Speaker 1: Kirk
Kaiser
Speaker 2: Mickey Eberts
Speaker 3: Danielle Young
Speaker 1 (00:00):
Glad you could join us on FM After Hours, the ultimate
podcast for all things facility management. We’re here to take you on a journey
into the ever-changing world of fm. Don’t forget to check out our gracious
sponsor, remediate your trusted partner in fire and life safety, compliance and
Granger for the ones who get it done. And with that, let’s dive in.
Speaker 2 (00:21):
Welcome back to FM after hours. My name’s Mickey Eberts,
and I’m joined by my co-host, Danielle Young and Kirk Kaiser. I’ll start off by
thanking our sponsors, remediate in Granger, and today we’re going to talk
about staffing and healthcare. Kirk.
Speaker 1 (00:37):
Yeah. So with that, we have some alcohol because we’ve
said we were going to do it all along. And this is probably the topic where
they can drive you to drink sometimes. Right? Exactly. So we got a little
whistle pig today. That’s right. Yeah.
Speaker 3 (00:50):
So if you’re at home watching pour a drink. Exactly.
Speaker 1 (00:54):
Unless you’re watching it in the morning.
Speaker 3 (00:55):
That’s
Speaker 2 (00:56):
Right.
Speaker 1 (00:58):
Go ahead, pass it on around to him. Yeah, so staffing.
It’s me. There you go. There you go. Thanks. Yeah, like it.
Speaker 3 (01:10):
Yeah. You’re
Speaker 1 (01:11):
A whiskey girl.
Speaker 3 (01:12):
I’m a whiskey girl Through and through all day, baby.
Speaker 1 (01:15):
There you go. What’s your favorite?
Speaker 3 (01:22):
What is the name of it? It’s not Jameson, but it’s the one
that’s a level up from Jameson. Tell more. Do
Speaker 3 (01:29):
Okay. Okay. Yeah.
Speaker 1 (01:30):
Nice. What about you, Mickey?
Speaker 3 (01:33):
There’s not much I won’t drink. Amen. Honestly, that’s a
valid point. Yeah.
Speaker 2 (01:40):
I mean, I like scotch whiskey, gin. It doesn’t matter.
Vodka, tequila. Very good.
Speaker 3 (01:47):
So let’s cheers to staffing and we’re going to
Speaker 2 (01:48):
Cheer to staffing. Cheers.
Speaker 3 (01:53):
Ooh, that’s nice. Yeah, smooth. Let’s get into it all.
Speaker 1 (01:57):
All right. So
Speaker 2 (01:58):
Yeah, you want to kick us
Speaker 1 (01:59):
Off? So man, staffing for healthcare, and I think we can
talk about it from a few different points of view from as a contractor, someone
providing labor, and then maybe if you can obviously take the lead on from the
facility standpoint and that Definitely. And I know you’ve had experience on
both sides of the equation, but especially on which is a nice bridge where you
can relate to both. So yeah,
Speaker 2 (02:24):
One of the things I get really excited about just in
general, when we talk about facilities management in healthcare specifically,
there’s not a lot of people that realize that it’s a career path. And when you
get into it, it’s a fantastic career path. So if you have basic maintenance
skills, you can use a hammer, a screwdriver, you can get in the door as a
general maintenance mechanic at any hospital in the country. And you’re
starting out at anywhere from 14 bucks an hour to 20 bucks an hour to depending
on your skillset. And you don’t have to have education for that. You don’t have
to go to college. It’s something you can get into. And in addition to that,
you’re working in a very comfortable environment. It’s climate control. So
every now and then you have to do something in a sub-basement, but very rarely
are you outside unless you’re on snow patrol or something like that. But
depending on where you live, there’s not a lot of that. So you get in, you can
start at the bottom level, you’re still making decent money, you’re in a good
environment, and then you have tracks you can go through can to the trades. So
HVAC, plumbing, electrical, a lot of times the hospital will help or pay for
all of your schooling because they need those trades and they’re very difficult
to find. And for typically when someone goes and becomes a plumber, they look
to go join a union and work through that vector, if you will.
(04:04):
So hospitals aren’t going to hire union plumbers unless
they’re shops a union.
Speaker 1 (04:11):
So
Speaker 2 (04:12):
You can go to school and within a very short period of
time, you’re making 28 bucks an hour, you’re making 32 bucks an hour, and you
can stay there for your entire career if that’s what you want to do. So it’s
very stable.
Speaker 1 (04:29):
When you pick a track, let’s say you go in there and you
want to get into plumbing or something, are you pretty well pegged on that
track or can you learn plumbing and do that for a couple of years and switch
up? Or how does that tend to flow?
