teams must stay current with changes, including inventory, procedure and computerized maintenance management software updates. Facilities managers should remember to utilize ASHE’s NFPA 99 Risk Assessment Tool all equipment and spaces, especially the updates and changes.

Staff improvement

Managers should not fear that highly competent staff will leave their organizations but instead should be concerned they will stay when left untrained. Training programs can improve staff effectiveness, confidence, quality and retention.

A key is taking the process one step at a time. Managers should make a checklist, procedure or step-by-step handout of one task and ask for a team member to follow, review and edit for success.

Ideally, technicians on the facilities manager’s team will increase their knowledge of health care physical environment systems and eventually become supervisors, managers, directors and Certified Health Care Facility Managers.

Related article // Teaching the facilities staff to run a new hospital building

There are few things as exciting as bringing a new building, addition or central energy plant online. For complex equipment and spaces, the first step is a standardized, measurable and sustainable training model for all staff.

Facilities staff must be educated on identification of egress paths, fire safety device locations, alarm activation points, temperature control systems and every other system needed to operate a facility.

Learning a new facility can seem overwhelming without a defined plan. Frustrations from clinical staff will quickly emerge if facilities teams lack the information to resolve concerns developed by new building operations. There are multiple strategies available to help reduce training times.

Facilities managers should utilize suppliers, vendors and members of the planning, design and construction group to formalize topics to increase staff familiarity with the building and how patient care is supported through proper operation. Video demonstrations, interactive diagrams, scenario-based simulations and emergency response walkthroughs can be used to reduce training time and increase knowledge retention for the operation of equipment and spaces.

For everybody’s safety, all new staff members must be oriented to the building on topics such as fire alarm activation exits and fire extinguisher locations. Creating a well-developed safety training program starts long before occupancy or the first patient arrives. Facilities and safety staff must take a role in planning the building-orientation training for new staff as soon as the space is nearing completion.

The handoff information from the design and construction team is critical to successful building operation. A facilities team will not be successful without understanding the full capabilities and methods of procedure to perform complex systems operations and maintenance.

Additionally, this communication point cannot be considered a one-time event but rather a realistic process that involves multiple levels of information sharing to ensure operators are more knowledgeable than installers. Open communication about expectations and practical learning methods for facilities must be included in the construction process to ensure the facility performs better than designed beyond turnover. 

Jason Lea, CHFM, CHC, Sr. MECH, SASHE, is the director of facility operations at Cook Children’s Medical Center in Fort Worth, Texas. He can be reached at jasonlea2002@outlook.com.