An often-missed opportunity to boost your hospital ratings

For more than 30 years, U.S. News & World Report has helped patients and facilities find the best healthcare providers through the magazine’s annual “Best Hospital” lists. Not surprisingly, ratings are based on such factors as patient outcomes and processes of care. What might be a surprise, however, is that healthcare facilities management (FM) can contribute significantly to a hospital’s ratings.

In fact, facility managers at leading healthcare organizations often strive to be part of the patient care team alongside nurses and doctors.

“FM professionals understand their contributions to patient and caregiver safety, and how their work can elevate patient perceptions of high-quality care,” said Alison Flynn Gaffney, FACHE, Division President, JLL Healthcare. “FM’s role is even more influential in the shift toward value-based payment models. since FM directly impacts the quality metrics tied to hospital reimbursements from public healthcare programs.”

However, FM’s behind-the-scenes contributions are often overlooked. The following are the hidden ways in which FM can boost your healthcare organization’s ratings in U.S. News & World Report’s “Best Hospitals,” Press-Ganey patient satisfaction surveys, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and other consumer ratings and rankings.

Improved patient outcomes

Patient outcomes, comprising discharge to home speed and survival rates, are, of course, most important in the U.S. News & World Report’s ratings. One major cause of prolonged hospital stays and adverse outcomes are hospital-acquired infections (HAIs), which afflict up to 10% of U.S. hospital patients annually, according to data from The Center for Disease Control.

When a contaminated bed curtain can spread MRSA, or an outdated HEPA filter can jeopardize an entire hospital by allowing the spread of airborne viruses, FM is clearly on the frontlines of prevention. Well-trained FM teams also keep a sharp eye on sinks, faucets and plumbing leaks to prevent mold and bacteria growth that can lead to pneumonia, gastrointestinal infections and other potentially deadly HAIs.

FM teams also are instrumental during catastrophes—including natural disasters and pandemics—in positioning the healthcare facility to respond. In the depths of the COVID-19 pandemic, for instance, the hospitals most able to serve patients during the onslaught were those with highly effective FM teams that quickly converted rooms to zero pressure and adjusted HVAC systems to limit the airborne spread of COVID-19.

In addition, a seasoned healthcare FM team proactively works to reduce the risk of patient—and nurse—falls, which are one of the most common hospital-acquired conditions (HACs) that affect quality scores. Acting as part of the caregiver team, FM professionals will implement best practices, like installing no-slip floors and smoothing hard corners, correctly placing support rails, implementing appropriate toilet and furniture height, and other measures to reduce fall risks.

As stewards of building equipment and systems, FM team also are on the frontlines of ensuring that patients are diagnosed and treated as quickly as possible. Using preventative maintenance methodology, a sophisticated FM team prevents failures of building systems and equipment, such as refrigerators and imaging machines, that are vital to patient care.

FM also takes the lead on the general environment of care that influences patient recovery and length of stay. Keeping facilities clean and well-maintained, with pleasant window views, residential-style furnishings and relaxing artwork on the walls, reduces patient stress and improves recovery time. FM teams also can provide measures to reduce noise and create a more healing setting.

Boosting caregiver effectiveness, job satisfaction—and retention

Since the ratio of patients to nurses directly affects outcomes, staffing levels are included in the U.S. News and World Report ratings. For example, increasing the patient-nurse ratio from five-to-one to six-to-one increases mortality risk by 4% to 7%. However, by taking care of daily equipment and facility administration needs, a coordinated FM team can free nurses to spend more time on patients with fewer interruptions.

Pre-COVID, nurses were interrupted every 11 minutes on average, according to JLL research. Those interruptions directly impact patient care, safety and experience. Simply replacing printer ink can consume valuable caregiving time, for example. If eight nurses across a facility spend one hour per day managing facilities issues, the hospital loses eight hours of nursing care—the equivalent of another full-time nurse. 

More important, in a time of chronic nursing shortages, effective FM can make the difference between nurse job satisfaction and costly turnover. Maintaining proper air filtration and negative/positive airflows, for instance, ensures that nurse health and wellbeing is being prioritized alongside that of patients. Managing everyday facilities tasks—from cleaning spaces to ensuring that personal protective equipment is available—reduces nurse frustration and makes it easier to focus on care.

To further ease the burden on nurses, some hospitals are piloting the zone maintenance approach to FM—a new concept that aligns FM with the needs of caregiving staff. In the simplest terms, zone maintenance means creating zones within the hospital and assigning each zone to one general maintenance mechanic. The dedicated mechanic assumes “ownership” for upkeep, repairs and general maintenance in their zone, with the support of an engineering team.

Fully integrated into clinical care, the zone mechanic participates in the clinical team huddle every morning and is recognized as part of the patient experience. In addition to being cost-efficient, zone maintenance helps assure nurses that critical equipment will always be available and functioning—and that their role no longer includes making sure the coffeemaker is working.

Elevating the patient experience

Patient perceptions extend far beyond actual medical treatment to include more difficult-to-measure aspects of the overall experience. Such issues as flickering lights and fluctuating room temperatures can exacerbate discomfort and stress, for example. Perceptions of lax hospital security or patient protection measures, lax infection control or poor building maintenance also undermine patient experience and recovery. Worse yet are catastrophic events, such as onsite violence or a widespread dangerous HAI.

Unfortunately, a single sentinel event can destroy a hospital’s reputation and its ability to provide care for a community. A strong FM team helps reduce reputational risks by ensuring that comprehensive safety and security measures are maintained, that building systems are highly reliable and that HAI prevention measures are strictly followed.

When it comes to consumer guides and ratings, medical expertise and quality of care will, of course, always be key indicators of quality. However, leading healthcare providers increasingly understand quality of care and patient outcomes are inextricably linked to their facility’s quality. To overlook FM’s contribution is to overlook a critical part of the healthcare experience.