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This paper presents research findings of 365 NHS Trust executives in the UK and builds on work carried out on risk perceptions and treatment in facilities management operations and business support activities in the NHS Trusts. The research utilises a business approach of viewing healthcare facilities not only as fixed “assets” occupying hospital sites and space, but it also considers them as that “tangible” part of the service chain process underpinning the provision of clinical services to both internal (departments or directorates) and external customers. The research found that customer satisfaction, service delivery certainty, customer involvement, service quality reliability, health and safety are highly rated by the NHS executives. The paper classifies healthcare related risk constructs into seven elements namely: customer care, corporate, legal, commercial finance and economics, business transfer, and facilities transmitted.

To evaluate the use of neural networks in healthcare facilities risk management.

The data used to develop the input to the national health service facilities risk exposure system (NHSFRES) was solicited from 60 healthcare managers. Risk exposure system has been developed using the risk knowledge that was articulated from experienced healthcare operators through postal questionnaires and repertory grid interviews. This knowledge was then transformed and represented in Trajan 4.0, an expert system shell that uses artificial neural networks as its modelling technique.

It provides healthcare facilities operators an avenue to evaluate their own risk management method (point score system) based on their own healthcare business knowledge/judgment and corporate objectives for various FM service operations.

The key issue that should always be noted by NHSFRES users is that, the concept of measuring or evaluating business risks will always be uncertain. Professional judgment, based on sound information, is an essential element in interpreting and using the system.

The model provides healthcare facilities managers a vehicle for predicting pre‐ and post‐facilities risk‐factors in healthcare operations before they occur. A clear understanding of the risk signals would mean that appropriate management course of action should to be considered that will improve FM operators' business performance.

The NHSFRES is developed using the risk knowledge that was articulated from experienced healthcare operators through postal questionnaires and repertory grid interviews. It provides a reasonable early warning signal to the healthcare managers, and can be used by decision makers to evalute the severity of risks on healthcare facilities business operations.

There has been immense pressure exerted by healthcare service consumers and other stakeholders for trusts to purchase, manage and deliver care service at the optimum cost. Many are searching for sustainable strategic options which would proactively redesign, revitalise and manage the effectiveness of their clinical and non‐clinical services. This study evaluates how a facilities management partnering arrangement in the National Healthcare Services (NHS) trust could lead to cost savings and improved customer focused service provision in NHS trust hospitals. It investigates how a modern day approach of managing non‐core related services under one umbrella, facilities management, has brought about innovation, competitiveness, and entrepreneurial skills to reduce some of the escalating costs in the Derbyshire Royal Infirmary. Concludes that facilities management partnering arrangements can secure added value to the healthcare sector and therefore enhance service quality and improve the corporate image.

The history of the development of non-clinical services in infection control (IC) dates back to the pre-modern era. There is evidence of health-care facility management (HFM) services in Roman military hospitals. With the fall of the Roman Empire, Christian beliefs and teaching shaped the development of HFM in monastic hospitals. It was not until the late Victorian era that the link between HFM services and diseases caused by “miasma”, or bad air, became established. The discovery of bacteria in the modern scientific era reduced the level of importance previously attached to non-clinical causes of infections. Today, in the NHS, HFM services continue to be treated as though they had no real role to play in IC. This paper aims to collate historical and epidemiological evidence to show the link between HFM and IC.

The evidence gathered in this research paper is primarily based on an in-depth review of research from a wide range of sources. A “within-study literature analysis” was conducted to synthesise the research materials. This involved the application of “between-source triangulation” to verify the quality of the information contained in the studies, and “between-source complementarity” to provide an in-depth elaboration of the historical facts.

Historical and epidemiological evidence shows that HFM services such as cleaning, waste management, catering, laundry and maintenance continue to play a crucial role in IC. This is corroborated by evidence gathered from the work of renowned pioneers in the field of IC. However, reforms in the NHS have failed to consider this, as HFM services have been largely fragmented through different partnership arrangements.

Among many other things, this research raises the profile of HFM staff in relation to the issue of IC in hospitals. It presents convincing evidence to show that the relationship between the clinical and non-clinical domains in controlling infections in hospitals has a long history. The findings of this research give HFM staff invaluable information about the significant role of their profession in the control of infections in hospitals.

This is one of the few studies examining the historical development of HFM services, as well as their contribution to IC. Other work in this area has mainly been framed from a clinical health-care perspective.

Risk management in the healthcare sector is a highly relevant sub-domain and a crucial research area from the humanitarian perspective. The purpose of this paper is to focus on the managerial/supply chain risk factors experienced by the government hospitals in an Indian state. The present paper analyzes the inter-relationships among the significant risk factors and ranks those risk factors based on their criticality.

The current research focuses on 125 public hospitals in an Indian state. Questionnaire-based survey and personal interviews were conducted in the healthcare sector among the inpatients and hospital staff to identify the significant risk factors. An integrated DEMATEL–ISM–PROMETHEE method is adopted to analyze the impact potential and dependence behavior of the risk factors.

The analysis asserts the absence of critical risk factors that have a direct impact on patient safety in the present healthcare system under investigation. However, the results illustrate the remarkable impact potential attributed to the risk factor, namely, staff shortage in inducing other risk factors such as employee attitudinal issues, employee health issues and absenteeism altogether resulting in community mistrust/misbeliefs. Maintenance mismanagement, monsoon time epidemics, physical infrastructure limitations are also found to be significant risk factors that compromise patient satisfaction levels.

Multiple options are illustrated to mitigate significant risk factors and operational constraints experienced by public hospitals in the state. The study warrants urgent attention from government officials to fill staff vacancies and to improve the infrastructural facilities to match with the increasing demand from the society. Furthermore, this research recommends the hospital authorities to start conducting induction and training programs for the hospital employees to instill the fundamental code of conduct while working in hectic, challenging and even in conditions with limited resources.

Only limited papers are visible that address the identification and mitigation of risk factors associated with hospitals. The present paper proposes a novel DEMATEL–ISM–PROMETHEE integrated approach to map the inter-relationships among the significant risk factors and to rank those risk factors based on their criticality. Furthermore, the present study discloses the unique setting of the public healthcare system in a developing nation.

To investigate if game theoretic reasoning may be used to explain a lack of cooperation in buyer‐supplier relationships within construction and facilities management. In order to make an empirical application of the prisoner's dilemma (PD) game, possible important variables are operationalized and empirically measured.

Empirical data concerning pay‐offs and the variables in the discount parameter formula (created in this paper) have been obtained through interviews with clients and contractors in the Swedish construction sector.

This paper suggests a way to operationalize pay‐offs and the discount parameter, making empirical measurements possible. Owing to differences in pay‐offs and the discount parameter, different forms of contracts will affect cooperation. Cumulative values of cooperation are much higher in lasting relationships than in occasional transactions. Thus, the best way to facilitate cooperation between rational players is long‐term contracts.

Since, the values used are based on empirical data collected from a few respondents, they should be viewed as illustrative empirical examples, rather than statistical generalizations.

From a game theoretic perspective the practice of project partnering may not solve problems regarding lack of cooperation. To increase the incentives for cooperation, the actors should work together in long‐term relationships instead of focusing on single projects. Long‐term strategic partnering is, therefore, beneficial for the construction and management of facilities.

This paper makes empirical application of the PD game possible by operationalizing and empirically measuring game theoretic variables that previously have been given values set by the researcher rather than by the players in the game.

Construction management research (CMR) surveys frequently use questionnaires that employ “Likert-type” items, Likert-items, and Likert scales to capture respondents ' self-reported attitudes. This Editorial builds substantially on earlier observations by Holt regarding the significance of appropriate questionnaire response scale design and, use of the relative importance index (RII) method to analyse those data such scales yield. The paper aims to discuss these issues.

