1 most important driver for the patient


Healthcare providers today are facing growing competition such as
increased cost pressures, a growing number of elderly, chronically ill
patients, evolving quality and regulatory requirements.

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 Today’s healthcare providers try to focus on what they shall do as
to take care of their patients, they try to do more than deliver just the
medical services to their patients they also try to give them a very
comfortable and relaxed (hotel) accommodation and that is done through
choosing/implementing the best facilities management services needed to look
after their people and premises. And of course they try all of that with
respect to saving money, reduce risk and improving the appeal of the settings.

And one of the most important driver to present this hotel service to
the patients is knowing their needs and try to fulfill them through the services,
but not only the services quality are the most important driver for the patient
/customer to judge the value of the perceived services but also the
relationship between the provider and the customer (Ch.coenen, 2014)

In this paper we will try to focus on the interaction or relation between
the facilities management employees and the patient and how we can benefit from
this interaction.


Facility management had been always defined as the discipline in which
an organization tries to raise the efficiency and reduce cost (Ch.coenen,
Until the European norm was established in 2006 by the European Committee for
Standardization (CEN) to create a terminological foundation for this field of
Management. This norm defines Facility management as the “integration of
processes within an Organization to maintain and develop the agreed services
which support and improve the effectiveness of its primary activities” (CEN, 2006) another definition of
facilities management as we got many and many of them but I will refer to the
ISO 41011 definition , “it is Organizational function which integrates people,
place and process within the built environment With the purpose of improving
the quality of life of people and the productivity of the core business” (ISO, 2015), Which means, in
simple words it’s the function of 
integrating the management of facilities, management of services and
management of relationship.

From this simple definition we can see the importance of facilities
management inside the healthcare facilities as we need the three pillars inside
any of the healthcare facilities and we need to manage them properly as to get
the maximum output from them

management in healthcare

The provision of Facility management and other
non-medical activities to healthcare organizations has been growing and it got
a high impact on the quality and effectiveness of healthcare services. (Gelnay, 2002)

Improving patient care is a high priority for all health care providers
with the overall objective of achieving a high degree of patient satisfaction. The
quality of patient care is essentially determined by the quality of
infrastructure, quality of training, competence of personnel and efficiency of
operational systems. The fundamental requirement is the adoption of a system
that is ‘patient orientated’. Existing problems in health care relate to both
medical and non-medical factors and a comprehensive system that improves both
aspects must be implemented. Health care systems in developing countries face
an even greater challenge since quality and cost recovery must be balanced with
equal opportunities in patient care (Rao, 2004).


Customer service
skills are important for FM staff when they have direct contact with patients. Proper,
neat appearance, kind words and a sense of respect will make patients feel
better and more satisfied with the services they receive. Most of the facility
management staff works behind the scenes and others have direct contact with

What kind of facility services can be introduced inside healthcare
facilities? (SN EN15221-4)



Front of House Services,
including switchboard, reception, porters, helpdesk and post room

Logistics (Transport)

Estate Management

Retail Management

Mechanical and Engineering(Maintenance

Car Parking and Security

Linen and Laundry

Sewing – Room Services


Washroom Services


Receipt and Distribution.


But mostly the
ones who got a direct contact with the patient and would have interaction with
them are mainly the Cleaning, Catering and sometimes the Maintenance personnel
please see table (1).




Interaction Level







Table (1): Levels of interaction between service personnel and

The vision of any healthcare facility should be the patient
is the most important person and it must be recognized by all those who work in
the system.

We will try to focus on some of the non-medical factors which
are very important for the patient satisfaction in hospitals such as (Rao, 2004)

Access. Accessibility of both the hospital and the physician.

Waiting. Waiting times for all services should be minimized as much as

Information. Patient information and instruction about all procedures, both
medical and administrative, should be made very clear.

Administration. Check-in and check-out procedures should be ‘patient friendly’



Non-medical employees
importance in healthcare

Not only the
medical employees have an impact on the patient but also the non-medical
employees as we just mentioned that some of facility management employees have
a direct contact with the patients and that means that they must have either
positive or negative impact on them.