Speaker 2 (04:45):
I think you can switch if you want, but typically you
don’t see a lot of that. The most flexible track would be HVAC because it can
naturally lead to building automation, low voltage, electrical. And you also
see a lot of electricians can float a little bit as well, but your only
constrained by your own imagination and a poor leader. To me, if you’re a
plumber and you decide you want to learn something else, it just makes you more
valuable. If your leader is not up to that, then find somewhere else to work.
Speaker 1 (05:26):
Right,
Speaker 2 (05:27):
Right.
Speaker 1 (05:28):
Yeah. Do you find most in today’s environment, like here
in 2024, do you find most facilities being adequately staffed, understaffed?
Speaker 2 (05:39):
No, they’re understaffed.
Speaker 1 (05:40):
Yeah.
Speaker 2 (05:40):
Yeah. So we’ve talked about this in several layers in this
podcast. We talked about insourcing versus outsourcing. One of the problems
with insourcing work is it’s very difficult to find the staff. The other
problem is you’re CFO has regulatory reasons why he or she is watching your
staff. They’re constrained. They’re never going to tell you this. They’re just
going to continue to drive for you to cut labor. One because of the
constraints. Two, because it’s the quickest route to drop the cost inside the
organization. You can come up if you’re a financial leader, how many times have
you sat down with the operator and they’ll tell you, well, we’re going to
manage the cost and they don’t manage the cost. But if you force the staff
reduction, it’s managed
Speaker 1 (06:39):
At
Speaker 2 (06:39):
Least short term.
Speaker 1 (06:40):
And definitely facilities are seen as a cost center, not a
revenue center. Right.
Speaker 2 (06:44):
A hundred percent. That’s a great point. You don’t have
typically have the flexibility that a nurse does or a doctor to come in and
say, well, we’re going to generate more revenue by doing these procedures. We
haven’t done these before. We’re inefficient at it. So if we add staffing, we
can become more efficient. You’re typically looked at as a cost center
Speaker 5 (07:10):
And
Speaker 2 (07:11):
They want that cost to be as low as possible. So just to
give you a couple of ideas, there’s a wide range, but what I always drove to is
one FTE per 30,000 square feet. Now our viewers, they’re going to do their own
math and they’re going to go, I don’t even have close to that. I’ve got one ft
E per 80,000 square feet or one FTE per a hundred thousand square feet. Now
we’re talking about healthcare space. So when you get into office buildings,
then my number would go to about one FTE per 70,000 square feet, and I would
drive my operation that way. Rarely was I successful though. Again, because of
you’re fighting your CFO, you’re fighting the dynamics of what happens in a
hospital.
Speaker 1 (07:59):
When the CFO goes and looks at that, do they have that
metric in mind or is that just from your experience?
Speaker 2 (08:08):
That’s a fantastic question. In general, they don’t have
that metric in mind. What they do is they will bring in different groups that
show them benchmarks. The problem is the benchmarks they get because the
consultants they choose are healthcare specific, are per patient days like
that. And so that has little to nothing to do with the cost of maintaining a
building. Your square foot doesn’t diminish unless you mothball a space and
you’re not going to do that, right. It takes too much to do it. So you still
have to maintain the space regardless of whether there’s a patient in there or
not. If it’s a piece of equipment, it’s got to be PMed, it’s got to be
Speaker 3 (08:59):
PMed.
Speaker 2 (09:01):
So they’re not thinking along the lines of the, where I
get my numbers comes from Ashe and ifma, different associations inside
facilities management. And by the way, mine might be a little dated. It’s been
a while since I’ve been inside a facility, but the CFO’s looking at completely
different metrics. It’s your job as a facility leader to expose your CFO
Speaker 1 (09:27):
And
Speaker 2 (09:28):
Potentially whomever you report to these metrics and
explain why they’re important.
Speaker 1 (09:32):
So can you do ASHY or ifma publish, anything like that?
Speaker 2 (09:36):
Yes, they do.
Speaker 1 (09:36):
They do. So you can go there and get the information they
can. Nice.
Speaker 2 (09:39):
And they come out and every three to four years, they’ll
do some sort of published study that updates it and it goes into everything. I
mean, it’ll get into how many coordinators you might have, how many plumbers,
how many electricians, how many general maintenance mechanics. You have to make
sure you’re looking at the data, right? Because some of them include square
footage, will include roof spaces. You may have to back those out. And there’s
a word for that, and it’s escaping me right now, but normalize, that’s it. You
need to normalize your numbers to your operation.
Speaker 1 (10:23):
So
Speaker 2 (10:23):
An example, they may have this many FTEs per square feet,
but their numbers include maintaining beds.
Speaker 3 (10:33):
And
Speaker 2 (10:33):
In your hospital, you don’t maintain the beds as a
facility department, the medical equipment department does or vice versa. So
you got to compensate for that. And the sooner you expose your administration
to these numbers, the better one. It gives you credibility because you didn’t
make it up. A professional organization created it. And also they’re looking,
so how they get this information is they do data request to a facility, people
around the country. And so I got ’em many times. So you’d lay out how many
buildings you manage, the type of space, what your staffing ratios were,
Speaker 3 (11:16):
And
Speaker 2 (11:16):
Then you submit, then they break it all down and come up
with, okay, here’s the 10th percentile, here’s the 50th percentile, here’s the
90th percentile.
