Consistent throughout this chapter is the theme of transparency and communication. Adequate staffing with appropriate expertise must be funded in an auditable manner to ensure that hiring processes can be fully planned and executed. Nationally, the median number of square feet per FTE for the maintenance staff is 50,000; 22 percent of respondents reported that they outsourced the function. In this model, facilities managers can negotiate a lower price with a self-performing vendor, but they will have some compromise Self-performing vendors may not always be able to guarantee the best technician for every service. To search the entire text of this book, type in your search term here and press Enter. IFMA releases benchmark report for facility management Jan. 21, 2019 Report includes FM strategies for organizational agility and change management. For instance, at VA Portland Healthcare System, the committee heard from a panel of tradespeople who worked on a swing shift through the night hours to complete minor renovations and not impact daytime hospital operations. Sustaining the model requires insight and observations relevant to the success of the VHA mission and thus can and should be inclusive of key staff input. Leadership commitment is especially important to sustain the model in order to preserve its relevancy and acknowledge the importance of the facility engineering staff to the overall VHA mission. A TRAINING MANUAL . Results of root cause analysis of any facility failures and adverse facility events that occurred that year. Facilities management is what we sometimes call “infinity work” – it never ends. They must respond to requests for information from HQ that require data pulls and analyses, which may not be done consistently across VAMCs or even between staff members at the same VAMC. The baseline is the level of staff that the least infrastructure intensive medical center would require. Coordinating with multiple staffing agencies is error-prone and inefficient. The SME task force must be methodical and comprehensive in its documentation of the model design. It also illuminates the need to address related processes for further study—some that may require additional investment and some that are a matter of expanding existing business practices at no additional cost. If staffing continues to be a challenge, defer other lower priority functions. These steps begin to flow into a continuous cycle synchronized with the organization’s budget cycle. Ideally, the Facilities Management (Engineering) Staffing Model can help medical center directors adequately address risks to timely, safe health-care delivery based on the unique infrastructure requirements of their medical centers. Facility operations staff addresses management, building operations, and engineering and administrative support. The vast changes coming forward from the merger of many DoD medical services under a Defense Health Agency (DHA) umbrella, where they will be streamlined and consolidated, has the potential to impact the veteran population across the country. Once again, the variations are explained in part by the different ways that the facilities are used and the different expectations that organizations have for their facilities. For grounds care, the median is 30,000 acres per FTE; 82 percent said they used outsourcing for to handle grounds care. If HR will only support performance objectives with 90 percent compliance as sufficient to meet—or exceed—the standard, clearly this creates a policy-driven problem for the chief engineer to mitigate. In many cases, these programs have been limited to plant operations, which are segregated as an individual support service and function in a silo environment. Because the model provides insight into the unique infrastructure attributes at the individual medical center, it becomes a powerful tool for each director to manage risk as he or she makes staffing level decisions for his or her Facilities Management (Engineering) department. Predecisional involvement may include the task force of Facilities Management (Engineering) consulting with the union(s) during model development. Operations and maintenance typically includes the day-to-day activities necessary for the building/built structurei, its systems and equipment, and occupants/users to perform their intended fu… RECOMMENDATION 5.4: The Veterans Health Administration subject-matter expert task force should document areas of data quality gaps, enhancements, or suggested corrections; observations for potential Facilities Management (Engineering) performance-level standards and associated key performance indicators; and potential policy gaps. 4 VHA Facilities Management (Engineering) Staffing Methodology. Most states define standards or requirements for non-custody positions such as Facility CAO in department policy. Consequences of “never events” are not equal across all customer bases and across VHA missions. A description of the staffing model chosen for a 30-bed skilled nursing facility or acute inpatient unit 2. Last, all stakeholders should be able to see the logic behind the thresholds for each parameter and the logic or justification for the staffing variances for each threshold of each parameter. Note that the first review of the model is suggested in the first year of implementation and labeled as an “initial” review. These challenges should not be seen as roadblocks to progress on the initial model. and Support (OCAMES) (Broskey, 2018, 2019). This could also achieve efficiencies by acting as a strategic sourcing of a best in class type of capability (e.g., roofing or HVAC repair). It will follow with a discussion of resources, to include