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This research aims to investigate the implementation of the new ward housekeeper role in a hospital setting. The purpose is to propose a model to demonstrate how facilities management (FM) departments and clinical ward teams work together effectively to deliver catering and cleaning services.

The context of the implementation of the role was deemed a necessary feature, particularly to understand the organisational structures. In this case, the context was a hospital, and the underlying mechanisms that were in place included local recruitment and retention issues. Therefore, an interpretive approach was taken, and a series of semi-structured interviews was the primary method to collect data, supplemented by some non-participant observation and document analysis.

The findings from the two themes enable the development of a model to illustrate the working relationships between FM departments and clinical ward teams.

The findings from the study are of significance for hospital facilities and estates departments and clinical stakeholders who have the responsibility of ward catering, cleaning and the environment.

The significance of this study emerges through the advancement of methodology within the context of facilities in health care and through the contribution to knowledge and practice as a result of the proposed mode. This was the first type of study to look in detail at ward housekeeping models, using an interpretive approach over a relatively long period of time.

In 2000, a national initiative “Enhancing the Healing Environment” (EHE) was launched by the King's Fund to celebrate the millennium. This aimed to support nurse‐led teams to undertake an environment improvement programme in their National Health Service (NHS) hospital. Sheffield Care Trust (SCT) decided to carry out this project in its intensive treatment suite, a psychiatric intensive care unit (PICU) providing care for up to six patients. There were no known examples of an EHE project being undertaken in a PICU elsewhere in the NHS. The purpose of this paper is to examine the impact of EHE design principles in improving the patient experience, from the perspectives of staff and patients.

A focus group and individual interviews were used as the primary method of data collection. Secondary data comprised sets of statistics related to pre‐ and post‐refurbishment periods.

It was found that staff and patients liked many aspects of the changed environment. Staff felt improved openness of space, natural light, fresh air, reduced noise levels and greater choice of spaces to provide care, were most important. Patients cited a high quality, comfortable and homely environment (not like a typical NHS ward) as important; they also valued high standards of cleanliness, tidiness, choice and being able to view the outside, open windows and let in fresh air. Experiencing high quality clinical care was equally important. Incidence of physical assaults decreased markedly in the new environment.

NHS mental health services trusts will understand the benefits of applying EHE principles in PICUs or similar environments. Some project management shortcomings are identified and improvements suggested.

This paper is of value to NHS mental health trusts which need to decide on the effectiveness of different design principles for PICUs or similar environments.

If NHS hospitals wish to influence patients to choose them and, as the literature review suggests, cleanliness will be a key‐influencing factor in making that choice, it would seem important for hospitals to understand what factors lead people to decide whether a hospital is clean or dirty. The research aims to identify what the key factors are that influence patients' perceptions of cleanliness and to rank these factors in order of importance.

The project utilised a mixed methodology to collect the data. The hospital staff and people who had been recent patients took part in focus groups in order to gather their views. The current hospital in‐patients were surveyed through the use of a paper questionnaire.

The main themes that influence the perceptions of cleanliness emerging from the analysis can be summarised under three broad headings – appearance of the environment, physical cleanliness and staff behaviour. The findings suggest that this subject is much more complex than the production of a list. The appearance of the environment is a complex set of perceptions based on what individuals believe to be important, what they observe and what they expect. The research suggests that the appearance of the environment is the most important factor.

The paper starts to explore the factors that influence patient perception of cleanliness and provides practical information to NHS estates and facilities managers.

The purpose of this paper is to investigate the possible common factors in 15 Acute Hospital Trusts in the UK that achieved excellent scores at all their sites in four years of national Patient Environment audits.

A desk‐based study tested for external factors, organisational commonalities or particular contractual arrangements which the sample might have in common. A second piece of work was then undertaken; an ethnographic study that examined the behaviours exhibited by 22 managers in six of the trusts. The second phase of research will be described in a separate paper.

The research found that no external, organisational or contractual commonalities could be identified as shared by the trusts that formed the Research Group. This led the researchers to ask further questions as to the management/leadership of the FM Managers who had achieved consistantly high standards of Patient Environment over the four year period.

The research reveals that the trusts which achieved high standards of Patient Environment had no shared advantage in terms of external, organisational or contract characteristics. Thus, it should be possible for all trusts to achieve consistently high standards.

This is believed to be the only study looking at influences and characteristics that are outside the FM Managers' control and impact on the FMs' ability to deliver consistantly high standards.