Speaker 1 (11:24):
Sure. Yeah. And then what about when you go for budgeting
and stuff? So when you’re going to ask for more people, you can bring things
like these statistics. What else can you do to try to bolster your, bolster
your, Hey, we need a couple more people in there.
Speaker 2 (11:43):
Well, let me start with protect the people you have.
Speaker 1 (11:46):
Okay.
Speaker 2 (11:47):
That’s very important. So as I got a little bit higher up
in management, so when I became a manager and I had supervisors that report to
me or director and had managers that report to me on a monthly basis, we’d go
through the budget and if they had a position that was open and posted or not
posted, and they’re talking about needing this position. So I’m asking
questions, you haven’t had this in three months, and if you’re still getting
your work done, you’re going to lose the
Speaker 1 (12:17):
Position.
Speaker 2 (12:18):
So get it posted, get it hired. Use the resources you were
given in your original budget. So now if you’re going to ask for more staffing,
then the most obvious way to be successful is to demonstrate a business reason
why you need that.
(12:40):
And so now we’re talking about insourcing versus
outsourcing. So it could be, well, let me back up before I go there. It could
be staffing coverage. So an example, maybe you don’t staff second shift, maybe
you don’t staff third shift, there’s quantifiable reasons that you should.
You’ve got nurses that are getting upset, nurse leadership’s getting upset.
Oftentimes facilities in those second and third shifts and weekend shifts, they
play a security role. So necessarily they’re not usually walking around in a
security uniform, but it’s an individual that can respond to an incident and it
makes people feel safe. So there’s different reasons why you go down the road.
So one, are you solving a problem that the organization has? And then two, go
into the business piece of it, which is you’re paying $200,000 a year for
movers and you can do it for a hundred thousand. You need two staff, you need a
bunch of hand trunks.
Speaker 1 (13:44):
Art would be so happy you just said that.
Speaker 2 (13:46):
He would actually, and hey, listen, actually art couldn’t
make it today. He’s on a family vacation. He would be very happy that I said
that. Now he would take it way too far and go down the road, but we’ve already
had that discussion. He would be very happy.
Speaker 3 (14:02):
I love that you saved it until he wasn’t here. Oh
Speaker 3 (14:04):
Yeah, totally. He’ll give him a call, he’ll watch it and
be happy. Now, I always knew. So
Speaker 2 (14:11):
That’s another way to get additional staff, and I won’t
rehash the whole insource outsource equation, but things like moving data
drops, landscaping, those are things that you can do that are much less risk.
Now if you live in Wisconsin, I’d be very careful before I outsource snow
removal. You might have a good year and then you might have a bad year if you
decide to outsource it. Have contingency plans. Right.
Speaker 1 (14:43):
As someone that was in snow removal, the first part of my
career, I worked for a company and did magnesium chloride. And it’s interesting
when the snow really starts flying and people need people, you can’t find ’em.
You are
Speaker 3 (14:56):
Dime a dozen.
Speaker 1 (14:56):
Yeah,
Speaker 3 (14:57):
You are in trouble. I’ll tell you, you’re looking for him
in a snow storm.
Speaker 3 (15:01):
Yeah.
Speaker 3 (15:01):
I’ll tell you a funny story. So
Speaker 2 (15:04):
I was working at a hospital system in Wichita. I started
in April, I think of 2007. So we’re still, it’s outside of when you would think
you’d have a lot of snow,
Speaker 3 (15:16):
But
Speaker 2 (15:16):
We had, I’ll get the days wrong, on a Monday, we had 12
inches of snow on the next, the following Wednesday, we had 18 inches of snow,
which was crazy. So my guys were under a lot of stress. We had set up rotations
and we were using companies and we had to augment with internal staff. It was
so bad. So I decide I’m going to help. I’m going to go out there and I’m going
to help. So I get suited up and I go out there and they’re all laughing at me.
They’re like, what are you doing out here? I always wore a suit and tie. So
I’ve got overalls over my tie and all this, and two minutes into it, I go to
climb up in a truck, fall out of the truck, land in the snow laying there,
everybody’s laughing. I do a snow angel jump back up, and then they’re like,
you stay out of the truck. You just use a shovel. Yeah, it was funny.
Speaker 3 (16:14):
Oh man.
Speaker 2 (16:16):
Oh my gosh.
Speaker 3 (16:17):
I pay money to see you do a snow angel.
Speaker 2 (16:20):
I do it with my kids today if it snowed. I was just trying
to play it all.
Speaker 3 (16:26):
Yeah, super embarrassed. Yeah.
