TECHNICAL GOVERNANCE
Table 4. Procedures and adminstrative staff. Function
organisation 4
Parameter Parameter 1
2 Requirement Extension Buildings (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 complex that 200,000 more manages several
principals, polyclinics
up of a number of human resources that meet the minimum requirements set out in the following tables. The tool illustrated below makes it
possible to dimension in sufficient detail, from a few input data related to the size and complexity of the activities carried out, the consistency of the human resources to be dedicated to the technical services area. The consistency resulting from the application of this method is able to meet all the organisational needs of the technical area. Each ‘function’ represents a specific
macro-activity of a technical nature of the hospital structure: the maintenance of the value of building and plant engineering works, the ability to coordinate and draw up studies and designs for new realisations, the necessary administrative legal support, and the possibility of making use of further functions that meet specific legal requirements. Each hospital and healthcare
organisation will then be able to activate, according to its own needs, one or more functions with internal resources and delegate the other functions to third parties. This method of calculation offers a
criterion for determining the minimum number of staff in the technical area for the optimum management of the property assets.
A first level of differentiation is evident
in the following requirements: l Managed assets >50,000 m2 or more buildings).
l Managed assets >200,000 m2 one or more buildings).
(with one (with
l Complexity: I and II level complexity (DEA).
52
Building and facility maintenance management – see Table 1 Maintenance management activities require technicians (experts, surveyors, engineers) dedicated to the coordination of workers, design, execution, and administrative procedures aimed at managing interventions to keep buildings in good condition and, above all, hospital installations in good working order. The organisation may envisage providing an on-call service for up to 12 continuous hours from Monday to Saturday (e.g. from 8.00 am to 8.00 pm) and a standby service for the remaining 12 hours. On-call service is intended for the coordination of workers (and/or external companies) during work performed on a stand-by basis outside normal working hours. The number of technicians, in
accordance with the provisions of the national collective labour agreement (CCNL) for personnel in the SSN sector, is sized to cover on-call shifts with a minimum of one technician per shift for low-complexity facilities and up to 50,000 m2
, and two technicians per shift
in other cases. In high-category facilities, there will also be managers competent in the various specialisations (construction, electrical, mechanical) and among these the coordinator in charge of the function will also be identified. This function, in addition to the in-house
core of technicians, may also provide for a pool of operational workers with different specialisations: electricians, plumbers, construction workers, refrigeration technicians, heating plumbers, lift operators, medical gas maintenance workers, gardeners, etc. The number of
operators will be increased in relation to the size of the real estate to be managed. Although the trend over the last thirty
years has been to outsource management and maintenance activities, it is still possible to find some situations with technical operators employed directly by healthcare organisations.
Investments: development, programming, design, and execution – see Table 2 The size of the human resources required to deal with programming activities, studies, the drafting of projects (technical and economic feasibility and executive), the management of works, and testing for investments is also determined in this case by the type and complexity of the assets under management. Within this core group of people, project managers (RUP), contract execution managers (DEC), construction managers (DL), testers, etc. must be included. The professionals in the team must also manage the external contracting of architectural and engineering services and coordinate processes that start with the analysis of needs and materialise with ideas that must be implemented and made operational very often in functioning hospitals that must continue to guarantee patient care with the highest degree of safety. Operationally, the application of the proposed criterion acquires a multidisciplinary ‘public works management office’ capable of dealing with every aspect of the development of an intervention, or the availability of a team of professionals capable of following the executive part of the planned work and its acceptance.
IFHE DIGEST 2024
(>25) Single
Billing/ Tenders
‘S’ with beds liquidations )
Under building
with multiple 50,000 More than buildings
a building Under One or
Large structure 200,000 more single or with
2 buildings 2 2 1 3 1 11 1 2 Data entry/ 1
Secretariat/ personnel
1
Collaborator Director tenders and
transparency management contracts 1 6
Grand total
Administrative assistants and collaborators
2 buildings
2
3
1
5
1
14
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