Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future (2020) / Chapter Skim
Currently Skimming:
4 VHA Facilities Management (Engineering) Staffing Methodology
4 VHA Facilities Management (Engineering) Staffing Methodology
Pages 48-66
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 48... ...
functions and responsibilities at a VAMC with a low level of infrastructure complexity, followed by application of several infrastructure complexity parameters that require a variance from baseline staffing levels. Each infrastructure complexity parameter impacts Facilities Management (Engineering)
|
From page 49... ...
Last, the chapter closes with an example illustrating how the VHA Engineering Staffing Methodology could work, using notional infrastructure complexity parameters and staffing variances beyond the baseline. As noted in the interim report and Chapter 3, any resource planning and staffing methodology requires an estimate of the amount and types of work to be completed and the time and effort necessary to complete the designated work (NASEM, 2019d)
|
From page 50... ...
Staffing Model based on a shared understanding of the desired level of performance for different functions, it could not find evidence that such performance levels have been defined across all VAMCs, beyond those that define requirements for specific systems or processes, or perhaps the implied goal of "achieving or surpassing Joint Commission standards." A recent Government Accountability Office report (GAO, 2018) reached a similar conclusion: To provide quality care for the nation's veterans, medical centers must be clean, safe, and functional.
|
From page 51... ...
should establish and define desired performance levels for VHA Facilities Management (Engineering) that flow from the organiza tion's mission or policy and that can be used to drive more specific performance goals, objectives, and performance measures for Facilities Management (Engineering)
|
From page 52... ...
Furthermore, the committee heard that VHA Facilities Management (Engineering) performance is evaluated regularly, and almost constantly, by entities such as the Office of the Inspector General, Joint Commission, Occupational Safety and Health Administration (OSHA)
|
From page 53... ...
staffing could be linked to specific KPIs reflecting target levels of performance. For example, VHA could link Engineering staffing levels with the risk of negative events occurring, after those negative events, in turn, have been linked to patient outcomes.
|
From page 54... ...
It attempts to balance the need to incorporate critical infrastructure complexity parameters that impact Facilities Management (Engineering) workload and that vary across VAMCs, with the need to create a communicable, transparent model that will be easy to explain and understand, such that chief engineers, medical center directors, and other stakeholders can feel confident about the results it produces.
|
From page 55... ...
Every VAMC must have at least this level of staffing. Beyond the baseline staffing levels, staffing variances reflect additional workload associated with infrastructure complexity parameters that vary across VAMCs.
|
From page 56... ...
Incorporating Infrastructure Complexity Parameters into a Baseline Staffing Model The baseline staffing levels should be supplemented with a set of parameters that reflect significant ways in which infrastructure complexity varies across VAMCs and thus impacts the workload for Facilities Management (Engineering) departments.
|
From page 57... ...
Parameters That Could Be Considered in the VHA Engineering Staffing Model This section briefly describes parameters that could be considered in the VHA Facilities Management (Engineering) Staffing Model.
|
From page 58... ...
education and research measures. Some of its parameters are undoubtedly correlated with facility maintenance requirements, but the Facility Complexity Model does not capture the full story for infrastructure complexity, particularly for VAMCs in the lower categories of the Facility Complexity Model.
|
From page 59... ...
STAFFING METHODOLOGY 59 6. Buildings on the Historical Register -- In addition to building age, some buildings have been designated as historical.
|
From page 60... ...
Statistical modeling techniques, such as regression analysis, can be used to evaluate the extent to which indicators of infrastructure complexity (e.g., gross square footage, facility condition assessments) account for variability across VAMCs in current Engineering staffing levels.
|
From page 61... ...
The committee developed this to illustrate the outputs of the staffing methodology, assuming that the baseline staff levels have been established and that a set of infrastructure complexity parameters and their associated thresholds for triggering staffing variances have been selected. As noted earlier, decisions about which parameters to include in the staffing model and the thresholds within each parameter that trigger a staffing variance beyond baseline should be informed by a blend of expert judgment and analyses of links between existing staffing levels and KPIs.
|
From page 62... ...
departments in VAMCs that have responsibilities or infrastructure or systems that other VAMCs do not, such as a 24/7 staffing for a water purification plant or a fire station. Each of the first five infrastructure complexity parameters in the notional model has three thresholds, labeled A, B, and C
|
From page 63... ...
For example, for the square footage by usage type parameter, the Level A variance threshold for ambulatory space is 400,000 square feet, the threshold for Level B is 200,000 square feet, and the threshold for Level C is 100,000 square feet. For the facility condition index infrastructure complexity parameter, Level A is associated with greater than 25 percent of buildings or departments receiving a grade of D or F, Level B with 10 percent receiving a grade of D or F, and Level C with 5 percent receiving a grade of D or F
|
From page 64... ...
As noted above, the application of the staffing methodology must also incorporate adjustments to the FTE levels to reflect worker non-available time due to holidays, rest breaks, and leave. In Figure 4.6, the notional VAMC meets threshold A for square footage dedicated to ambulatory, operating suite, inpatient, and ancillary purposes, and threshold B for square footage dedicated to administrative and parking garage purposes.
|
From page 65... ...
The staffing methodology described in this chapter can be used to do rough "what-if" analyses -- for example, discussing the number or scope of additional NRM projects that could be undertaken with more staff, and the relative offset in FTEs required to maintain facilities in their existing state but would require discussions with the medical center director about how exceptions to the model output differ from impact to the staffing variances associated with the already-defined infrastructure complexity parameters, thresholds, and staffing variances above baseline. SUMMARY In summary, this chapter describes a staffing methodology that accounts for the fact that Facilities Management (Engineering)
|
From page 66... ...
Over time, as the context in which the model operates changes, the infrastructure complexity parameters, thresholds, and staffing variances may need to change. The point is that the methodology described in this chapter can change in transparent ways, which allows for discussion and clear understanding of how Facilities Management (Engineering)
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.