Speaker 2 (16:29):
Yeah, it was funny. But going back to your question, so
you’re in your budget cycle, one, protect what you have. Two, find business
reasons to increase staff. And here’s another thing that’s hard. Raises are
hard to come by in hospitals, and usually they’re lower than the cost of living
increases. So it’s hard to keep people, especially if you have an electrician
that’s licensed or you have a plumber that’s licensed or an HVAC person that’s
licensed because sort of the selling point is, wait, hold on. If you go do
that, yeah, you’re going to make $5 more an hour, but you’re going to be in a
truck and you’re going to be outside and you’re going to be doing service
calls. And some people get that and some people don’t. So one of the things
that you have to take it upon yourself as a facility leader is you have to
understand human resources and you have to understand recruiting and retention,
and you have to do your own work. So hospitals will do, you are in hr,
Danielle, what’s it called? It’s the study where they figure out the pay
scales, what the appropriate scales are supposed to be. There’s a term for it.
Speaker 3 (17:48):
It’s been a minute. I’m so sorry.
Speaker 2 (17:50):
So essentially a market study, that’s what it called
market study. Market study. They’ll go off,
Speaker 3 (17:54):
It’s a market study.
Speaker 2 (17:55):
There you go. And they’ll say, okay, a plumber should make
X and they will give you a low, a high and a median, but they’ll mess it up
because they don’t understand anything other than healthcare. So your HR is
usually not doing the work. They’re paying somebody to do the work. They’re
paying a firm. The firm they pay specializes in healthcare, but healthcare to
them means nursing means doctors, means radiation technicians,
Speaker 3 (18:31):
CNAs, and
Speaker 2 (18:31):
Exactly.
(18:33):
So then they get this group, they’ve got housekeeping, and
they’ve got facilities and they’ve got medical equipment technicians, and
they’re like, we got to do something with these guys. And so they forget that
working in healthcare is more complicated than working in an office building.
So they’ll come back with salaries for a general maintenance tech at 10 to 13
bucks an hour. So you’ve got to be able to articulate, hold on, this isn’t
right. Again, you can go back to Ashe, you can go back to ifma, and you have to
be diligent with that when they’re doing their market study, you’re doing your
market study or you’ve done your market study and you’re giving them the
information before it goes forward.
Speaker 1 (19:19):
So when you go give that to them and you’re trying to
like, well, let me take further step back. If you go find an electrician and
it’s someone that’s got potential, and you’re going to go, Hey, you go in and
we’re going to pay you to get trained up and pay you to go get that at the
point that they’re trained up and now they’re an electrician, then it’s not
just healthcare. It’s the entire electrical market. I mean, they can go work
for an electrical contractor, they can go
Speaker 2 (19:47):
Start their own business,
Speaker 1 (19:47):
Start their own, whatever.
Speaker 2 (19:49):
So typically, what if you’re smart? And I wasn’t always,
so I did this wrong several times, but the right way to do it is to reach an
agreement upfront to say, look, we’re going to put you through this program.
You’re going to agree to work for us for X length of time under certain
conditions. So we’re going to pay you market rate, but you’re going to stay
with us for two years, three years, whatever that is.
Speaker 1 (20:14):
So to try to keep ’em on, right?
Speaker 2 (20:16):
Yeah.
Speaker 1 (20:18):
So in the event you have gaps in your people and you have
a special project that came up. You have the joint commission came through and
now you got to go fix a bunch of stuff or whatever the case may be. So when we
started looking at, okay, we need to start looking at bringing in outside
labor. So I mean, I will just put it in two camps. Well, maybe three camps.
There’s skilled labor, there’s qualified labor, people that can come in and
work in a hospital and know the rules and procedures for working in a hospital.
And then there’s just completely unskilled, let’s just say temp labor, right?
So when you go after the, is that, do you think those are the three buckets or
am I missing something or
Speaker 2 (21:01):
No, that’s pretty much it, but let’s talk about the
significance of the differentiation between those buckets. So there’s almost
skilled and then super skilled. So another story, which this was one of the
worst things that ever happened in my healthcare career. I won’t talk about
where, but I was at a hospital system, and we may have already talked about
this, but we had transformers that were 12,480 volts inside our energy center.
You don’t want that. You want that outside. We put it in capital for a couple
of years to get ’em moved. The project got approved. Okay, now you can’t just
call an electrical company. So usually as a layman, when you talk about the
difference between low voltage and high voltage, you’re talking about the
difference between that outlet versus a thermostat. Okay, that’s not what we’re
talking about.
(22:13):
There’s high voltage and then there’s high voltage. So we
did a bunch of research. We found a company that had all the certifications and
the licenses and demonstrated that they had done projects like this in the
past. We hired them, the guy’s on site for less than an hour, and the high
voltage electrician messes up, does something wrong with his meter, the
electricity goes through and blows his meter up. And so he’s electrocuted, he
gets sent back. I don’t want to exaggerate 15 feet in the air. He codes now
amazing. It’s called a code blue. And every hospital has a team that responds.