The purpose of this paper is to describe research which investigated the interdependencies between facility management performance and costs, and primary processes in hospitals. Through the implementation of the German diagnosis related grouping (DRG) system and the resulting cost pressure, the need for optimized use and operation of the spatial resources in hospitals is growing. In the DRG system, the provision of ready to use infrastructure is treated as a fixed cost and is allocated to patient cases by a single cost driver. In reality, very different services are needed to provide ready to use functional space.

A primary activity based cost model for facility management (FM) services in relation to functional space units in the hospital is developed. Using process and cost data of an empiric research study from four German hospitals, a model is developed for a key functional space unit in the hospital, the operation unit. The relevant FM services structured by a product‐oriented approach are determined by real data. For these services, process figures are derived and implemented in a basic cost estimation model. The cost estimation model is compared to the cost approach of the DRG system.

In an explorative study, the model provides an approach for a patient focused cost allocation of FM services for the operation unit. Depending on the time spectrum of operations great differences between this approach and the legal cost allocation approached in Germany can be determined. One way for hospitals to face the consequences may be the determination and optimization of relevant FM services according to a primary process portfolio.

The activity based cost model should be developed for further space units in the hospital. Thus, a holistic approach to FM and strategic planning of space and FM services could be achieved. Further, the explorative study should be enlarged to a greater database for the development of general key figures for FM in relation to the primary processes.

The model can be used by hospitals for strategic planning of the FM costs and services in relation to the capacity and utilization of the operation unit. The impact of changes of the primary performance portfolio on the utilization of corresponding infrastructure can be simulated. Thus, cost data can be made available to support strategic decisions.

There is no existing cost model for the hospital considering FM in a holistic way in relation to the primary processes.

The purpose of this paper is to discuss the current state of FM preparedness required to deal with the risks to healthcare delivery posed by climate change‐related extreme weather events.

Selected stakeholders were invited to participate in targeted focus groups that, using the ROMS methodology, explored the status of current knowledge and preparedness of the NSW health system to deal with the expected demands imposed by increasing incidences of extreme weather events. Findings are summarised and discussed in terms of the key stakeholder objectives identified. Further areas of required research are then discussed.

The key objectives of the stakeholders were readily agreed, however a lack of information regarding the quantifiable impacts forecast to be associated with climate change constrained the development of other than generic strategies for dealing with these impacts. Further areas of research included assessment of changing demand for health services, likely physical impacts on facilities and their adequacy in coping with these, implementation strategies for augmenting coping capacity and associated costs, plus the need for integrating disaster planning and management strategies to ensure the continuity of operation of health facilities during extreme weather events.

The paper outlines the status of current knowledge regarding the likely impact of climate change‐related extreme weather events on healthcare infrastructure. It explores key issues and determines where future work should be undertaken to ensure that rigorous FM responses are available to cope with a clear and identified threat to the health of the Australian, and similar communities.

The purpose of this paper is to provide an exploratory look at facilities and estates management help desks in four different case study organisations.

A case study methodology was adopted, with semi‐structured interviews and observations as the principal methods to collect data.

The findings suggest that the key factors for the success of a facilities management (FM) help desk include mapping out all customer requirements, recruiting the correct operating staff, ensuring an appropriate working environment and client communication once the help desk is operational.

At the time of the study there had been relatively little research completed focusing specifically on FM help desks. The paper will be of value to facilities and property managers who are considering implementing a help desk service.

The purpose of this paper is to identify and investigate the contribution made from the estates services to the quality of the patient experience from the perspective of all estates staff ranging from front‐line staff to directors of estates and facilities. The work is exploratory in nature owing to no known earlier studies in this area.

A postal questionnaire is distributed to a non‐random self‐selecting group of National Health Service (NHS) estates staff – therefore those staff working in the areas of maintenance, engineering, building, gardening and general office estates management. A total of 920 questionnaires are distributed to the 46 NHS trusts. There are 202 responses, which is a return rate of 22 per cent.

It is clear that overall estates staff consider their job/service to be important to the patient experience, 94 per cent of respondents indicate they did. This is further confirmed by 82 per cent of estates line managers considering their job to be important to the patient experience. In terms of how estates feel they contribute to the patient experience, there is a range of responses, however the main reason highlighted is the recognition that the hospital could not function without the service being provided, i.e. the maintenance of essential services, water, power and the general infrastructure. Estates departments perhaps need on patient awareness of the services they provide and the importance of them in making the hospital function.

The results presented provide a useful insight into how estates departments in the NHS perceive their contribution to the patient experience. However, they are not without limitations. First, the sample size is relatively small; and second non‐random sampling techniques are used.

The findings suggest a number of avenues for future work. The most obvious would be to investigate the level of awareness from patients regarding estates services in the NHS.