The Maintenance Issues of King Fahad Hospital in the Kingdom of Saudi Arabia - Term Paper Example

?Chapter 5 This chapter primarily focuses on the maintenance issues of King Fahad Hospital (KFH) in the Kingdom of Saudi Arabia and is based on the previous chapter of literature review and data findings. Maintenance of hospitals plays a very important role because appropriate upkeep and maintenance of the physical structures only increase the sustainability of hospitals. Chapter 2 presented the literature review, whereas chapter 4 presented the results and analysis of the data collection methods that have been employed. From the previous chapters it is quite evident that poor designing of buildings is one of the main causes, which have led to the wrong maintenance of buildings. It is quite necessary to conduct such a study in Saudi Arabia, as it is one of the most resourceful countries. Unfortunately most of its resources are wasted on unnecessary purposes like maintenance of buildings, especially hospitals. So this study bring to light a good point that maintenance costs would be less or not required at all if there is no faulty construction. However, there is a need to focus on the relationship between design building and maintenance, in terms of reduced maintenance budgets, in order to avoid design defects in Saudi Arabia, as the harsh climate of the Saudi Arabian Rub Al-Khali shortens the life of buildings. Therefore, this study will talk about the appropriate steps that should be considered while building new infrastructures in the future. Poor designing leads to defects and imperfections in the building structure, and it occurs due to defects in material selection, ventilation arrangements that are made as well as flooring defects that occur during the construction process of the building. The beginning chapters lay emphasis on maintenance and stress that maintenance of buildings is increasing annually by great margins in Saudi Arabia. One of the main cause for this increase is the defects that take place during the construction process itself because if a building is constructed with the right selection of quality materials with the right design concepts and with the accurate plan then the maintenance cost required will be much. This is due to the fact that quality building material during construction will obviate the necessity for frequent repairs. As a continuation of the previous chapters it is an understood fact that building designs, which ignored the maintenance practicality and adequacy were the main determinants of increased maintenance costs in case of the hospitals in Saudi Arabia. But this maintenance is difficult because of the non-availability of replacement materials, skilled personnel and lack of funding for maintenance purposes. Hospital maintenance in Saudi Arabia is governed by a number of rules, which resist breakdown provisions of hospitals. Compared to other buildings, it is a hospital that requires timely and appropriate maintenance, as it is a life saving institution as doctors try their maximum to treat the patients. It is an established fact that hospital buildings should be based on the equipments that the hospital plans to install. Thus, the issue of maintenance stems from the wrong designing concept that has been used. Design faults in hospitals require costly restoration as maintenance cost or it requires the total tearing down of those buildings. Specification writing defect is a design fault, which is of high importance in the construction of hospitals. The next identified defect in design fault is the wrong material selection. Thus, proper care should be given with respect to procurement of materials and it would be good to prepare a material requirement plan in advance so that shortage of materials does not lead to the procurement of defected materials. In the literature review it has been mentioned about TQM or Total Quality Management. TQM is considered as a revolutionary approach to successful organization. The numerous researches in TQM have materialized from realistic requirements of organizations implementing the principles, which is highly practical oriented. There have been continuous efforts carried out in formulating TQM in the quality management of construction industry and as a result many researches were carried out in knowing the effect of TQM in the quality management of buildings, especially, the maintenance of hospitals. Quality is treated as an essential factor and is considered a good strategy to survive in a better and profitable way for the organizations. The quality of the products used and the reliability in the construction process is ideal TQM that is needed in the construction industry so that there is no faulty design and that less maintenance is required. As required in the quality management of any product the same quality management issues are also needed in the maintenance of the King Fahad Hospital (KFH) in the Kingdom of Saudi Arabia, and they are raw material testing, facilities and equipment training, building control and finally finished product testing. This data collection was based on the responses of interviewees and results of the questionnaire regarding the subject topic of maintenance issues in the KFH. The first data collection method employed was the interview process. The interview was conducted among five interviewees on four areas of the maintenance issues in the King Fahad Hospital. The questions were related to maintenance issues and were focused in this approach. The questions constituted of eight categories of maintenance defects that were analyzed in chapter 4 and they are as follows: maintenance issues, the material selection defects, climate conditions defect, maintenance equipment, workers maintenance defects, maintenance