leadership engagement—necessary to implement and sustain the model—as well as a summary of sustainment considerations to support a recurring update of the model. Facility management organizations across the U.S. are adjusting their staffing models to address major shifts that have occurred over the past 10 years in occupancies, facility asset strategies, corporate financial objectives, and the retirement of experienced The baseline, parameters, thresholds, and variances should be annotated in a transparent manner that facilitates clear review and coordination during development to ensure that the design is robust and the logic is sound. The risk associated, TABLE 5.1 Notional Implementation Process and Sustainment Cycle. It also includes closer coordination with DHA to stay apprised of developments in its care strategy that will impact patient load and service delivery to the veteran population and thus demand facility considerations on the VHA side. Successful change management is more likely to occur if the following steps are included: RECOMMENDATION 5.8: The Veterans Health Administration (VHA) leadership at the Deputy Under Secretary for Health for Operations and Management should actively supports the design, implementation, and sustainment of the VHA Facilities Management (Engineering) Staffing Model, including a deliberate annual review of the VHA Facilities Management (Engineering) Staffing Model. Until such levels are provided, the task force will need to articulate a set of working definitions of performance levels to guide their work and to foster transparency in how the estimates were derived (see, VHA may have potential gaps or conflicts in policy that need to be resolved or clarified. Change management is discussed in more detail later in this chapter because of its critical importance to the entire effort. The Facilities Management Department currently employs 125 trades staff and supervisors to maintain approximately 180 facilities. It is also important to recognize and address the potential risks associated with capturing, analyzing, and interpreting big data. The important factors in determining staffing levels are coverage requirements (e.g., weekday only, 24/7), emergency response requirements, NUR621 Week 7 Assignment: Select an appropriate staffing model for a 30-bed skilled nursing facility or acute inpatient unit.. ORDER CUSTOMIZED SOLUTION PAPERS – Assignment: Select an appropriate staffing model for a 30-bed skilled nursing facility or acute inpatient unit. Adia’s technology reduces no-shows by 50% compared to traditional staffing, and gives businesses the … Facility management organizations across the U.S. are adjusting their staffing models to address major shifts that have occurred over the past 10 years in occupancies, facility asset… Treatment for cancer patients in an outpatient setting is diverse and complex in their clinical presentations, with increased acuity influenced by comorbidities such as diabetes and heart disease. RECOMMENDATION 5.9: After the model is through the design and validation phase, the Veterans Health Administration should issue a policy for implementation and sustainment of the model, including the annual review. © 2021 National Academy of Sciences. National survey provides benchmarks for FTEs per square foot. It may se… Healthcare facilities must be prepared for potential staffing shortages and have plans and processes in place to mitigate these, including communicating with HCP about actions the facility is … A strategic infrastructure investment strategy should consider the following issues (including, but not limited to): The output of an infrastructure investment strategy could also be a key factor in the annual review of the VHA Facilities Management (Engineering) Staffing Model in the context of how it may inform, with longer lead time. All stakeholders should be able to see and understand the logic and justification. With Staffing Considerations for Special Populations. The approach would have VHA identify a task force of experienced VHA Facilities Management (Engineering) SMEs in each of the three functions (Engineering Administration, Operations and Maintenance, and Capital Projects) to develop the fundamental workload estimates that underlie. RECOMMENDATION 5.7: The Veterans Health Administration (VHA) should conduct a review of facility workforce funding that is modeled by the VHA Facilities Management (Engineering) Staffing Model to identify potential issues such as hire lag or funds migration in the process (1) identified at the individual Veterans Administration Medical Center (VAMC) level and aggregated to the VHA Headquarter level; (2) requested by VHA Headquarters to Congress; (3) appropriated by Congress; (4) distributed by VHA Headquarters to the Veterans Integrated Services Network (VISN); (5) distributed by the VISN to the VAMC; and (6) executed by VAMC. Therefore, 100 percent HVAC preventive maintenance by engineering staff is required. Of note, the VHA Engineering Staffing Model output differs from that of the Facility Complexity Model. VHA could consider a long-term strategic infrastructure investment strategy that, unlike the current SCIP process, incorporates strategic initiatives. As such, the medical center director is the logical leadership champion to provide positive emphasis to the model effort and consistent communication to the workforce on each step. U.S. Department of Justice National Institute of Corrections 320 First Street, NW Washington, DC 20534 . organizational models, it took a group of FM subject matter experts and two research professionals several months and multiple iterations to create. It is the committee’s view