So they respond, they revive this guy, but he’s all messed up. He’s burnt,
right? He obviously goes in ICU. He lives when this happens. So our emergency
power is down and our normal power is down.
(23:24):
So we got people upstairs, they call it bagging, squeezing
the oxygen into patients that have to have it. So we’re running around, we get
the emergency generators online relatively quickly, and we had three
generators. All three of them would carry the load of the hospital. And so
you’re scared to death. I mean, that’s a good situation to be in because if one
goes down, you have two. If goes down, you’re okay. You can get ’em fixed. But
we set up rounds and all these things to make sure we had enough fuel and they
kept running. We couldn’t find another company to come in to fix it. So I ended
up having to call the power company. And the power company says, it’s not our
problem. So I say, Hey, I need help. We’re a hospital in the community. I need
help. They’re continuing to argue with me. I finally get upset and say, okay,
no problem. I’m going to get off the phone. I’m going to call the news. I’m
just going to call the news stations and let ’em know who I am, what I got
going on, and that I’ve called you for help hour later, they’re out there.
(24:45):
Now how many things are that serious? Actually more than
you think. If you’re having somebody work on your fire pump, if you’re having
somebody work on your emergency generator, if you’re having somebody work on
your medical gas system, you better damn well know for sure and have done the
research that they know what they’re doing. And by the way, you better have a
backup plan.
(25:06):
So if you’re going to do a shutdown and you’re bringing in
a specialty company, have a plan for if something goes wrong, do they have the
resources? That was a mistake I made. I didn’t ask them, how many people do you
have that can do this? Right? Sounds stupid. And I felt stupid, but it was very
scary. So it’s one thing to have an electrical company come in to pm your
panels. It’s another thing to have them work on really high voltage gear. So as
a facility leader, the hard thing is you don’t know everything. And so you’ve
got to be very careful when you’re, first of all, you got to continuously
learn. Second of all, you got to have context, which now you’re talking about
building relationships with engineers and your vendors and learn about each of
their specialties. You need to develop your staff because when I’m telling you
the story about the power going out, the guy who saved the day that got the
generators back online was my lead electrician. I couldn’t do it. Matter of
fact, this guy’s name’s Dale. And I said to him, what do you want me to do? And
he said, go stand at that door and don’t let anybody come in here.
(26:28):
So that’s what you do. So you really need to pay attention
when you’re repairing critical equipment.
(26:37):
So now go into your mid skillset stuff that would be
anything that’s connected to life safety or this sounds dramatic, but could
cause death in the event of a failure or critical harm in the event of a
failure. You want to be very careful with that. Now you’re talking about, I
need, and I don’t want to diminish HVAC, but if you’re changing a motor out on
your HVAC unit that serves the administration building, you’re less concerned
and you can be a little bit looser in terms of who you’re having to do it. And
then when you talk about unskilled, and I actually, I don’t want to offend
anybody. I worked on a landscaping crew when I was right out of high school. It
takes skill to do it, but if they mess up, they’re going to tear your grass up.
They’re going to kill a plant, they’re going to miss something when they’re
cutting. They may run into throw a rock at a car. You want to vet ’em, but
you’re okay if they’re bringing people in with shovels, cleaning your
sidewalks.
Speaker 1 (27:52):
But I will say one of my buddies had a staffing company. I
spent an afternoon over at his place and it was nonstop call after call after
call about what the temp employees did. And I mean, he was so good at just
deflecting it at the end of the day, but that’s what you get because they don’t
understand even shoveling sidewalks. What is the requirement for a hospital?
What does happen and what does? And it’s just not the same level. And so I
would say the completely unskilled, you still have to actively, actively be
there, manage and on the spot to watch it because that’s a great point because
if they’re shoveling, they may not get out of the way For someone walking on
the sidewalk, they may not help someone out that needs to be helped out. They
may not do the things that set the level of standard that’s required for
healthcare.
(28:47):
So you have to be there. I mean, sitting the situation if
nothing else. And I think that’s where that’s sort of that next level up, which
is finding people that are qualified to work within healthcare. And so the
second you step inside the building, it’s like do they have shots and
immunizations that they need to, have they bag been background checked? Have
they been vetted out? Even if they’re not going to be an employee of the
hospital, all those same things still have to happen. They can’t go into the hospital
and be sick. You’re not going to put them in a situation if they’ve got a
sketchy background to be in a situation that’s not, shouldn’t be there,
especially if you’re even as a temp laborer, if you’re putting ’em in an area
where kids are, or anything else.