management, design defects and maintenance contract defects. The third perspective the interview presented was related to maintenance issues through design in eleven categories, assessing the impact of design defects relevant to KFH maintenance and they were: design issues, the material selection defects, climate conditions defect, structural designs, specification writer defects, architectural design, construction drawing defects, architectural drawing defects, design team defects, harmful human behaviors defects and administration of design team defects. Questionnaires were distributed to 30 participants who were chosen from different administrations and department under the Administration of project & maintenance at General Directorate of the Health Affairs Al-Baha to meet the quantitative research requirements. The results provided by the interviewees in the interviews were more or less the same and all reached to the same conclusion that the problem of maintenance occurred due to wrong and faulty construction issues, which started at the time of design implementation itself. All the interviewees identified the key maintenance issues while the fourth interviewee did not provide much of an opinion because he did not have experience in maintenance issues as he was only a designer. But as an expert in hospital designs it is understood that he should have a little information regarding maintenance as it is known that wrong designs lead to more maintenance and, therefore, the maintenance costs increase. The results of the first interviewee identified the key maintenance issue as daily consumption of materials and spare parts for civil, electrical, plumbing, carpentry work and repair of air-conditioning system. The second interviewee stated that lack of spare parts and low quality material are key maintenance issues. The views of the third interviewee were the non availability of spare parts in the market and the low quality materials as well as issues like water leakages, lack of protection against lightning, ventilation, short lifespan for systems, poor internal and external materials and also the inadequate thickness of the insulation surface layers. The fourth interviewee did not identify any maintenance issue because he did not have experience in maintenance field and was an expert only in the hospital designs. In KFH, the main defects were lack of spare parts, water leakages, lack of protection against lightning, ventilation, short lifespan for systems, and lack quality in thermal expansion material, insufficient thickness of the insulation surface layers and lack of quality materials. These defects had led to the depletion of maintenance budget besides an increase in maintenance costs. Moreover, defects in the hospital can identified easily because of the physical damages in some parts of the hospital. It is an identified fact from the data findings that the above listed defects lead to constant repairs, which in turn involve consumption of large volumes of materials. The defects in the construction cause damage to walls, floors, ceilings and furniture. Due to these problems, constant repairs and maintenance works should be undertaken, which again pose an expense threat to the Saudi Arabian economy and deplete its budget enormously. The maintenance works that need to be done in the KFH will have many adverse impacts on the hospital maintenance, especially in terms of an increase in the budgeted cost of maintenance expenditure. PESTEL factors play an important role in hospital maintenance. Members of the design team should refrain themselves from heavy lobbying from suppliers to purchase their products over competitors so that only quality materials are used in the construction purpose. The Maintenance staff is required to have appropriate knowledge and skills regarding the regulations, structural systems, building design, building materials and other sub-ordinate legislation so that there is no construction and maintenance defect. Among the social factors it is very important to prevent accidents on site due to improper maintenance. In spite of improvements in materials, construction method technologies and support, the lifespan of hospital buildings have decreased over the past few decades and one of the attributed reasons for this are the climatic changes and other environmental impacts, which decrease the life span of the buildings. Limitation of knowledge with respect to lack of understanding for future maintenance needs is also one of the main causes why proper maintenance is not possible in hospital buildings. In order to prevent maintenance problems at an early stage of the design, specific knowledge and expertise is required from the design team along with the element of appropriate coordination between the design and the maintenance team for proper investigation of how and when the next maintenance is required. If there are no design faults then the maintenance budget as well as the time required for maintenance will be less, therefore, the emphasis on design implementation is very important. Data related to the impact of design and maintenance defects on the maintenance of hospital buildings in Saudi Arabia reveals that there is strong requirement for maintenance of hospitals because defects like leaking of rainwater into the ceiling, walls, floors and furniture will increase the repair and maintenance costs. Maintenance is the activity to guarantee that physical possessions carry on to accomplishing their intended tasks so that this activity must consist of counteractive and anticipatory tasks. Physical possession of every building must include various facilities, apparatus and other substances used to finish the building. Design is one of the most essential things that must be developed before constructing