TECHNICAL GOVERNANCE
Table 1. Building and facility maintenance management. Function
organisation 1
Parameter Parameter 1
2
Requirement Extension Buildings Surveyor Electrical Mechanical Civil ‘S’ with beds )
(m2 First level: Small hospital
Second level: I and II level complexity
detached buildings
Third level: I and II level complexity Large hospital Over One or
(>25) Single
Under building
with multiple 50,000 More than 4 buildings
a building Under One or
Large structure 200,000 more single or with
4 buildings 7 7 6 24 1 1 1 3 6 6 3 19 2 4 4 3 Electrical Mechanical Civil
engineer engineer engineer/ architect
TOT engineer engineer engineer/ TOT architect
13
Technical assistant
Executive directors
4+ buildings 50
8+ 50
8+ 50
4+ 50
24+
complex that 200,000 more 2*(S-200)/ 2*(S-200)/ 2*(S-200)/ 2*(S-200)/ 8*(S-200)/ manages several
50
principals, polyclinics
regulatory contents of technical competence with regard to anti-seismic protection, fire prevention, gradual energy-environmental sustainability in terms of reducing energy consumption, periodic control for environments that house emergency areas, operating compartments, intensive care and nuclear medicine, periodic monitoring of the state of efficiency and safety of the facilities, and periodic control of the compliance of building works. Coordination of these activities increasingly requires high competence in project management techniques.
In particular with regard to hospital and healthcare facilities:
“The organisation takes care of the suitability for use of the facilities and the timely application of the regulations concerning the maintenance of facilities and equipment, and it is good practice that evidence is given the contribution of the staff in the management of these facilities.” To meet this criterion, each region and local management will have to document the requirements in its governance system that highlight: l The fitness for use of facilities and installations.
l The management and maintenance of equipment.
The overriding objective of this requirement is to ensure that the healthcare organisation is able to offer its patients, staff, and visitors a safe facility. In order to achieve this, it is necessary to manage the structure, have facilities to reduce, control and prevent risks, and maintain adequate safety conditions.
IFHE DIGEST 2024 All organisations, regardless of their
size and specificity, are required to organise technical governance structures for the efficient and safe maintenance of buildings, facilities, and equipment. In Italy, responsibility for health
organisation lies with the regions, and determining common guidelines would allow for uniformity in technical areas as well. The strategic objective of the work carried out by S.I.A.I.S. – The Italian Society of Architecture and Engineering for Healthcare – is to identify programming recommendations/ guidelines that define a health authority ‘organisational model’ of a technical nature, so as to make the technical function a moment of excellence, an element of wealth and generation of value for the health authority or hospital and for the professionals involved. In compliance with the indications of the guidelines, each health authority or hospital can identify, taking into account its specific characteristics (size of the organisation, presence of a territorial catchment area, complexity of the technological level, etc.), the most suitable organisational model to meet its needs, consistently providing for the sizing of the organisational units. Moreover, the actions for the
enhancement of technical governance must be consistent with the general strategy for the estate property modernization of the National Health Service (SSN) which places the needs of citizens-users at the centre of planning and management and recognises the role and responsibility of professional resources in promoting quality.
Strengthening, integrating, and coordinating professional resources The hospital building presents itself as a container of high technical and technological complexity, whose rationalisation and integration is an increasingly pressing need and whose level of structural and organisational flexibility must be maximised. In addition to the primary need to
strengthen technical professional skills, in order to encompass all the necessary specialities, and to integrate their activities, there is also the need to coordinate the responses and develop the proposals that professionals in the technical areas can provide. This can be done with respect to strategic orientations and operational needs, through a constant dialogue, first and foremost with the medical, health, and nursing components. Within this framework, new
organisational models have been developed, which allow: l The optimal use of the professional resources available in the workforce and the enhancement of skills, in order to have all the professional skills needed to an extent appropriate to the complexity of technical management in healthcare.
l The integrated management of technical and technical-managerial services, in order to improve their results in terms of safety, efficiency and cost-effectiveness.
l The assignment of levels of responsibility and autonomy commensurate with the role played by the technical component in the operation of the companies.
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