Changing the way we work

While in practice many of us are still looking forward to moving towards the paperless help desk, the technologies that facilitate this are far from new. New technologies are often developed for implementation in the factory or office and we seldom see the cutting edge in healthcare facilities. However, much of what is new now could well be helping us to make cost and efficiency savings towards what may well be stringent targets in 2011.
    
In a recent television interview NHS chief executive David Nicholson spoke about the challenge of delivering efficiency savings and how facilities management can contribute while adding value to the patient experience. Specifically he outlined 5.5 per cent growth over the next two years but after that, two or three or four years with very little growth. He noted that: “We need to think five years rather than two…over the next two years when we have money to invest we must invest it in things that will improve productivity across the system as a whole and that is where we want to see people focusing their attention.”

A vital role
Of course in this context where he says “people” he is referring specifically to Facilities Managers as he was being interviewed in the context of healthcare facilities. The interviewer went on to ask David where he felt the opportunities were for savings to be made, especially in the light of the year on year efficiency savings that facilities teams have been asked to make over the last decade. The response was interesting: “One is making the system work more efficiently,” and he cited specifically food provision, buildings and using the power of the NHS to get value for money on our purchasing. Mention was also made of DHL and the new steps they have implemented for the NHS supply chain. When pushed further on this the following was noted: “One thing about facilities is that it is talked about COST rather than the value they add to the patient experience and patient services. Facilities have a vital role to play...”
    
So why note all this when we are supposed to be focusing on the use of new technologies to support effective facilities management? Simply that if the NHS chief executive sees that the facilities teams around the country have a vital role to play in improving patient care and clinical outcomes then we need to be doing all we can to ensure that Trust and Health Board CEOs all around the country are aware of this view. One way of doing this is to bring to their attention the new, innovative and cutting edge technologies that could be of significant benefit to the FM teams in their day-to-day duties but may also well prove to be transferable to other areas of healthcare staff.

Walk and talk
One example of this is the “Push to Experience” technology that is currently available through the mobile phone network. Within healthcare facilities we often experience difficulties with caring for lone workers. A quick look at the HFC’s FM Document Exchange shows that this is a current and live topic with several new policies relating to lone working arrangements.
    
On the estates side we are used to having staff out in a van doing odd jobs of maintenance on outlying properties but now this is affecting other staff too. On some of our larger sites we have remote plant rooms or storage areas and the potential for accidents while staff are on their own is considered quite high. Push to Talk provides a simple means of getting messages between staff and from control to staff without the restrictions of on site radio systems, walkie talkies or pagers. A member of staff can simply report that they are going into a vulnerable area and this can then be monitored in case they do not report as being clear in reasonable time. A poor example perhaps? This technology can also be applied to emergency repair and cleaning rapid response teams, the IT maintenance team and other similar groups. A message can be broadcast from a base station (the help desk computer for example, equipped with a standard head piece) asking for the nearest person in a group to a location. Individuals can respond from their own phone by simply pressing the talk button. This is not a mobile phone call – the transmission is carried on the data channel.
    
Taking this a couple of steps further the system can be used to locate (Push to Locate) where the control can see each unit (mobile phone) on a map on screen. Those of you who are parents may well already be using this technology as Google Locate for your children. A further application is Push to Video – so the video capabilities of your mobile phone can now be used to send streaming video of a faulty whatever to a more experienced colleague or even the manufacturer for live assistance. Now think outside of facilities…
    
District nurses and midwives are always in and out of people’s houses and in rural communities can often be out of normal communication capabilities. An emergency button can be used to summon assistance or simply to report location for the next call. Ambulance crews could use the video capabilities for assistance with diagnosis or additional advice at the roadside. One technology; many applications. At least one facilities manager, having seen this at the recent HefmA conference, was going back to his board with a suggestion for their entire remote working staff in one of the shires counties.

Infection control
There has been a small exhibition of new technologies doing the rounds recently under the banner of the HCAI Innovations Project. While this is looking at HCAI prevention it has clear implications for FM teams. Privacy for patients in their bed by the use of what Paul Cryer calls “clicky glass”. Panels of glass on castors that can be positioned around a bed space or other patient area and when privacy is called for a press of the remote control turns the glass opaque. Yes the current demonstration kit may be an expensive and heavy replacement for a portable screen or bed curtain but see this installed in a cubicle style single bedded bay and it provides the benefits of isolation (for barrier nursing) while providing an open and light environment for the patient but still the privacy of a single room when required.
    
New designs of bedside cabinets that are seamless and so easier to clean and keep clean and can incorporate transponder based locks avoiding the need for keys and the dirt trap that conventional locks generate. New commodes that are far easier to keep clean – while the list is not endless the project is certainly well worth a visit and the next event where we are aware it is on show is the Flourishing FM conference at the Kassam Stadium in Oxford on 16 and 17 September. Mike Phillips, the design and development director from the Renfrew Group, is due to give a talk on the project at this conference.
    
Looking up the scale a little there is a new hospital being built by Serco for NHS Forth Valley. This has been designed for a technology that I first installed in the 10/20 Laminate Factory in Kings Norton, Birmingham for Triplex Glass in 1977. Please don’t laugh too loud but I believe this was the UK’s first robotic factory and it was designed to produce the windscreens for the then new Rover SD1. OK so I know I am showing my age and why am I promoting the implementation of a technology over 30 years old? Simply that this will be the first UK hospital that has been designed specifically to cater for facilities robots. There are special dedicated “pathways” through the hospital to ease the flow of robots and facilities staff independent of patient areas and visitor walkways. Meals, for example, will be delivered through these pathways, which include a purpose built tunnel from a service area into the main unit and dedicated corridors and lifts into both clean and dirty areas, into the appropriate area for the ward housekeeping staff to take over and deliver to the patients. It may be an old technology but it is completely up to date in terms of the robotics and its application for healthcare.

Keeping up to date
While talking about this project at the recent AHCP Conference in Glasgow Mike Mackay, project director for Serco, cited some other new technologies that in his opinion are changing the way we do things within healthcare facilities. Interestingly he noted the most recent of these as being the very medium that the David Nicholson interview I started this article with is being transmitted through. Launched in May 2009 Focused FM TV is a web based TV channel established specifically to promote and propagate the very best of healthcare facilities best practice, innovation and also policy from the various UK health departments. Focused FM TV is a free to view channel that is run by the same company that manage Health Exec TV, the channel established to help keep NHS organisation non executives up to date. It already has innovation in the form of Medi-Cell portable operating theatre suites and Panasonic Tough Book computers that are already in use for patient records, especially with children, but can also be used for facilities teams working in tough environments or just as an aid to collecting patient questionnaire information as the units can be wiped clean without the risk of getting alcohol gel in the keyboard of a PDA.
    
In appreciating that this is merely a glimpse into innovation and new technologies I hope that these thoughts encourage you to look at what is already available and could be used in a different way, or is just coming through and could be the trigger for new ways of working and delivering the very best of healthcare facilities to support our colleagues in keeping the population of the UK healthy.