the building. There are many alternatives on the subject of the organization of maintenance. One of the first alternatives is the extent to which the alternative is complete in house in opposition to the maintenances prescribed in contract. Maintenance of every organization happens regularly. Hospitals have a large amount of specific necessities in terms of their maintenances. So we can say that there are lot of differences between hospital building and general building in terms of their maintenance. Hospitals are mainly public ally funded or confidentially private and tend to have fixed yearly budgets. If the existing hospitals need any maintenance, existing departments in the hospital place requisitions for revitalization or upgrading of specific medical devices. This is done by writing a letter to the medical department in the hospital. The letter should consist of the entire specifications of the concerned medical device along with the reasons for the necessity of this device. To renew or to upgrade the medical devices in the hospital, the medical department in the hospital has to endorse such applications. The medical department in the hospital maintains a log for every medicinal device in the hospital, therefore they can evaluate if the medical device needs to be renewed by checking the history of this machine and the requirements of the department for the new medical device. Saudi Arabia is the one of the richest countries but at the same time this country has an underdeveloped status. Development of hospital maintenance in the country of Saudi Arabia consists of both anticipatory and breakdown necessities. The most widespread troubles for building maintenance on the subject of the hospitals in the country Saudi Arabia is reportedly non- accessibility of substitute materials, non-availability of skilled workers, and slow roll out of funding. On the contrary, it is also relevant to consider design imperfections on maintenance from a viewpoint of agent responsibility particularly, given the rising focus on design fault proceedings, risk reduction and building insurance. Various agents are associated with the design process of buildings. These agents are responsible in the event of a design imperfection in the building. The agents responsible for the construction of the buildings are: (1) the civil engineers, (2) the interior designers, (3) construction drawers, (4) the commissioning agents, (5) finally the architects and (6). For every organization’s construction there will be a set of teams responsible for particular project activities of the organization. Project management necessitates careful planning and organizing efforts with the intention of accomplishing the specific objective of constructing hospital. The first activity that a project team does is appointing a planning committee. The second task that is needed to be done is to get ready a project plan, which will calculate the budget of the project, the resources required for the implementation of the project, the risks associated by way of the project etc. Detailed research and expansion surrounded by the medical apparatuses in the market place have resulted in the development of diagnosis and management of the treatment of various diseases suffered by people. The leading medical device companies are evidently earning large profits from all the manufacturing. From the analysis, it is scrutinized that the share of the countries in the worldwide marketplace got Saudi Arabia in the prime position, possessing about half of the present marketplace. The policy of the hospital is to focus on three major issues: firstly, the brand (quality) of the medical device; secondly, the degree of after sale services provided by the company (supports, spare parts, maintenance) and finally, the price that needs to be paid. The design of the building has been made by considering all these factors. There should be appropriate control measures to be to be taken into consideration during the construction of buildings. As far as the hospitals are concerned the important place for people to relieve from their pains and injuries, it should be well equipped with proper safety measures. The essential fact to consider is the proper allocation of the effective resources and the money for the proper maintenance of the King Fahad Hospital. Quality should be the first thing to take into account and this must be maintained by the employees headed by the efficient engineers. There should be a separate person for each works. Every one has to perform their duties well in the construction work of the hospital. The works should be properly allotted to the employees and the supervisors have the noted responsibility to find the problems in the building sites. The defects in the maintenance and design of the construction of the hospital clearly show the absence of the highly qualified and experienced engineers. The usage of the poor quality materials for the building works will be the major problem in construction. So there should be proper quality checking while purchasing and receiving the materials. It is important to purchase the materials from the companies who keep quality standards. They have to prefer the companies maintaining the international standards. The quality control department has to try its best to check the quality of the soil, cement, etc. The safety measures also play a major role in the construction department. Most of the companies are recruiting a separate Health, Safety and Environmental officer for the welfare of their assets and the employees. The HSE officers also have the same importance like the senior engineers as they will help in taking care of the workforce in the construction sites. Every company has to notice the health and safety of the laborers toiling