A A N N I I NTEGRATED NTEGRATED
H H EALTHCARE EALTHCARE F F ACILITIES ACILITIES M M ANAGEMENT ANAGEMENT M M ODEL ODEL
Sarel Lavy and Dr. Igal M. Shohet
Technion – Israel Institute of Technology
Faculty of Civil and Environmental Engineering
OUTLINE
? Introduction
? Background
? Methodology
? Profile of facilities
? Conceptual model
INTRODUCTION
Business competition in healthcare
Requirements for economic operation
Higher efficiency demands
Developments in IT
Improved data processing capabilities
Artificial intelligence techniques
An Integrated Healthcare Facilities Management Model
BACKGROUND
The Pentagon of
Healthcare Facilities
Management core domains (Shohet and Lavy, 2004)
ICT
Healthcare Facilities Management
Maintenance Management
KPI’s, B enchmar king, Service life planning, C M
, PM, CBM
Perform ance M
anagem ent
Benchm arkin
g, Bu siness pe
rfor m ance, Build
ing ev aluation
techn iques
Risk M an
ag em
ent
Risk identification, A nalysis,
Quantification, Prioritisation, Value engineering, V
alue m anagem
ent
Development
Strategic planning, Reconstruction, Remodelling, Renovation, Rehabilitation
Su pply
Se rvic
es M ana
gem ent
Org an
isa tion
al lea
rn ing
, Ou tso
urc ing
, Cos
t-b en
efit
METHODOLOGY
? Structured field survey
? Statistical analysis
? Conceptual development of the model
? Computing development
? Validation
HEALTHCARE FACILITY CAMPUS
FIELD SURVEY
Profile of sample population of Israeli hospitals:
Number of facilities 12
Floor area (10
3sq. m.) 83.4 (68.1)
Parking area (10
3sq. m.) 25.6 (28.0)
Number of patient beds 669 (341)
Total ground area (10
3sq. m.) 241.7 (235.1)
Occupancy (patient beds per 1,000 sq. m. floor area) 8.91 (1.90) In-house maintenance employees 47.6 (21.8) Patient beds per in-house maintenance employee 14.6 (3.3)
Parameter Mean (S.D.)
FIELD SURVEY
Average space distribution, by designation of floor area in Israeli public acute-care hospital facilities:
42.7%
10.7%
12.8%
9.1%
11.3%
6.8%
6.7%
Hospital wards Offices
Utilities Energy
Laboratories Clinics
Other
FIELD SURVEY
Building Performance Indicator (BPI)
Monitor the performance of Healthcare facilities based on Life Cycle Costs of the building systems (Shohet et al., 2003).
Interpretation:
BPI > 80 – Building at good or high service level;
70 ? BPI < 80 – Building at marginal condition;
60 ? BPI < 70 – Building at deteriorating condition;
BPI < 60 – Building at poor condition.
Each building system or component at performance level lower than 70 requires
preventive maintenance
FIELD SURVEY
Roofing element (Exterior envelope): Pn = 50
FIELD SURVEY
Electrical board (Electricity): Pn = 80
FIELD SURVEY
Performance scores of public acute care hospitals:
Building systems Mean (S.D.) Highest Lowest
Medical gases 87.5 (10.5) 100.0 71.4
Communication 82.2 (10.1) 96.0 70.1
Structure 79.9 (6.1) 91.3 70.6
Elevators 79.6 (5.7) 85.9 70.4
Electricity 77.8 (6.9) 88.2 65.5
HVAC 77.0 (7.1) 87.6 64.5
Fire protection 76.6 (14.2) 93.7 44.2
Interior finishes 76.2 (8.8) 90.0 63.1
Exterior envelope 74.4 (10.1) 94.1 59.0
Sanitary systems 69.9 (9.9) 89.2 57.1
Total BPI 76.6 (5.9) 85.5 67.8
FIELD SURVEY
Power consumption – Prediction model
W=3.23(FL)-23,228.7
? W – Annual water consumption [Cubic m./year]
? FL – Floor area [sq. m.]
? r
2= 0.9680
Water consumption – Prediction model
E=22.66(OC)
2-24,944(OC)+7,662(EM)+6,876,372
? E – Annual power consumption [KWH/year]
? OC – Occupancy [Number of total patient beds in the hospital]
? EM – Number of employees
? r
2= 0.9748
CONCEPTUAL MODEL
Maintenance Performance &
Risk Management
Energy &
Operations Management Development
Models Knowledge Base
Maintenance Performance &
Risk Management
Energy &
Operations Management Development
Input
Reasoning Evaluator and Predictor
Output
CONCEPTUAL MODEL – INPUT
Definition of variables – Maintenance Management:
Geographic category (GEC); Type of facility (TOF);
Environmental conditions (ENV); Facility area (FAR);
Density (DEN); Occupancy (OCP); Actual annual
maintenance expenditure (AME); Actual maintenance resources (AMR); Availability of labor (AOL);
Facility designation (FAD); Actual service life (ASL);
Required service life (RSL).
CONCEPTUAL MODEL – INPUT
Definition of variables – Performance & Risk Management:
Physical performance (PPn);
Required performance (RPn);
Actual risk level (ARn);
Required risk level (RRn).
CONCEPTUAL MODEL – INPUT
Definition of variables – Energy & Operations Management:
Energy consumption (ECO);
Preparedness (PRE);
Actual annual operations expenditure (AOE).
CONCEPTUAL MODEL – OUTPUT
Maintenance Management:
Performance & Risk Management:
Energy & Operations Management:
Predicted annual mainetnance expenditure (PrAME);
Recommended maintenance policy (MPn).
Actual facility performance level (BPI);
Predicted risk level (PrRLn);
Predicted facility performance (PrFPn).
Predicted annual energy consumption (PrAEC);
Predicted annual operations expenditure (PrAOE).
Classify building/facility
Retrieve maintenance indicators
Predict maintenance activities and resources
Annual maintenance expenditure
Recommended maintenance policy Bank of performance
indicators
Case-Based Reasoning Input Interface
Reasoning Evaluator and Predictor
Output Interface Statistical models