Healthcare infrastructure management is the planning and structuring of how healthcare services and facilities operate most efficiently and effectively. Infrastructure includes the built environment but also the supporting elements of equipment, access, information technology (IT), systems and processes, sustainability initiatives, and staff.
Infrastructure management becomes particularly important in times of crisis. Hospitals and other healthcare systems rely on resources such as electricity, water, and oxygen. If there is a disruption to the supply of any of these vital resources, there needs to be a backup plan in place, for example, emergency generators to provide power for electrical equipment.
The Covid-19 pandemic has shown many countries where there are shortfalls in the infrastructure of their healthcare providers and services. It has also provided momentum for collaborative efforts and interventions to be better prepared for the future.
Infrastructure management starts at the point of planning and building facilities and should involve architects, engineers, and equipment managers who work holistically with the hospital or healthcare facility. Infrastructure should be:
- Planned and designed around the needs of patients to improve health outcomes.
- Facilitate high-quality, accessible, responsive, and safe services.
- Use space and resources as efficiently as possible.
- Inspire confidence in the general public.
When building a new hospital or updating healthcare facilities, planners should consider the seven domains of quality: patient experience, effectiveness, efficiency, timeliness, safety, equity, and sustainability.
Well-planned and managed infrastructure supports the fundamental aim of promoting improved standards of patient care and well-being twinned with a good experience of the healthcare system. Alongside this, a secondary aim should be to improve the well-being of staff, because this is inextricably linked to ensuring better healthcare.
Most health infrastructure plans factor in at least a shop, a café, and a prayer room on the site of a hospital, but one of the more intriguing developments in recent decades has been an understanding of the importance of green space. Sometimes referred to as healing gardens, these courtyards and atriums positively impact the well-being of both staff and patients.
A review in the International Journal of Environmental Research and Public Health (doi: 10.3390/ijerph14080864) from 2017 stated that “Viewing nature has been repeatedly demonstrated to provide a range of benefits for human health and well-being. Benefits include reduced anxiety, reduced stress, shorter hospital stays, lower heart rate, and increased directed attention.” The review goes on to explain that “It has repeatedly been shown that the sounds of nature such as wind, water, and animals, are preferred over anthropogenic sounds such as traffic, recreational noise, and industrial noise … Nature sounds have been used therapeutically to relieve stress.”
These considerations about the sensorial environment and atmosphere of all spaces within a hospital and how they affect stress levels are vital for a good patient experience and healing, as well as facilitating the important work of staff. Structures such as living walls and water features can provide the same benefits on sites with limited space.
The digital transformation of the healthcare sector has provided important improvements and services, particularly in primary care. However, in the desire to digitise and streamline systems, basic maintenance practices and healthcare facilities management can fall by the wayside. In an event like a pandemic or an extreme weather event, the lack of investment becomes evident.
This could be something as simple as the malfunctioning of air-handling units that help circulate clean, cool air meaning that there is a lack of infection control or leading to high temperatures in a heatwave. Not only do high temperatures make both patients and staff feel uncomfortable, with the possibility of some medical conditions deteriorating, but they also increase the need for some pharmaceuticals to be refrigerated and can cause bottlenecks in the schedule for surgical procedures.
It may feel more cost-effective to focus on more expensive, technologically advanced options and neglect the more basic requirements, but this is a false economy. As an example, almost 80% of 26.3 million respirators in the UK’s national pandemic stockpile were out of date when coronavirus hit the country. When a crisis occurs, time is of the essence , and healthcare facilities can quickly become overburdened
When hospitals are inundated, this has a direct impact on the physical environment. The need to create an efficacious space for clinicians that is accommodating to clinical practice under pressure should not be overlooked. When there aren’t enough hospital beds and gurneys have to remain in corridors this compromises patient care and poses further health and safety challenges.
An article in the publication Facility Executive from June 2021 highlighted that U.S. healthcare facilities were at the time approximately $391 billion dollars behind the acceptable standard of health care infrastructure. The authors state that prioritising facilities in need of change could substantially contribute to improving patient outcomes and the infrastructural environment.
When executed effectively, digitisation could offer solutions to the challenges that infrastructure management faces, not only around maintenance, but also around sustainability. The Internet of Things (IoT) facilitates smart buildings where connectivity and real-time measurements can support everything from clean air quality to reducing greenhouse-gas emissions. The benefits of IoT technologies are already evident in many health facilities in improvements such as reducing queues, controlling lighting and heating, delivering automatic check-in, tracking equipment, and cleaning.
The National Health Service (NHS) is the largest employer in Britain, responsible for around 4% of the nation’s carbon emissions. In October 2020, the NHS released an ambitious strategy to become the world’s first net-zero national health service. Through real-time energy monitoring and control, the NHS hopes for a 2.3% reduction in carbon emissions and a net annual saving of £120m by 2034. This level of decarbonisation reduces operational costs by optimising equipment and lighting strategies – the biggest consumers of energy and budget – via preventative and predictive maintenance programmes facilitated by artificial intelligence.
The healthcare industry across the world is rapidly changing and adapting to new challenges. While these seismic shifts happen, infrastructure and facility management needs to remain a priority, ensuring patient safety and consistency in public health, and minimising disruption to clinical services.
Learn more about how you can manage and lead healthcare professionals with an online MBA Healthcare Management from the University of the Commonwealth Caribbean (UCC) and support systemic change.