Several RII models are examined by their application to a data set. Objectives include to contrast their practicality in use, compare outputs, highlight limitations of some models and discuss methods of RII data analysis, interrogation and interpretation.

Principal messages are: all components of response scales should be carefully designed; alternative RII models can produce similar results of analysis; “simple percentage” RII models may not yield “real” percentages; the minimum rating scale integer should accurately reflect its descriptor; only rating scales offering a “0” response, or an “adjusted percentage” RII model can achieve unity; and RII outputs should be interpreted cautiously.

Uncertain application of the RII has been observed within CMR literature, so implications of the Editorial will be of direct relevance to this research community (and beyond).

Aside from that cited above, no additional literature has been identified that specifically links RII usage to CMR.

The paper aims to investigate the key components of facilities management (FM) in care and attention (C & A) homes from the end users’ perspective based on a post-occupancy evaluation method. Hong Kong is a rapidly ageing society. Elderly population may reach 24.3 per cent in the next 20 years, causing an increase in the demand for care services. Therefore, it is necessary to provide sufficient and satisfactory residential C & A homes with appropriate facilities for our elderly.

To collect subjective data from end users, a questionnaire survey was conducted in 119 respondents consisting of both elderly residents and staff of the C & A homes. To further understand the actual situations, site measurements were also used to collect the objective data from the representative homes.

The results indicate that three aspects of key FM components, namely, architect, building services and supporting, all have significant relationships with the overall satisfaction. The site measurements further revealed the actual environment of the seven C & A homes, especially the contrasts between homes with highest scores (Homes E and F) and lowest scores (B and D).

To provide a clear picture to the government and construction professionals, a number of practical recommendations were proposed, such as sufficient space with single or couple bedrooms, sufficient corridor width for two people in wheelchairs and white or pink as the colour scheme in architectural aspect; sufficient lighting, central air conditioning system and adequate quantities of natural fresh air in the building service aspect; and frequently updated menus, door lock and CCTV system for supporting facilities.

This paper applied site measurement on the representative homes to cross-check the quantitative results. The findings of this study can assist architects and facilities managers in C & A homes to improve FM services during the design and operational stages for improving the satisfaction levels of elderly residents.

In the past, FM performance was mostly monitored by technical and cost‐related KPIs, whereas the measurement of perceived internal service quality was widely neglected. Thus, the purpose of this paper is two‐fold: first, to develop an adequate model to capture the relationships between internal service quality, internal customer satisfaction and internal customer retention; and second, provide an instrument for the identification of areas of improvement for customer orientation in FM.

This research gives an insight into the relevance of customer orientation in FM. Following this, it introduces the concept of a FM Servicebarometer, highlighting an application of this model by presenting the results of an extensive quantitative survey that was conducted within a healthcare setting. Based on this model, various indices are calculated for the internal service quality, customer satisfaction and customer retention, resulting in the FM Quality Index.

Detailed analyses show insights into the interdependencies between various aspects of internal customer orientation in FM. In addition, driving forces of internal service quality, internal customer satisfaction and internal customer retention are presented.

The FM Quality Index (FMQI) allows both a longitudinal research and cross‐sectional comparison within FM. Thus, the FMQI may be applied as a tool for monitoring and managing internal customer orientation in FM.

FM Servicebarometer is a unique application of the service barometer approach within FM. Thus, it presents an innovative attempt to measure and control perceived service quality, customer satisfaction, and customer retention.

A company, outsourcing support services which are essential for the continuity of the company, may want to secure smooth functioning by tying a closer relationship with the service provider. While companies are modifying their support service sourcing strategies into alliances, there is also a need to readjust mechanisms to manage those transactions and the related risks. Focusing on collaborative facilities management environment, this paper examines coordination mechanisms that go beyond traditional market mechanisms. A proposed alliance management model is presented. The paper delineates a single case study of a triadic alliance between a client and its two partners providing in concert outsourced maintenance operations. The study was carried out using the action research method.