Speaker 4 (29:38):
Coming from my recruiting background and hearing you say
that and then also adding the extra layer that the hospital has to go through,
it makes so much sense as to why you would want to vet and background check and
ensure that the people that you’re hiring listen to what they need to do. It’s
like getting PTSD over here from coming from a staffing background.
Speaker 1 (30:00):
Yeah, that’s a good point. And I think especially when
it’s like a lot of times it’s the keys. If you need to go inspect something or
do something, A lot of respect is like, do you know you’re given the keys to
for the entire building where you can go virtually anywhere, maybe not in a few
isolated areas, but if you have a set of master keys, you can go pretty much
anywhere. Pretty much anywhere.
Speaker 2 (30:21):
Yeah. Usually it’s only the pharmacy that you can’t get
into the conversation. It brings up an interesting point. As a facility leader,
the things that keep you up at night and worry you are not the things that you
spend 90% of your time dealing with. So I talked about, oh, sorry, hit the
microphone. I talked about if an HVAC unit in your administration building goes
down, you’re not as concerned as if it’s in surgery or even the ICU or med
surg, but you’ll hear more about a painting that needs to be hung or a chair
that needs to be fixed, or there’s a hole in the wall in the administration
building, and because their administration, you react. So a part of what I
always did was I socialized the prioritization of work orders. So priority one
through priority five, and for us, priority five was always the highest. And I would
socialize the response time. I would socialize the expected repair time for
each of those different priorities. So I never had my technicians have this
discussion with the customer, but if need be, I’d walk over to administration
if they were raising hell, and I would say, remember, this is a priority one
work order. We’ll fix the hole, but take it easy. It’s snowing outside. I’ve
got everybody on a rotation. So you have to be able to, and you can only do
that if one, you’ve socialized it, and two, you’ve built credibility within
your organization. If you don’t have those things, then you’re going to be
looked at as just somebody who doesn’t care.
(32:28):
And you are. So I’m going to go back to the conversation,
the point you guys made about supervising and the expectations set around
everybody in the hospital. You’re a hundred percent, and I’ve made no mistake.
I’m the CEO of remediate. We’ve talked about that when we get in trouble, it is
almost 100% it has to do with an individual. One of our technicians has a bad
day, is not focused on what they’re doing. Now we’ve pretty much, I’m knock on
wood, we haven’t had in a long time issues where we create regulatory exposure.
(33:18):
So we’re working in the ICU without the appropriate gear
or the appropriate containment cart. We don’t have that, but we do had an
employee that’s on a ladder in a hallway and they cut themselves and they’ll
say, damn, or they’ll curse or whatever. Little things like that are get out of
the way. We had a call one time where one of our technicians was getting on the
elevator while a couple of nurses were willing, the patient trying to get the
patient out of the elevator was on a bed. Protocol is get out of the way. Let
them go first. The technician didn’t mean to do it. Once it was pointed out, he
felt very bad. But those little things in a hospital setting mean a lot. When
you walk down a hallway, look up, make eye contact,
Speaker 1 (34:20):
But it is all those little things. It is when you enter an
area, go find the head nurse, right? It is like how you carry a ladder. You
don’t carry it where you’re going to hit someone in the head. It is. Are
Speaker 2 (34:36):
You going to hit a
Speaker 1 (34:37):
Sprinkler head? Yeah, the sprinkler header, clean
environment, how are you? I mean, there’s so many things that in the hospital
are unique to the hospital that someone coming from the outside of the hospital
doesn’t know. They just don’t know that.
Speaker 3 (34:52):
And
Speaker 1 (34:52):
I think that’s the big difference maker in healthcare
specifically because those things make a big difference. That’s what for the
facility director, I assume, when you have vendors in there that know how to
operate and know what they’re doing, and it’s a very different experience than,
oh my gosh, he almost hit someone in the head with a ladder. He
Speaker 3 (35:12):
Didn’t
Speaker 1 (35:13):
Get out of the way for a patient, just went in and went
into a room to work. They had work to do. I mean, just the myriad of things
that you run into.
Speaker 2 (35:23):
That’s
Speaker 1 (35:23):
Just, it’s funny. My stepson, he and his mom were talking
the other day and she’s like, it’s common sense. And he looked at her and he is
like, mom, if I don’t know it, it can’t be common sense. Right? Amen. There’s a
lot of the truth of that, right? It’s like you think it’s common sense, but it
is not, if you know what I mean.
Speaker 3 (35:48):
Yeah. They haven’t been shown or told at least once.
They’re not going to
Speaker 1 (35:52):
No health. There’s a lot of that.
Speaker 1 (35:54):
Mean a lot.
