Research Works in Collaboration with CREAM to setup benchmarks on Total Asset Management Programme for hospitals and government building - Formulation of Scope

CREAM will be having a brainstorming session with the team from Unit Kerjasama Awam Swasta (UKAS) Prime Minister's Office (PMO) on 1st December 2011 (Thursday) at UKAS office, Putrajaya. The aim of this collaboration is to develop a benchmarking for Total Asset Management Programme (TAMP) for the hospital and government project under the 11th Malaysian Plan. This project is in line with the implementation of Project Finance Initiative (PFI) currently adopted by the government to carry out the project. Three projects have been identified as a case study namely;
a) Teaching Hospital UIA, Kuantan
b) Child Specialist Hospital, HUKM Cheras, KL
c) MITI Building

Research Workshop on Human Capacity Building in FM

Dear all and FM practitioners,

The above-mentioned workshop was held on 21 November 2011 in Holiday Inn Glenmarie Shah Alam. We have honoured to have distinguished speaker cum facilitator Professor Charles Egbu renown expert in knowledge management from University of Salford, UK. A full day workshop has been delighted with the informative and interactive session with Professor Charles. He highlighted the issues of human capacity building in Malaysia and also some part of the world.

Workshop on FM Implementation Practiced by PPUKM and PPUM

The above workshop has been successfully held in Grand Blue Wave Shah Alam on 21 October 2011. It was attended by more than 20 people and officer from PPUKM and PPUM respectively. The aim of the workshop is to get the detail activities involved with related to FM in PPUKM and PPUM. At the end of workshop, it was came out with a strategic approach of FM implementation practiced by PPUKM and PPUM

Workshop on Designing and Managing the Strategic Facilities Management (FM) Supply Chain: the Malaysian Context

Background of Workshop

This 2^nd series of Workshop on Designing and Managing the Strategic Facilities Management (FM) Supply Chain: the Malaysian Context was successfully held on 2^nd March 2011 at Cyberview Lodge and Spa Resort, Cyberjaya. The workshop was facilitated by FM expert Professor Dr Michael Pitt from University of College London UK and was assisted by Ms Samantha Price, research assistant at University of College London UK. It was attended more than 30 participants from FM practitioners, consultants, government agencies, academia and professional association. 

Introduction to Workshop

The process of procurement within Facilities Management (FM) is primarily one of buying in services through supply chain assembly and management. This role has matured as FM has moved from a simple operational engineering discipline to a strategic management discipline over the last ten years. Today FM is a strategic tool employed to deliver added value to organisations. FM has at its heart the need for an organisation and organisational motives to serve and it is mainly this that differentiates it from the discipline of property and/or estate management.

This workshop will examine the process of supply chain assembly looking at motivational and practical issues involved therein. Throughout the day we will develop a set of strategic supply chain development key areas and will re-examine these in the context of value added through the chain.

Objectives of Workshop

The Construction Research Institute of Malaysia (CREAM) in collaboration with the Faculty of the Built Environment, Universiti Malaya has organised this workshop with the following objectives:-

• To understand the form of the current typical FM supply chain in Malaysia
• To identify issues and challenges in relation to supply chain assembly
• To determine the key characteristics of FM procurement strategies in Malaysia
• To understand how perspectives and value impact upon FM services within the FM supply chain
• To begin to understand how sustainable practices can be incorporated into the supply chain 

Workshop on Performance Measurement in FM

A one-day workshop on Performance Measurement in Malaysian Facilities Management (FM) was successfully held on 26^th January, 2011 at the Concorde Hotel in Shah Alam, Selangor.

Objectives of Workshop

This workshop was facilitated by the invited speaker, Professor Dr. Low Sui Pheng, a well known Professor from the Department of Building, National University of Singapore (NUS). The workshop started with a presentation made by Professor Dr. Low Sui Pheng entitled: “Performance Measurement in Facilities Management: Singapore’s Experience”. The workshop being an exercise in performance measurement, Professor Dr. Low Sui Pheng presented a best practice model based on the Toyota Production System (TPS) which underpins the Lean Production Principles (LPP) which many forward-looking manufacturing organizations have strategically adopted to stay competitive. The LPP have been extended into the building industry and implemented as Lean Construction. The TPS, with four key underpinnings that straddle: (1) Philosophy, (2) Processes, (3) People and Partners, and (4) Problem solving (or the 4 P’s), was adopted as a best practice model in this workshop to benchmark performance measurement in Malaysian Facilities Management

Guided by the 4 P’s, the objectives of the workshop are;

·         To identify current practice in performance measurement in Malaysia,

·         To identify issues and challenges in performance measurement practice in Malaysia,

·         To determine characteristics of performance measurement for all buildings and services,

·         To chart a framework on performance measurement, and

·         To define the process involved in the development of performance measurement.

