EFM KNOWLEDGE AND KNOWLEDGE-SHARING


Delphi Design Study protocol & questionnaire design


Collation of


suggestions through qualitative analysis


8 statements


Review & approval through NHS HRA


Round 1


340 suggestions (129 participants)


Round 2 70 statements (124 participants)


Pilot study


Test with researchers (10 participants)


Refinement of questionnaire using pilot feedback


Round 3 15 statements (101 participants)


without consensus


7 statements with consensus


62 statements with consensus


8 statements without consensus


7 new statements suggested


Final List


69 statements with consensus


Preparatory stage


Round 1


of EFM prioritise financial management, affecting technology adoption and reliance on legacy systems. The insights gained from the research highlight the importance of aligning organisational structures with evolving knowledge demands, and designing targeted training programmes for effective healthcare EFM management.


Financial constraints and a sizeable backlog The critical role of EFM in enabling clinical services to be delivered effectively cannot be overstated. However, tasked with managing over 1,200 hospitals and 3,000 treatment facilities,1


Round 2 Figure 2: Flow chart of customised Delphi-technique across three rounds.


effective collaboration depends on various factors, including the organisational and cultural environment, and requires careful orchestration to foster widespread adoption within the organisation. Studies show that there is a lack of knowledge sharing among NHS Trusts’ EFM teams,4,5 affecting communication and patient safety, especially during COVID-19.6 The literature emphasises the need for strategic alignment, resource integration, and effective communication in healthcare EFM operations. There are three overarching


EFM professionals face


not just financial constraints, but also a significant £11.6 bn maintenance backlog and the goal of achieving Net Zero carbon emissions by 2040.2


These challenges


are compounded by workforce issues within EFM – an ageing demographic, high absence rates, and skills gaps.3 Addressing these challenges necessitates leveraging the collective capabilities and skills of the NHS workforce through enhanced collaboration and integration of fragmented services. However, achieving


Category Gender Age


Characteristics Male


Female Non-binary


younger than 35 years 35-44 years 45-54 years


55 years and older Technician (BL2-6) Manager (BL7-8a-b)


Job Level


Head of Estates (BL8c-d) Director of Estates (BL8d-9) Authorising Engineer Acute Trust


Authorising Engineer Combined Trust


Trust Type


Community Health Trust Mental Health Trust Contractors


Other (incl. ICS, CCG)


organisational levels within EFM: (i) directors of EFM at a strategic level – overseeing long-term planning and organisational vision, (ii) heads of EFM and managers at a tactical level – responsible for translating strategies into actionable plans, and (iii) engineers and technicians at an operational management level, focused on the hands-on execution of daily tasks. Each level has unique roles and knowledge requirements, making the flow of precise, coordinated information vital for effective EFM. Knowledge is not just information, but a valuable asset


R1 (n=129) 78% 21% 1%


11%


14% 29% 47% 26% 36% 10% 20% 9%


51% 10% 9%


12% 10% 5% 3%


R2 (n=124) 80% 19% 1% 7%


12% 35% 45% 21% 31% 12% 27% 9%


51% 10% 11% 7% 11% 6% 4%


Table 1: Participant demographics in the Delphi study across three rounds. 46 Health Estate Journal February 2024


R3 (n=101) 78% 21% 1%


6%


10% 33% 51% 14% 35% 11%


27% 14% 45% 12% 12% 10% 12% 7% 3%


that encompasses experience, values, and expert insight into organisational practices.7


Due to the context-dependency


of hospital buildings and operations, it is crucial to differentiate between mere data, and actionable knowledge essential for competent and effective decision- making. In this context, knowledge sharing (KS) goes beyond storing and retrieving information. It is about creating a system where knowledge, especially the tacit kind gained through experience, is shared and applied effectively. While technology plays a role in this process, the human element – the insights and experiences of staff – is crucial within the EFM context.5


As a


result, individual NHS hospitals require the abilities to access and apply knowledge from other hospitals to solve tasks more effectively, efficiently, and economically.8 This involves not just identifying the right type of knowledge to share,7


but


also understanding how it fits into the daily routines of staff, and aligns with the hospital’s goals.


Consider the task’s nature and context of use In developing effective knowledge- sharing systems for NHS EFM, it’s crucial to consider the nature of the task, the context in which knowledge is used, and the individuals involved. This approach ensures that knowledge sharing is not only about transferring information, but also about enhancing the collective expertise within the healthcare environment. There are distinct knowledge areas that are essential for catering to highly regulated healthcare settings. These extend beyond the traditional FM scope due to the critical impact on patient care and safety. In FM literature, there are eight core knowledge areas identified for FM professionals,9 including leadership, people management, and operational know-how. While these also apply to the NHS context, our study aims to extend this set of core knowledge areas to cater for the specific regulatory requirements of hospital EFM. NHS EFM teams navigate critical issues


Round 3 & Results


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