(35:56):
So taking someone from out of outside, if you just take a
general electrician like we talked about earlier and put ’em in that
environment and they’ve not worked in there, they can be the greatest
tradesmen, craftsmen, but if they don’t know how to operate in that
environment, it’s probably not going to go well. They don’t understand dust
containment. They don’t understand if you’re up above the ceiling, what do you
need to do? Do you need to go get a HEPA cart? Do, what do you need to do? They
just don’t understand unless they’ve been your point taught in and trained it
and reinforced it and stuff. And it’s a very different environment,
Speaker 3 (36:27):
Like taking a new construction guy and putting him in a
hospital. Yeah,
Speaker 1 (36:30):
Woof. Yeah,
Speaker 3 (36:32):
Exactly. They’re going to need some grooming,
Speaker 1 (36:35):
Right? Yeah. John, to your point, physical appearance and
everything else, and there’s written down unwritten things too, right? Relative
to jewelry and tattoos and tons of stuff, and nobody knows unless somebody
tells ’em. There’s no common sense in the healthcare environment. It’s just not
Speaker 2 (36:56):
Right. And it’s interesting too, because all hospitals
aren’t the same. You might have a religious base that could be a Catholic
hospital or any other denomination that really puts that at a critical
importance. A couple of stories. I was working at a Catholic hospital in
Eastern Pennsylvania, and every morning they would do a reflection. And so at
this time, I was a director. I worked for Sodexo, so we were a contracted
company, and one of the complaints I had when I first got there was the
facilities guys didn’t respect the reflection. So the expected behavior was
when the reflection was going on, you stop. You don’t keep doing what you’re
doing. It’s like if you’re in church and there’s a prayer going on
(37:58):
Now, I had never seen that before, but okay, that’s what
we’re doing. That’s what we’re doing. So you have to teach ’em, Hey guys, this
is how we behave. Another story around construction. We had a company that was
a very good construction company, did a lot of work in our medical office
buildings. We had a credentialing program that you had to go through, almost
like an RFQ to be on our bid list. And there were different sections. If you
met these criteria, you can work in medical office buildings. If you met these
criteria, you can work in regular office buildings, but if you were working in
or healthcare space,
(38:45):
You had to meet these criteria. This one company that
worked in the medical office, buildings kept asking to get on this other list,
and you don’t meet the criteria. No, I’m not going to do it, not going to do it,
not going to do it. A board member came down, sat with me and said, I’d like
you to give them a chance. So instead of saying, no, I did second day on the
job, one of their guys carrying a ladder the wrong way, popped a sprinkler
head, flooded the entire, so the OR was on the third floor below, flooded the
entire, or we had millions of dollars of damage. I had sprinkler water running
down the elevator shafts.
Speaker 3 (39:30):
Did you just sit back and be like, I told you so
Speaker 2 (39:34):
It doesn’t work that way. It doesn’t work that way.
Speaker 3 (39:37):
See, I’m just a little too sassy to be a facility
director, I think.
Speaker 2 (39:41):
But there’s a couple of things they didn’t do. So one of
the things that you’re trained to do is one, you know where the valves are, the
shutoff valves.
Speaker 3 (39:48):
So
Speaker 2 (39:49):
They didn’t know where the shutoff valves were. So it
wasn’t until my team got up there and got it shut down. The other thing is
there’s a wedge tool that you carry with you. If a head pops, you shove the
wedge tool in, right? It ain’t going to stop all the water from coming out, but
it slows it down.
Speaker 3 (40:05):
Slows it down, right?
Speaker 2 (40:07):
So small things. Now, I didn’t say I told you so
Speaker 3 (40:13):
You gave them the look,
Speaker 2 (40:16):
But I did have a conversation with the board member to
just say, Hey, listen, this is why we do what we do. But we already had a
contract with, so you’re going to work with them now. They had to pay for
damages, and I’m sure they had to go to their insurance company. So yeah, those
are good points.
Speaker 1 (40:35):
Yeah. I mean, I think back to getting started in
healthcare myself and pretty daunting. The first time you go in an OR area and
you’re doing something while stuff is going on, right? You’re completely gowned
up. You’re in there and you’re like, all right, you’ve been told the common
sense items, but you’re like, I’m uncomfortable. It’s a little ginger in there.
Yeah, a little nervous.
Speaker 2 (41:00):
Yeah. I’ll tell you a really scary story. I was a director
and I was being surveyed by the joint commission and the surveyor. So all joint
commission surveyors carry, it’s a little square box and it’s got a flap in it,
and you put it down by the door and it’ll measure, it’ll show you which way the
wind’s blowing right out of the room or in the room. We came up to a room that
had gas in it. It had a big fire symbol on it, flammable. And the joint
commission surveyor wanted to check the pressurization, and so he didn’t have
his box. So I’m like, okay, it’s good. He just kind of looks at me. He doesn’t
want to walk all the way back. My technician pulls a lighter out of his pocket.
I couldn’t believe it. Squats down and clicks the lighter. Oh my gosh. So it was
negative pressure. So it actually pulled
Speaker 1 (42:23):
It in,
Speaker 2 (42:23):
Pulled it in, and me in the survey, my mouth was just
wide. I wanted to tackle him. So that was, I don’t even remember how he cited
it. I know he did me a huge favor because I mean, it could have been terrible.