Study Visit to General Hospital Singapore

Date      : 4^th July 2011 (Monday)

Time      : 10.00 am- 5.00 pm

Introduction

A group of delegation led by Associate Professor Dr. Sr Syahrul Nizam Kamaruzzaman of Faculty of Built Environment Universiti Malaya, programme leader for the research project funded by Construction Research Institute of Malaysia (CREAM) had made a one day research visit to three hospitals in Singapore. The visit is one of the activity in the research project entitled Developing Sustainable Facilities Management : Towards Best Practices.  The members of delegation were included Professor Low Sui Pheng, Department of Building National University of Singapore (NUS), Dr. Sr Adi Irfan Che-Ani from Department of Architecture Universiti Kebangsaan Malaysia (UKM) and Mohd Khairolden Ghani, researcher from CREAM. The purpose of the visit is to learn and get better understanding on the Facility management (FM) practice in hospital in Singapore. The programme of visit is summarized as below;

No.	Time	Venue	Meeting with
1.	10.00 am-11.00 am	Singapore General Hospital (SGH)	Mr. Tan Jack Thian, Group Chief Procurement Officer, SingHealth Mr. Dexter Chia, Director, Operations & Infrastructure Planning SingHealth
2.	2.00 pm – 3.30 pm	Tan Tong Seng Hospital (TTSH)	Mr. Ong Kok Leong, Deputy Director Operations, Tan Tong Seng Hospital Mr. Md Nashir Bin Kadola Senior Engineer, Facilities Engineering TTSH Mr Leo Yuin Thim, Sous Chef TTSH Mr. Frankel Ng, Assistant Manager TTSH Mr. Tay Kok Beng, Senior Production Chef TTSH
3.	4.00 pm -5.00 pm	National University Hospital (NUH)	Mr. Koh Yong Lee, Assist. Director, Operational Support Services NUHS Ms Veronica Mah, Manager Support Services NUHS Mr. Jeffrey Fong, Senior Engineer, Support Services NUHS

Points of Discussions

Visit 1                                   : Singapore General Hospital (SGH)

Service Provider              : Singapore Health Services Pte Ltd (SingHealth)

Singapore Health Services (SingHealth) was established in 2000 as part of the restructuring of the public healthcare clusters. As the largest healthcare group in Singapore, SingHealth offers a complete range of multi-disciplinary and integrated medical care. The group consists of 2 tertiary-level Hospitals, 5 National Specialty Centres and a network of nine Polyclinics. Currently SingHealth is overseeing two hospitals namely Singapore General Hospital (SGH) and KK Women’s and Children Hospital on the maintenance aspect. The SGH started to appoint SingHealth to operational building maintenance to SingHealth after found out the precedent contractor does not perform well and also due to the high cost incurred. The scope of SingHealth in SGH covers maintenance parts such as chillers, cooling towers and so on. While for operation theater, there is special team contractor appointed to look after the building.   Therefore there is need to privatize building maintenance to SingHealth as a team to look after the facilities and building maintenance. In monitoring the maintenance aspect, the company adopted to use Key Performance Indicator (KPI) as a tool to measure in terms of response time and level of customer satisfaction. The company using survey form to measure customer satisfaction while patient survey form used as a measuring for patient satisfaction. The fix-in programme is being introduced by the company to do on site inspection by walking around the building to find the trouble and problem and resolve it quickly at site.

Organisational Culture and Benchmarking

In process of creating awareness and productivity, the company has adopted organizational culture to create friendlier, hospitality with patent and visitors. In 2009, SingHealth introduced a new leadership development programme to provide a common training platform for leaders, and build organizational leadership, retain organisational talent and drive employee performance. The programme arms leaders with common leadership competencies, creates a network and a shared culture that promotes collaboration and improvement. The cultivation of culture among the staff is very difficult to change unless with the continual improvement support by the management. The friendly service culture will reflect to the performance measurement especially for the technical staff. Culture is linking up with the originality of the people and the awareness among themselves. It can not be changed in overnight transformation. The programme is taken from approach done at Changi International Airport. So far, the company not has any benchmarking to position their service up to the certain standard. The reason not to have benchmark themselves, they do not to fight and compete with others that at the end of the day will give bad result of level performance. The service quality will certainly refer back to the contract agreement. They opt to have open discussion among the FM service partners to find the best way to improve their service.