hard in the site and the safety officers must regularly check the sites and ensure the safety of the workers. It is also important to consider the environmental issues with the construction of the hospital. It has to follow the safety measures from the local bodies associated with the building construction in the Kingdom of Saudi Arabia. The hospital has to be set in a place where it does not create any hazards to the environment and for the inhabitants living there. Another reason behind the poor quality is the performance of the workers. The employees are not satisfied with their low salaries. Many of them are tired with the overtime works and they were not getting the proper incentives for that. The motivation to complete the work will give a fresh air to the employees, thus, minimizing the errors and the repairs. The work experience of the employees also creates an issue in the maintenance works causing the damages and repairs to the hospital building. This will increase the maintenance costs and the work cannot be completed in time. The punishment through cutting the wages or fines will help to increase the attention of the workers in their work and lessen the damages. Maintenance administration plan has a very clear and specific objective. This is meant to reduce repairs permitting for maximum use of the system, at minimum maintenance cost. It is necessary to maintain a complete history of the scheme with the objective of improving preservation and cost presentation and to maintain records allowing evaluation of the efficiency of the scheme, cost of repairs and cost of maintenance. One must aim to decrease the chances of sudden breakdowns and accidental writing off of the asset. The hospital challenges problems of boost in maintenance needs due to defects in the hospital plan. This was based on their viewpoint of experience in the plan defects regarding the maintenance of the hospital. Evaluating the matter of maintenance of the building, the first interviewee identified the key maintenance problem as daily consumption of spare and materials parts for civil, plumbing, electrical, repair of air-conditioning systems and carpentry work. This issue stated a direct impact on the maintenance of the hospital involving high expenditure in the repair procedure. This expenditure had a strong attitude on the financial plan allocated for maintenance contracting. Another maintenance issue is lack of spare parts and low quality material. This issue stated that low quality materials require common changes within a short period of time, which again involves heavy expenses. However, it specially added numerous issues, which were lack of protection against lightning, water leakages, ventilation, short lifespan for systems, and poor external and internal materials as well as the weak width of the lagging surface layers. The major imperfections were lack of spare parts, lack of protection against lightning, water leakages, ventilation, lack quality in thermal growth material and short lifespan for systems, inadequate thickness of the insulation surface layers and lack of quality resources. These defects had led to the reduction of maintenance financial plan besides an increase in maintenance expenses. The most identified cause of the increase in maintenance costs in the KFH is the usage of defected materials, which has adversely affected the maintenance costs. A proper MRP (Material Requirement Plan) is the alternative solution for the correct procurement of accurate materials so that there are no defected raw materials and, hence, no construction faults. Due to the lack of proper instructions there was a compromise among the quality of materials that was used for construction purpose, which in the present times calls for an extra expense of maintenance cost in such a short time. Another identified cause is the design default, which could have been more carefully prepared taking into consideration the climactic condition that is prevalent in the kingdom of Saudi Arabia. The materials used in construction purpose of the hospitals were not resistant to the rainwater leakage; there was inadequate thickness of insulation and lack of sufficient water drainage with low quality in expansion joints materials, absence of appropriate design, which could not prevent collection of rainwater. These defects were identified and there was a requirement of appropriate maintenance costs. It is quite apparent that there are several defects associated with maintenance management, which had negatively impacted KFH maintenance. The defects resulted due to many causes like adopting the lowest price in approving the maintenance contracting, spending a long time to approve the repair orders, hiring inappropriate maintenance contracting and contractors, miscalculation of the actual costs of maintenance budget, lack of application and implementation of the conditions of contracting, limited worker salaries and unqualified workers. Architectural design was the main defect that most of the interviewees associated with wrong maintenance of KFH hospital. The findings and analysis of data revealed that while all the interviewees were aware of the negative impacts of the maintenance costs, most of them did not identify the cause as faulty design in the KFH, which calls for maintenance requirement in the first place. To conclude it can be stated that a building with unfaulty design and construction requires less maintenance and maintenance cost should be appropriately and quickly dealt with in order to prevent further damages. This is highly relevant in the case of KFH in Saudi Arabia. The maintenance should be done as early as possible and must be done using the apt materials with the right plan so that no further climactic changes can affect the hospital. Read More