Buildings’ impact on effective hospital services
Authors: Støre-Valen Marit , Kathrine Larssen Anne , Bjørberg Svein 
Published: July 2014

Purpose
– The purpose of this paper is to assess the status of the physical assets of Norwegian hospital facilities in terms of technical condition, building performance, usability and adaptability, thereby comprehending the main challenges for property management as part of facilities management (FM) within hospitals of the Norwegian Specialist Health-Care Services and permitting a discussion on a more strategic property management role.

Design/methodology/approach
– The research is based on an action research approach using data collection from surveys, schemes and questionnaires, literature studies, documentation analysis and workshops with an active research team involvement with stakeholders. In-depth interviews were undertaken with owner representatives, property management representatives and health-care deliverers, and a GAP analysis allowed a study of the quality of property management (as part of the FM).

Findings
– A severe technical backlog was documented together with a strong demand for structural upgrading, which was roughly estimated to be approximately 30-35 billion NOK in 2012 (3.75-4.4 billion euros). Improvements are necessary in all areas of FM delivery within limited economic frameworks, even though several examples of good property management (as part of FM delivery) were found. A gap exists between the general strategy concerning hospital assets and the property management role, particularly with regard to the translation of change in user needs into changed facilities. A need for an increasing professionalization of the role is pressing, turning attention from operational costs and control to potential added value. This requires a shift of focus from the property manager in order to implement visions and goals for the health-care sector, which involves several actions such as an improved communication between stakeholders and technically improved skills, thus ensuring the recruitment and capability of property management staff and improved measurement processes.

Practical implications
– This paper give two major recommendations: first, a stronger integration of the property management role as part of the FM delivery with the executive management of the Health Authorities and Regional and Local Health Trusts; and second, a nationally coordinated strategy for the development of property management in the Specialist Health-Care Services (called Strategic FM). The authors believe that developing a pool of competencies at the national level is necessary to develop the tools, methods and standardized measurements to enable a change in the use of the terms of added value and sustainability. Ultimately, this will enhance the assets of the health sector, and this paper suggests a model that allows for this development.

Originality/value
– This paper shows a model for property management as a strategic role in a holistic process involving all stakeholders from both the bottom up and the top down. The authors believe this process will engage the stakeholders in agreeing upon a clear vision and set of goals for the health-care service assets.