Concluding Remarks from SingHealth

FM should be maintained and operated by core group people to monitor works done by contractor. FM business is really depend on the financially stability and also the people. Good people in FM fraternity will give good and outstanding result in FM. There is require an awareness among people to appreciate and knowing better the function of FM and not perceived FM as basement issues which always hidden somewhere under the underneath building. FM requires a lot of monetary to be allocated for contractor to maintain building well because a lot of challenging issues in handling maintenance in health services.    

Visit 2                                   : Tan Tong Seng Hospital (TTSH)

Service Provider              : Tan Tong Seng Hospital (TTSH)

Tan Tock Seng Hospital (TTSH) is one of Singapore’s largest multi-disciplinary hospitals with more than 160 years of pioneering medical care and development. The hospital has 36 clinical and allied health departments, 15 specialist centres and is powered by more than 6,000 healthcare staff. TTSH sees over 2,000 patients at its specialist clinics and some 460 patients at its emergency department every day. TTSH is part of the National Healthcare Group, providing holistic and integrated patient care. With a strong quality culture steeped in patient safety, TTSH constantly challenges itself to provide faster, better, cheaper and safer care for patients. To achieve this, the hospital keeps abreast and believes in investing in its staff, facilities, medical technology and system improvements. In recognition of its commitment to excellent patient care and its comprehensive range of quality healthcare services, TTSH has been awarded the ISO 9001 certification and the prestigious Joint Commission International (JCI) accreditation.

Hospital Operational

TTSH is also known as pandemic hospital in Singapore if outbreak of pandemic happens. It will act as command centre for pandemic such SARS, H1N1 and so on. The special team has deployed to alert to handle the crisis.  The FM operation in TTSH is through in-house approach whereby the dedicated team to look after the matter on FM as well designing with special requirement to meet customer satisfaction. The advantage of the out sourced approach, the management can act fast and efficient in the event of pandemic happen. They will deploy the staff to alert on the demand of patient and also ready facilities during the pandemic. Previously TTSH is also out-sourced to other companies but due to some reasons the service had been took off.

Fire System and Waste Management

The TTSH has given the priority to the response time to the problems encountered. In the event of fire, the TTSH is equipped with the operation centre so called Fire Command Centre (FCC) operating 24 hours with the dedicated staff. The FCC is equipped with the latest technology control system to overseeing any fire or breakdown for the whole complex of TTSH. A few services still out-sourced to company such as ISS Group Facility Services Ptd Ltd and SAM Corporation to handle waste services as a vendor for collecting waste.  The TTSH is using Computerised Material Management System to manage the waste and housekeeping. The system is build customized to meet the requirement which give more efficient and good productivity. Waste services are cover housekeeping, pest control and also landscaping. The waste is segregated into toxic, chemical, pharmaceutical, recycle, hazardous and biohazard waste. The measurement and monitoring used in waste management is covers by tracking volume of the waste, licensing procedure, daily collection frequency, timing, transportation and waste spills. The service partner is bounded with the contract vendor agreement and non-disclosure contract to ensure the requirement and target is achieved. To give better service quality to the customer, the TTSH has given the service partners to find their way to improve services. Their service on waste management has adopted best practice in terms of cleaning clothing, general housekeeping, toiletries and isolation room. TTSH is also known as most productive and efficient in terms of housekeeping among hospitals in Singapore.

Food Services

The TTSH is only hospital in Singapore provide halal food for patient and staff. The kitchen section is equipped with six freezers and six chillers to cater the food. The food materials endorsed by Majlis Ugama Islam Singapura (MUIS) will only supply to the hospital. Their service also bound to the standard of contract and quality assurance to ensure the quality service given to the customer. To be more productive and efficient for food service, the hospital is using Electronic Meal Ordering System (EMOS). The kitchen also equipped with latest machine for food service and they also providing stacked food for emergency team in duty around the clock. The food service section of TTSH is also providing service to nearby hospital such as National Neuroscience Institute, National Cancer Institute and some institutes. 

Concluding Remarks from TTSH

The TTSH will conduct strategic management retreat with senior management yearly to find the way to improve the productivity and efficiency of service to customer. The top management of TTSH is always given strongest support to the operational teams to provide good service quality through Key Performance Indicators (KPI) to ensure customer satisfaction is met at all times. The space planning design has always taken into consideration by the team to do space design to cater customers and friendly environment. The TTSH team has set up master planning design team to look into this design.

Visit 3                                   : National university Hospital (NUH)

Service Provider              : National University Health System (NUHS)

The National University Hospital (NUH) is started operations on 24 June 1985. The NUH is 1^st Restructured Hospital in Singapore. The National University Hospital (NUH), a member of the National University Health System (NUHS) , is a tertiary specialist hospital that provides advanced, leading-edge medical care and services. Equipped with state-of-the-art facilities as well as dedicated and well-trained staff, the NUH is a major referral centre that delivers tertiary care for a wide range of medical and dental specialties including Cardiology, Gastroenterology & Hepatology, Obstetrics & Gynaecology, Oncology, Ophthalmology, Paediatrics and Orthopaedic Surgery. It is the principal teaching hospital of the NUS Yong Loo Lin School of Medicine.

