COMPETENCY IN HEALTHCARE FACILITY MANAGEMENT:

A LITERATURE REVIEW

Roslan Ali
Universiti Kebangsaan malaysia
Adi Irfan Che Ani
Universiti Kebangsaan Malaysia

Abstract

Purpose – The purpose of this paper is to examine the current status of competency
framework and to explore approaches to further advancing related research and
practice in developing competency framework in healthcare facility management.

Design/methodology/approach – A literature review method with a content analysis

approach was adopted. Based on pattern of the literature, a three-level competency
modelling framework has derived such as human resources, customer satisfaction and
strategic planning.

Findings – The intent of this paper to explore a competency model for healthcare
facility management in Malaysia and ensure human resource development contribute
to competent workers and reduce gap on customer satisfaction.

Research limitations/implications – Competency in risk management still allow for

exploration, especially in reducing incident related to damage of property and lost of
lives. Therefore, the study shows implications to healthcare facility management in
the context of risk management.

Originality/value – