Akintola Akintoye

A Methodological Approach to Identify Key Performance Indicators and Measures in Maintenance Services in Infection Control

Hospital-acquired infections (HAIs) are a major problem in the United Kingdom (UK) and worldwide. The UK has one of the worst rates of hospital-acquired infections (HAIs) in Western Europe. One reason for such poor performance is the failure of healthcare officials to tackle the root causes of HAIs in the National Health Service (NHS). The position of healthcare officials is that HAI is mainly a clinical issue; requiring the attention of clinicians. As a result, most of the infection control policies and guidelines do not sufficiently address the non-clinical causes of HAIs in the NHS. There is strong epidemiological evidence suggesting that HAIs can also occur because of the poor performance of facilities management (FM) services. An example of an FM service that has a strong link with HAI is healthcare maintenance. Despite being linked to such infections as aspergillosis, legionnaires etc, healthcare maintenance services (HMSs) in the NHS have nonetheless failed to attract the attention of healthcare authorities. In this study therefore, we examine the methodological approach in identifying the key performance indicators and measures in HMSs in infection control. This study is divided into two main sections. In the first section, we examine different research paradigms, as well as, the rational for choosing interpretivism in this study. The second section, which is on the research design, examines the research methodology and research methods applied in this study. Addressing these methodological issues is important in identifying the key performance indicators and measures in HMSs in infection control.

The history of healthcare facilities management services: a UK perspective on infection-control

Purpose n n n n nThe 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. n n n n nDesign/methodology/approach n n n n nThe 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. n n n n nFindings n n n n nHistorical 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. n n n n nPractical implications n n n n nAmong 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. n n n n nOriginality/value n n n n nThis 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.

The abolition of the contracts "contracts in writing' rule in the 2009 Construction Acts: potential implications for UK adjudication

Purpose – The UK construction industry has been at the forefront of finding efficient, cost‐effective and fair methods of resolving disputes. Therefore, to ensure the 1996 Act is more effective in achieving its intended objective, the new Act came into force on the 1 October 2011 in England and Wales, and 1 November 2011 in Scotland. The purpose of this paper is to explore one of the most important amendments in the new Act, the abolition of the “contract in writing” rule. The extent to which the UK industry is aware of the likely implications of the abolition of the “contracts in writing” rule in the new Act on the adjudication has not been empirically explored – which is the core raison detre of this paper.Design/methodology/approach – A web‐based, online questionnaire survey method was employed to collect data. Descriptive analysis was used to analyse the data obtained from the 102 completed and usable questionnaires for inference and conclusion. This research employed t‐tests to compare means of smal...Purpose – The UK construction industry has been at the forefront of finding efficient, cost-effective and fair methods of resolving disputes. Therefore, to ensure the 1996 Act is more effective in achieving its intended objective, the new Act came into force on the 1 October 2011 in England and Wales, and 1 November 2011 in Scotland. The purpose of this paper is to explore one of the most important amendments in the new Act, the abolition of the “contract in writing” rule. The extent to which the UK industry is aware of the likely implications of the abolition of the “contracts in writing” rule in the new Act on the adjudication has not been empirically explored – which is the core raison detre of this paper. n nDesign/methodology/approach – A web-based, online questionnaire survey method was employed to collect data. Descriptive analysis was used to analyse the data obtained from the 102 completed and usable questionnaires for inference and conclusion. This research employed t-tests to compare means of small to medium-sized enterprises (SMEs) and large organisations. n nFindings – The findings suggests that the UK construction industry is well aware of the abolition of the “contracts in writing” rule in the new Act and the industry perception is that it is good for their business. The survey revealed that the amended rule in the new Act would significantly increase number of adjudications, number of hearings before the adjudicator, assessment of witness evidence, costs of the adjudication process, and timescale of an adjudication process. The three most important challenges to the adjudication process with the amended rule in the new Act include: assessment of wholly oral or partly oral contract terms that were agreed, availability of evidence, and availability of information. There are no significant statistical variations between the responses of the SMEs and large organisations. n nPractical implications – The paper concludes that the new Act will have significant impact on the UK adjudication. Therefore, the UK industry urgently needs to adopt and become accustomed to quite significant changes in the new Act. It is advised that an industry-wide awareness-raising programme on the new Act needs to be developed and deployed. n nOriginality/value – The paper improves understanding and awareness of the construction industry professionals regarding the likely implications of the abolition of the “contracts in writing” rule in the new Act on the adjudication.

The abolition of ‘contracts in writing’ rule in the new 2009 construction act: potential implications for the UK adjudications

Purpose – The UK construction industry has been at the forefront of finding efficient, cost‐effective and fair methods of resolving disputes. Therefore, to ensure the 1996 Act is more effective in achieving its intended objective, the new Act came into force on the 1 October 2011 in England and Wales, and 1 November 2011 in Scotland. The purpose of this paper is to explore one of the most important amendments in the new Act, the abolition of the “contract in writing” rule. The extent to which the UK industry is aware of the likely implications of the abolition of the “contracts in writing” rule in the new Act on the adjudication has not been empirically explored – which is the core raison detre of this paper.Design/methodology/approach – A web‐based, online questionnaire survey method was employed to collect data. Descriptive analysis was used to analyse the data obtained from the 102 completed and usable questionnaires for inference and conclusion. This research employed t‐tests to compare means of smal...Purpose – The UK construction industry has been at the forefront of finding efficient, cost-effective and fair methods of resolving disputes. Therefore, to ensure the 1996 Act is more effective in achieving its intended objective, the new Act came into force on the 1 October 2011 in England and Wales, and 1 November 2011 in Scotland. The purpose of this paper is to explore one of the most important amendments in the new Act, the abolition of the “contract in writing” rule. The extent to which the UK industry is aware of the likely implications of the abolition of the “contracts in writing” rule in the new Act on the adjudication has not been empirically explored – which is the core raison detre of this paper. n nDesign/methodology/approach – A web-based, online questionnaire survey method was employed to collect data. Descriptive analysis was used to analyse the data obtained from the 102 completed and usable questionnaires for inference and conclusion. This research employed t-tests to compare means of small to medium-sized enterprises (SMEs) and large organisations. n nFindings – The findings suggests that the UK construction industry is well aware of the abolition of the “contracts in writing” rule in the new Act and the industry perception is that it is good for their business. The survey revealed that the amended rule in the new Act would significantly increase number of adjudications, number of hearings before the adjudicator, assessment of witness evidence, costs of the adjudication process, and timescale of an adjudication process. The three most important challenges to the adjudication process with the amended rule in the new Act include: assessment of wholly oral or partly oral contract terms that were agreed, availability of evidence, and availability of information. There are no significant statistical variations between the responses of the SMEs and large organisations. n nPractical implications – The paper concludes that the new Act will have significant impact on the UK adjudication. Therefore, the UK industry urgently needs to adopt and become accustomed to quite significant changes in the new Act. It is advised that an industry-wide awareness-raising programme on the new Act needs to be developed and deployed. n nOriginality/value – The paper improves understanding and awareness of the construction industry professionals regarding the likely implications of the abolition of the “contracts in writing” rule in the new Act on the adjudication.