F S Nazeer , S Gunatilake and T Ramachandra

1. Department of Building Economics, University of Moratuwa, Moratuwa, 10400, Sri Lanka /sabrinanazee@gmail.com F S Nazeer, S Gunatilakeand T Ramachandra Significant Sustainable Facilities Management (SFM) Practices in the Health Care (HC) Sector

2. BACKGROUND • Health Care (HC) is identified as one of the most polluting industries. HC is recognised as the second energy intensive sector emitting 8% out of total 40% of CO2. • HC is ranked among the top 4 sources in spreading harmful substances in affecting health and wellbeing of the society. • Even though HC is recognised as “caring for the healthy” it undermines the population by being a threat to their health and wellbeing. • This creates a demand for FM to adopt sustainability practices in the HC sector as they are identified to be in an unique position to deliver real differences in retrofitting sustainability practices in buildings. • Integrating sustainability into FM practices differ to organisations for Eg: facility features, organisational scale, business sector, organisation characteristics, context of operation and culture. 2235

3. RESEARCH PROBLEM • Implementation of sustainable practice is not easy as sustainability needs to be achieved in balance of economic development in parallel construct of protecting the environment and the mutual benefits to society (Meng, 2014). • Green accounting, individual metering, energy management and energy labelling are most relevant SFM practice in housing sector, Denmark (Nielsen, Jensen and Jensen, 2009) • Eliminating Sick building symptoms, accessibility to public transport, energy efficient facilities, water efficient facilities and 3Rs in waste management practices etc were identified most relevant to office buildings in Singapore (Shari & Soebarto, 2014) • Use high quality and long lasting material (linen), recycle waste water, Install low-flow sinks, toilets, showers etc and design to preserve views etc in hotels ((Ahn & Pearce, 2012) • SFM practice differ among facility types from offices to housing, retail locations, healthcare, hotels, universities, world heritage sites and others. • “what sustainable practices to be integrated into the current FM practice in healthcare?” remains unanswered. 2235

4. RESEARCH PROBLEM • Lack of understanding about sustainability and unwillingness of integrating sustainability are preventing to practice SFM (Elmualim et al., 2009). • Current sustainable assessment fails to focus on social, environment and economic aspect of sustainability (Eaganl, 2007). • LEED and BREEAM have a specific version for HC facilities focused on environmental sustainability, with limited focus to social and economic aspects. • Baaki et al. (2016) recognised the need of assessing SFM in relation to economic, environment and social aspect, yet the research did not state how SFM practice to be evaluated. • Graubner, Pelzeter, & Pohl (2016) highlighted the importance of assessing the performance of SFM practice in German facilities. This research was generalised to all facility types suggesting 23 sustainable criteria, and emphasising the requirement of having different criteria for different facilities. • lack of evidence to support the research into the performance appraisal of SFM practice in healthcare holistically. 2235

5. RESEARCH AIM Identifying significant FM services and sustainability practices in HC sector considering the principles of sustainability 2235

6. RESEARCH METHODOLOGY FM services and sustainability practices: Document review - 52 documents published journals, conference papers etc were reviewed from 1990 to 2017 Delphi Survey 2 Rounds 10 experts including (05) facility managers, (03) engineers, (01) medical director and (01) quality manager who possessed more than 10 years of experience in FM practices in HC RII, Overall performance weightage (OPW) 2235

7. Literature findings • FM is multi-disciplinary and the practice of FM refers to the various FM services performed in an organisation (Boateng, 2011; Nutt, 1999). 2235

8. Literature findings • Sustainable FM (SFM) is defined as “delivery of sustainability within FM” • SFM is the solution for “unsustainable buildings and unsustainable building operation” (Nielsen, Jensen & Jensen, 2012) • SFM practice incorporate sustainable practices in relation to aspects of social, economic and environmental sustainability into existing FM practices • 91 HC specific sustainability practices were identified • sustainability practices were identified in meeting • 36% meeting the environment • 33% social principle, principle and • 31% economic principle of sustainability 2235

9. Results and Findings • Significant FM services and sustainability practices • Delphi Round I: • 8 out of 11 FM services and • 39 out of 91 sustainability practices were identified as significant. • Delphi Round II: • 3 FM services were found non-significant and • 05 out of 52 sustainability practices were identified significant. • Consensus Reached • 8 FM services as significant • 44 Sustainability practices as significant 2235

10. Relevancy of sustainability practices to the sustainability principles 48% of them were found to address the environment principle, 32% of them addressing social principle and 20% meeting economic principle of sustainability 2235

11. Discussion • BS: the most important FM service in integrating sustainability • RII of 0.94 and a total weight (W.FSerBS) of 18.368. • 22 Out of the 30 total sustainability practices were identified as significant. • “ensure appropriate onsite, off-site storage and transport of non-hazardous, hazardous waste and medical wastes” and “identifying applications for energy saving measures” obtained the highest OPW of 0.9024. • QM: second most important FM service in integrating sustainability • RII value of 0.90 • 4 out of 8 sustainability practices were identified as significant. • Literature also QM was emphasised - if left unattended it is more vulnerable in spreading diseases 2235

12. Discussion • SP: second most important FM service in integrating sustainability • RII value of 0.90 • 2 out of 10 sustainability practices were found significant: W.FSerSPvalue of 1.5300 • Social concern less importance. Supported by the Sunday Times [31] in which the editor highlighted the ignorance of HC sector in meeting social responsibility in the context of Sri Lanka. • RE and HR: highly referred in literature • RII value below 0.70 • MM: Literature and experts view non-significant 2235

13. Way Forward • Questionnaire survey will be conducted • to identify the relevancy of sustainability practices to the classified FM services, • to assign appropriate scores for the sustainability practices in developing an assessment framework to evaluate the SFM practice in HC sector. 2235

14. Sabrina NAZEER sabrinanazeer@gmail.com 2235