Backed by substantive expertise and experience, the NUH was chosen by the Ministry of Health in 2007 to develop two new national specialist centres, the National University Heart Centre, Singapore and National University Cancer Institute, Singapore to meet the growing need for cardiac. In 2004, the NUH became the first Singapore hospital to receive Joint Commission International (JCI) Accreditation, an international stamp for excellent clinical practices in patient care and safety. It was also the first hospital in Singapore to receive a triple ISO certification concurrently for Quality, Environmental, and Occupational Health & Safety Management Systems in 2002.

Focus Areas NUH

The NUH is focusing on three key areas namely education, clinical ware and research. 

Education : Students learning alongside healthcare professionals, developing their skills under mentorship

Clinical Ware:  Scientists partner their clinician colleagues to develop solutions to problems that doctors wrestle with on a daily basis.

Research:  A dynamic environment actively encouraging clinicians, basic science & clinical researchers to work together.

NUH Roles in Facilities Management

FM covers a wide range of activities and embraces broad scope of services. Its functions include but are not limited to building operations and maintenance. It encompasses building services, workplace safety, real estate management, infrastructure development and maintenance, business support and customer/employee support as shown below.

a)      Strategic Planning and project management

b)      Marketing and communications

c)       Finance, information technology, human resources and administration

d)      Benchmarking and facility functions

e)      Real estate and property management

f)       Best practices and environmental management

g)      logistics, operation and maintenance

NUH FM’s Strategic and Operational Plans

a) Implementing sustainable practices though improvements and innovations to save energy, to provide better workspaces for employees, and to improve the operation of buildings.

b) To ensure smooth business environment across the organization by synergizing resources between in-house and out-sourced manpower.

c) Planning and designing for continuous improvement of service quality. eg,. Benchmarking standards, service level agreements.

d) Systematic service appraisal and project evaluation – quality, value for money, compliance and risk assessment.

e) Formulating effective and efficient operations and maintenance strategies.

NUH Human Capacity Building

The Hospital is being run by outsourced service partners, contract workers and in-house staff.

a) Gaps identified

b) Skills / proficiency of the workers provided might not be adequate

c) Language barrier between different level background of staff

d) Insufficient manpower provided.

e) HR policies

f) Stringent assessment procedure during the interview stage.

g) Training courses to ensure manpower is well-equipped

NUH performance measurement

a) Setting standards/KPIs as a measuring tool.

b) Regular review of standards / KPIs.

c) Increasing standards and improving on KPIs.

d) Evaluate performance to ensure standards are implemented and KPIs are met.

e) Enhancing quality of service and customer satisfaction.

f) Conduct weekly meetings between OSS and service partners to go through the daily operations issues.

g) Improve response time to breakdowns/faults

h) Maintain the systems regularly in tip top conditions

i) Water and Energy saving

j) Life Cycle costing

The KPIs for maintenance are as follow:

a) Frequency of breakdowns received from the users to the Fault reporting centre or BASCO.

b) Walk through, preventive maintenance, inspection.

Leveraging ICT

The employees have to manage and integrate clinical, financial and operational information that grows with the practice. Most hospitals now reply on ICT that helps to manage all the medical and administrative information.

a) ICT in FM function as following:

b) Helpdesk management

c) Asset management

d) Planned preventive maintenance systems

e) Time and attendance management

f) Computer aided facilities management

g) E-commerce – Coda financials and coda e-procurement

h) Network infrastructure

i) Business continuity and disaster recovery

Concluding Remarks from NUH

The success of the facility management is relying on the good support and cooperation from service partners. It is crucial when there is required for pandemic happen. Therefore, the hospital is set up Pandemic Readiness Response Team (PRRT) to deploy emergency manpower in such occasion. FM team is very critical especially in hospital because it involve safety and life/dead of patient and staff. The hospital has taken proactive approach in improve their awareness among staff by introducing Service Culture Unit. The unit will provide a platform to inculcate education and awareness among staff to be more friendly especially those involve in patient care, pottering and uniform staff. It will reflect image and company representation in promoting service culture in hospital. In NUH, the implementation of e-services such as e-request for pottering and response time, dispatch and so on. They believe the total FM should be introduced in hospital using electronic based to meet the performance required. FM also plays roles to cultivate in conserve energy, green building to be more sustainable for long run.