And we ended up giving the guy a final written warning. And the thing is, the
guy had been there for 20 years. He was a great technician. He was trying to
help. He lost his head for a second and did something stupid
Speaker 3 (42:59):
In the moment. He’s like, I know how to help in this
situation, and you No.
Speaker 1 (43:06):
Right.
Speaker 3 (43:07):
What
Speaker 1 (43:07):
Are you doing? This is why when they show
Speaker 3 (43:09):
Up for their accreditation audits, everybody goes home.
Speaker 2 (43:11):
Yeah, yeah,
Speaker 3 (43:12):
Exactly. That is true. I mean, you clear
Speaker 2 (43:15):
It. You all contractors get out, right?
Speaker 3 (43:17):
Yeah.
Speaker 2 (43:18):
Oh, yeah. Yeah. That’s a good point. Unfortunately, he was
one of my staff.
Speaker 3 (43:24):
You have to claim him.
Speaker 2 (43:27):
I never let him go in another joint commission walkthrough
again, man. Yeah, it was scary, but I mean, it worked out okay. It just
underscores the importance.
Speaker 1 (43:39):
Right?
Speaker 2 (43:40):
And my recommendation, if you own a company that provides
service to hospitals, spend as much time as you can understanding infection
control and life safety requirements. Just understand that you can’t prop
certain doors open. You can’t put ladders in front of certain things,
understand what happens when a sprinkler head pops, and make sure that
knowledge gets passed down to your most junior employee.
(44:21):
And we do that. I mean, we spend a lot of time training.
They go through all sorts of modules to make sure that you don’t make those
basic mistakes. A buddy of mine owns a construction company in Texas. He called
me. He had a job replacing ceiling tiles. It was right outside of an ICU. The
guy, the tech was going to have to work on Saturday. He didn’t want to work on
Saturday, so he quit using the containment cart and just to try to go faster.
So he got caught. And guess what? They lost that hospital as a customer.
Speaker 1 (45:10):
Yeah. Dust in the environment is, especially when you do
spend a decent amount of time above the ceiling, it’s not the cleanest space,
right? No,
Speaker 3 (45:19):
It’s not.
Speaker 1 (45:20):
There’s a reason why those policies are in place in every
hospital is a little bit different too. When do you have to have a containment
cart? When not, can you just remove a ceiling tile and inspect, or do you have
to have a containment cart even to do that? Or is it just when you do work? And
so like you said before, every hospital’s a little bit different. It’s the same
way, even within health systems, it’s not like it’s, it’s a system wide
requirement. I mean, you see different requirements as you go from hospital to
hospital,
Speaker 1 (45:49):
Within the same system.
Speaker 2 (45:51):
Yeah, you do.
Speaker 1 (45:52):
Yeah. And furthermore, the interesting thing for me has
always been when you’re in there, you don’t really see contractors with a set
of life safety plans.
Speaker 1 (46:02):
Don’t hand ’em out, so they don’t know what is this
business occupancy, is it not? Is this a rated wall over here? Is it not? I
mean, you can tell that’s the OR area, but once you get outside of there, it’s
not really crystal clear and it’s hard to know. And so if they don’t have those
set of plans to know what the area is rated for, what it’s being used for,
imagine the layman coming in from outside. It is different when you’re a
hospital employee, you probably got a little, at least a little bit different
level of knowledge about what is going on in that area. But people don’t, they
don’t carry a set of life safety plans around, so you just don’t know that,
right?
Speaker 2 (46:44):
Yeah. You can have contractors that continuously work in
hospitals and they begin to become complacent.
Speaker 2 (46:57):
Don’t make sure they have updated life safety plans.
They’re punching holes in walls during their construction process. There are
firewalls. They don’t pay attention to it. The biggest perpetrator are IT
companies.
Speaker 2 (47:15):
Punch holes in your firewalls. It doesn’t even matter. And
so you need to have a above the ceiling permit process. You need to have
control of it. You need to have the right drawings. You need to have a vetting
process for your contractors, whether it’s construction related or maintenance
related.
Speaker 2 (47:33):
Need to be able, you should set minimum expectations that
they demonstrate that they’ve trained their employees.
Speaker 1 (47:41):
I think we’re bumping against the time. So maybe should
continue this for the next segment.
Speaker 3 (47:47):
Love it.
Speaker 1 (47:48):
And then maybe we start out with that. What should you
look for as requirements for your contractors and stuff, and what should you
put in place and Yeah. Yeah. Good idea. Yeah, thanks. Thank you for hanging out
with us on FM after hours. Make sure you follow us on all of our social media
platforms for your regular dose of Facility insights. As always, a big shout
out to remediate and Granger for their gracious sponsorships. Catch you next
time on FM after hours.