CROSS-SECTOR COMMUNICATION
Overcoming key barriers to EFM knowledge-sharing
Best practice and know-how are often hard to share effectively among NHS EFM departments – due both to organisational, social, and political barriers, and a lack of an effective overarching strategy for knowledge dissemination. A team from the University of Cambridge Engineering Design Centre (EDC) and Institute for Manufacturing (IfM) is investigating how best to overcome these barriers and enable effective knowledge flows among such professionals. Carl-Magnus von Behr, a PhD researcher at the Institute for Manufacturing (IfM), Professor Tim Minshall, the inaugural Dr John C Taylor Professor of Innovation at the University, and head of the Institute for Manufacturing and its Centre for Technology Management (CTM), and John Clarkson, Professor of Engineering Design, present the first results from the initial research stages.
Hospitals are in a state of continuous flux and change as a result of a variety of influences – ranging from chronic stresses such as demographic changes, new care models, and a ‘Net Zero’ carbon target by 2040, to various adverse events. These pressures are forcing such healthcare facilities to operate resource-efficiently while preserving resilience against adverse events. In Health Building Note (HBN) 00-07, the NHS defines resilience as ‘the ability of an organisation to adapt and respond to disruptions, whether internal or external, to deliver organisationally agreed critical activities’.1 Although there is no universal definition of resilience in academic literature, most researchers emphasise the need for ‘diverse capacities of a healthcare system that allow it to maintain the delivery of high-quality care during and after events that challenge, change, or disrupt its activities, by engaging people in collaborative and coordinated processes that adapt, enhance, or reorganise system functioning in response to those events’.2
Characteristics resilient NHS EFM services need in the face of change Due to the special nature of hospitals, EFM departments in such facilities are required to be resilient ‘24/7’ to support high-quality and safe care delivery. As a result, any changes – regardless of whether they are expected or unexpected – caused by internal stresses or external shocks need to be addressed and managed effectively. Unprecedented challenges due to the COVID-19 pandemic uncovered hitherto unknown capacity limits – as seen with the medical oxygen infrastructure at various NHS Trusts, necessitating process adaptations which challenged the resilience of both the workforce and infrastructure. At the same time, the ‘Net Zero’ and broader greener NHS agenda have created significant
Faced challenges
Ageing population Maintenance backlog New models of care Net-zero CO2
target
Natural disasters Man-made disasters
Adverse events
Sustainability Goals
Chronic stresses
Resilience
Figure 1: Resilience and sustainability as goals for NHS EFM departments to mitigate and adapt to chronic stresses and adverse events.
challenges, since some current engineering solutions towards resilient healthcare estates conflict with environmental sustainability ambitions.3 Against this backdrop, IHEEM proclaims the requirement for ‘healthcare engineers and academics worldwide to collectively work together, share best practices and develop new innovative solutions’.3 Similarly, recent research on organisational resilience highlights the crucial role of organisations’ knowledge base to implement the socio-technical interventions required for the optimised design and usage of healthcare estates coping with unexpected and threatening challenges in a resilient manner.4
Actively fostering collective knowledge
The importance of actively fostering a collective knowledge base became apparent during the early waves of the COVID-19 pandemic, when the lack of shared knowledge among NHS EFM departments ‘limited Trusts’ ability to effectively respond to MGPS patient safety concerns’.5
During the first wave of COVID-
19, a project – which involved collaboration between the IfM (a division of the University of Cambridge’s Department of Engineering) and the Cambridge University Hospitals NHS Foundation Trust – analysed the oxygen supply at the city’s Addenbrooke’s Hospital in response to the pandemic, and produced a significant amount of know-how and best practice (summarised in an article on pages 45-48 in the January 2021 of HEJ).
However, observing the slow spread of such findings across the NHS Trust landscape, and the subsequent concerns related to sufficient oxygen provision ‘in at least a dozen NHS Trusts’,5
raises
serious questions about the effectiveness of inter-organisational knowledge flows in the NHS. Since the ‘Net Zero’ ambitions require the NHS EFM community to ‘collectively work together [and] share best practices’,3
the process of
knowledge-sharing – which is defined as the ‘process of transference of experience and organisational knowledge to business processes through communication channels between individuals’,6 significant improvement.
– needs November 2021 Health Estate Journal 57
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