That’s why it is
so important that each employee must understand his role in the healthcare organization
and appreciates its importance. An employee has
both a function and a purpose (Solomon, 2015).

How can we differentiate between the function and the purpose as an
example Cleaning personnel his function is cleaning but what is the main purpose,
key message of this function it’s the vision of the facility management team
i.e. he must be aware of this function and what exactly he is doing, he must be
aware of all the material he is using, what is the patient facing.

Factors that influence the patience hospital choice are convenient
administrative procedures, quality of services, hospital image, cost of
treatment, and health insurance coverage. (Saeed, 1998) .

in Facility management

Most of the services offered by Facility management providers include
interpersonal contact between customers and the Facility management service
provider’s employees. The behavior of these employees

Plays a very important role in the perceived quality of the entire
Facility management service offering (Coenen, Prosocial service behaviors and their role in influencing
perceived service Quality, 2002)

In addition to the need for Facility management to be the driver of
managing processes, tangibility and Personnel to create value for the customer,
relationship management is also very important. This is because customers figure
out the worth their relationship with the service provider, which means that
they will not only base their process of figuring out the worth on the quality
of the service of a Facility management provider only  but also the quality of the whole relationship
In this way, relationship quality becomes an important driver of perceived
value and customer happiness from meeting a need or reaching a goal and service
quality and relationship quality interact with one another. Because facility
management services are an important feature/ trait of a provider from the
customer’s way of seeing things. (Ch.coenen, 2014), one after the other
positive experiences with these services cumulate to a positive overall
perception of the relationship. More than that, a high perceived relationship
quality helps customer interactions. The better the Facility management  provider and customer know and value each
other, the more open and helpful the interactions between them (Georgi, 2000)Relationship quality
is defined as the ability of the provider to fulfill the customer’s relational needs
(Bruhn, 2002)Rather
than just being the sum of the qualities of all the interactions within a
customer relationship, relationship quality also concerns aspects that are
central to the concept of the relationship. Therefore, two central dimensions
of relationship quality must also be managed by professional Facility
management  (Georgi, 2000)The first is “trust”, which is the
customer’s ability  to forgo any
additional investigation and just rely on the corporation’s behavior in the
future, and the second is “familiarity”, which is closely related to trust, but
is based on the past. These two dimensions characterize the degree of
convergence with the other party in terms of their attitudes and modes of
behavior (Ch.coenen, 2014)


What is interaction its “the differing effect of one independent
variable on the dependent variable, depending on the particular level of
another independent variable” (Cozby, 1997)

investigated the effect of the following five factors on the satisfaction of
healthcare users:

of communication between staff and


skills and experience of service



staff reaction toward patients; and

of treatment versus patient expectations.


In which shows that the level of communication/interaction between the
staff and the patient is one of the most important factor affecting the
customer satisfaction in Healthcare facilities. of course due to the presence
of the patient and the facility management team especially the Cleaning,
Catering and with lower percentage the Maintenance personnel there will be an
interaction between them and this interaction can be positive or negative
depending on the patient perceiving and on a lot of factors from the Facility
management team in the other side such as the appearance, communication skills,
the level of education and training.

As shown in table (1) and from my point of view that the main important
division in facility management that have a high interaction with the patient
are cleaning and catering in which  we
can enhance their skills by further training to be responsible for more than
just cleaning or food services and they can be a part of the medical part
through their interaction with the patient, for example instead of the entrance
of one personnel to clean the room 2 persons can enter the room one can be
responsible of the room cleaning can be responsible of talking and
investigating the patient health and through some training with the doctors or
nurses those questions could be questions 
as to check the memory or the emotional feelings of the patient.

When people come into hospital, the quality of their interactions with
staff is key to shaping experiences during their stay. For example, older
people want nurses and others to use interactions to maintain identity (“see
who I am”), to create community (“connect with me”) and to share decision
making (“involve me”) (Bridges, 2010). And as we can see
that always nurses are busy as they got a lot of responsibilities which I
believe if the catering and cleaning staff had the proper training they can
easily perform that role of interaction as to give a better quality of service
to the patients.


















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