that a well-developed model will contribute to the decision process, not replace the judgment of experienced professionals. The conventional wisdom is that staffing models are all about the numbers. By the tenth month of Phase 3, the entity will provide a series of briefings to the appropriate stakeholders and leadership in an appropriate order, incorporating feedback after each session (e.g., the SME task force; the CEFAC; the model sponsor; the medical center directors and chief engineers by VISN). In addition, VHA has opened outpatient clinics and established telemedicine and other services to accommodate a diverse veteran population and continues to cultivate ongoing medical research and innovation. The better the data, the more equipped leaders at every level will be for decision-making. Another concept worthy of consideration for application VHA-wide would be to assess where a low-density, specialized skill could be located centrally in a geographic area and support the VAMCs in that region within a reasonable commute. 4 step process of understanding the situation, facilities, conditions, and expectations, analyzing the needs and changes required, planning, and then executing an approved plan will be explained. These decisions are impacted by a myriad of considerations, often local, which include availability of talent for hire, access to contract options, and risk the facility is willing to accept based on competing demands. The Cost worksheet tables allow you to modify costs as they change without modifying any … BeLinda P. Watson . VHA should consider union involvement, both timing and extent, to ensure smooth implementation of the staffing methodology and any resultant staffing model. Due primarily to organic growth or mergers and acquisitions, healthcare systems often find themselves managing their facilities in a bifurcated manner, with individual hospitals operating more or … For example operating room suites are a crucial element of hospitals. Last, it will offer areas for further study on issues the committee believes could impact the VHA Facilities Management (Engineering) staff, and thus the model, in the near future. OBJECTIVES 1. Typically, change management strategies employ a structured approach to ensure that changes are implemented smoothly and successfully to achieve lasting benefits. • A description of the quality metrics and other data that was used to determine the most appropriate staffing model. The report is a comprehensive analysis of the most recent operations … Staffing is performed by all managers . Implementation and sustainment of the model will require continued emphasis to maintain momentum on this effort. The numbers are only part of the answer. You're looking at OpenBook, NAP.edu's online reading room since 1999. Le Groupe Derichebourg, spécialiste des prestations de services aux entreprises et aux collectivités, a retenu HR Access, expert des services d’externalisation RH et Paie, pour la gestion globale de son nouveau Système d’Information en Ressources Humaines (SIRH). This equates to a staffing … It may be helpful to have human resources support and advice on the communications to ensure that appropriate information is included to answer anticipated personnel action questions. The National Academies of Sciences, Engineering, and Medicine, Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future, Permanent Chief Engineer Facility Advisory Council, Phase 1: Design of “Initial Model” (12 Months), Phase 2: Coordinated Verification of Initial Model (6 Months), Phase 3: Coordinated Working Model Independent Entity Verification (12 Months) and Validation, IMPLEMENTATION PROCESS AND SUSTAINMENT CYCLE, Organizational Support and Leadership Commitment, Synchronizing Implementation and Sustainment with the Budget Cycle, VHA Facilities Management (Engineering) Staff Investment, Integration in Strategic and Interdisciplinary Planning, Leveraging Big Data, Machine Learning, and Artificial Intelligence, 1 The Need for a Staffing Methodology for the Veterans Health Administration, 5 Design, Implementation, and Sustainability of the VHA Facilities Management (Engineering) Staffing Model, Appendix A: Committee Meeting and Workshop Agendas, Appendix B: Committee Biographical Information, Appendix C: Nature of Veterans Health Administration Facilities Management (Engineering) Tasks and Staffing, In at least some instances, the task force will likely find that the data for an important parameter (a) are not sufficiently reliable or valid (see, VHA Engineering does not have a clearly defined set of performance-level standards for the provisional SME task force to use as a target for estimating baseline staffing levels or staffing variances. This chapter will address the considerations for a process to design, implement, and sustain the model as it operates in the dynamic context described in the previous chapter. In the end, the model will not provide hard and fast answers to staffing, and the judgment of seasoned professionals will still be required. Insourcing provides that opportunity. Facility staff in many cases must manually enter data into multiple systems (e.g., CAI, CAPRES, and work-order systems), creating an opportunity for human error. The success of the VHA mission to provide an effective environment of care is directly dependent on well-functioning infrastructure and operational facilities. Instead, it should be recognized that the model will be a living tool that is refined during annual review as these challenges get addressed. Chapter 4 described the context in which the Veterans Health Administration (VHA) Facilities Management (Engineering) Staffing Model will operate and a staffing methodology that starts with a baseline and then applies infrastructure complexity parameters to capture the specific factors that impact the three Facilities Management (Engineering) functions defined as in-scope by the study sponsor. when determining the thresholds within the facility parameters. The third-party entity would review all data sources and logic algorithms. It should also consider the emerging factors that could impact those assumptions and estimation procedures, such as programmed facility investment or changes in Joint Commission requirements. Closely monitor potential assumptions, risks, dependencies, costs, cultural issues, and so on that could impact progress toward achieving the vision. To encourage acceptance, it helps when stakeholders’ ideas are incorporated and implemented in the change process. These models leveraged a task force of subject-matter experts (SMEs) in the design of the model. However, a review to compare the amount of funds distributed to the medical center for Facilities Management (Engineering) staff against the amount of funds executed for Facilities Management (Engineering) staff should be conducted. The third party may be an office or a function with VHA or an outside vendor. Once the design phases are complete and VHA leadership is ready to proceed, the implementation may begin. PRISON STAFFING. 3. It would be helpful to assess the analytic approach to the SCIP process to include the data sources, required documentation, transparency, and the link to the agency’s strategic long-term infrastructure investment plan. Creating very sophisticated models is a waste of time if decision makers are not willing to buy into the premises and act on their findings (Motion, 2019; NASEM, 2019e). VHA's building inventory has sites of different ages, and often there is a mix of building size and age at each site or campus. Understanding. The Appraisal of Guidelines for Humidity and temperature control in operating room suites is a mandated quality and patient safety requirement. Auditability of this funding request, appropriation, distribution, and execution is helpful to identify systemic issues such as hire lag or funds migration and provide fundamental insight into the applicability of the model. The chapter emphasizes the importance of sustaining the model and offers a list of suggested items to review on an annual basis as part of that sustainment. The Best Facilities Staffing Agencies The best industrial employment agencies specializing in facilities staffing secured the Best of Staffing award by obtaining at least a 50% Net Promoter® score indicating that they provide exceptionally high levels of service to their facilities … Is facility sustainment increasing sufficiently to match inflation, and does it take into account an appropriate facility degradation factor (. With support from the medical center directors and CEFAC, the SME task force should then use a coordinated review process to have all medical center directors and chief engineers vet the initial model. Shift presence, maintenance, and vendor support are the areas that support … Last, the chapter provides thoughts on areas for further study that could impact the facility operations and Facilities Management (Engineering) staff in the near future. Changes of infrastructure at the medical center level: Unique requirements or new requirements (i.e., traumatic brain injury or post-traumatic stress disorder care), Demographic population shifts (i.e., gynecological care for the growing number of female veterans), Leased status (i.e., community-based outpatient clinic locations and capacities). Changes in strategic plans for hospital missions (i.e., being subsumed by a larger VAMC or experiencing reductions in clinical services offered). Nearly any action that changes the status quo will require resources, whether it be hiring, realigning, contracting, or reducing Facilities Management (Engineering) staff. The Facilities Management (Engineering) staff in the hospital is the critical link to make this happen. This chapter provides a suggested process and timeline for the design, implementation, and sustainment of the VHA Facilities Management (Engineering) Staffing Model. IT Facility Management Services (Technology Staffing) We offer Facility Management Services on Service Level Agreement (SLA) Model, Cost+ and Manpower based support model. For the purposes of this document, the Security Office is defined as a centralized entity within an agency or an organization that has responsibility for security-related activities. This may trigger requirements to inform the appropriate VHA union(s). Implementation of this staffing model will require an investment that should be transparent in both the budget request and the distribution and execution of the appropriated funds. Ultimately, this should help improve Facilities Management (Engineering) operations across VHA and improve the accuracy of the VHA Engineering Staffing Model over time. For example, custodial services can be provided more efficiently, in terms of square feet covered by a single FTE, in a 500,000 square foot high rise than in a K-12 system that offers pre-kindergarten in a variety of small spaces. In the FAA staffing studies (NRC, 2007, 2013), an independent third-party validation was a recommended step in the review and validation of the staffing models. This should include the reasons for the change, the benefits of successful implementation, as well as the details of the change. Discussion is also provided on the need for a strategic infrastructure investment strategy. This creates multiple points for adjusting the model, as needed, based on future reviews. The entity would then run scenarios for all 172 VAMC Facilities Management (Engineering) departments,2 taking care to exclude the functions that are not included in the model. View our suggested citation for this chapter. For example, new construction coming online could impact the outputs of the VHA Engineering Staffing Model, because the workload for Facilities Management (Engineering) staff will be impacted. Big data sources go well beyond spreadsheets and databases to include real-time capture and processing of e-mail, video, chats, and location-tracking information. Throughout this study, the committee was impressed with the judgment of the VHA Facilities Management (Engineering) staff as they made management decisions in a resource-constrained environment. Once the medical center directors receive their funding, it is their decision on how the funds are executed. behind the baseline staffing FTE estimate. A long-term strategic investment strategy may assist VHA with achieving sufficient funding to meet its infrastructure needs. Search Facilities management jobs in Seattle, WA with company ratings & salaries. Adoption of process changes described in the section “Areas for Further Study” later in this chapter. Post-decision involvement may include briefing the union(s) on the resultant model and allowing the union(s) to request impact and implementation negotiations. Staffing models should be reviewed on a regular basis to reflect changes in technology and practice . This process will mirror some of the scenarios likely enacted in Phase 2, but the difference is that the third party has no vested interest in how closely (or not) the model outputs match current Facilities Management (Engineering) staffing levels. • What is your staffing level for custodians in square foot per full time equivalent employees (sq.ft./FTE)? Not a MyNAP member yet? It will then provide a conceptual process and timeline to methodically design and implement the model, with attention paid to the integration of the model into the budget cycle. Health care can be an inherently dangerous endeavor, and patient safety demands as close to perfection as possible from all staff members, including those in administration and VHA Facilities Management (Engineering). Learn more about IFMA … The facility management team to include the PREA Manager will prepare the facility’s staffing plan. Over time as these opportunities are pursued and implemented if appropriate, they may streamline parts of the facility staff workload and help offset areas of the facility mission that may cause an increase in Facilities Management (Engineering) staff. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website. Ready to take your reading offline? To this end, the model should inform the decision maker, not replace them. Define a clear vision that can help stakeholders understand what the organization is trying to achieve within the agreed time frame. The staff variance values will be estimated in terms of FTE employees, and estimated separately for each threshold of each facility parameter for each of the three major functions (Engineering Administration, Operations and Maintenance, and Capital Projects), and possibly even at the level of specific jobs. This is especially important for talent management and retention. Based on the role and responsibilities of OCAMES, it would be logical that this office would continue to be the sponsor and provide oversight and management for all steps of the model. Rather, it could prompt more thinking about the parameters, thresholds, and staffing variances to ensure that the SME task force can explain how and why they believe their work is on target. IFMA is the world's largest and most widely recognized international association for facility management professionals, supporting over 23,000 members in more than 10 0 countries. This forum could be referred to as the Chief Engineer Facility Advisory Council (CEFAC), and VHA should consider convening the CEFAC on a recurring basis, potentially quarterly. manpower analyses. personnel management is to develop a staffing model which is specific to the facility systems, business functions, and operational mandates of the organization. The design process includes phases with an associated time frame, as depicted in Figure 5.2. facility management, i.e. The facilities manager … Property & Facilities Management staffing Your employees require a unique intersection of hard and soft skills to succeed in their roles. The Federal Property Management Reform Act of 2016 requires federal agencies to perform workforce projections to assess the property-related requirements of the federal workforce. To help facility managers zero in on practices of comparable buildings, this report breaks down the responses by ten different types of facilities: owner-occupied commercial office, multitenant commercial office, higher education, K-12 systems, health care, hospitality, federal government, state government, municipal government, and retail. The task force should provide this information to the Chief Engineer Facility Advisory Council and the model sponsor for their review, guidance, and action as appropriate. Although the numbers generated by the staffing model justify and quantify, the actual staffing plan each medical center director approves will ultimately be a balance of risk versus resources as he or she apply his or her expert management judgment to the model output. Ocames ) ( Broskey, 2018, 2019 Report includes FM strategies for organizational agility and change.... Of change management is discussed in more detail later in this Report have! 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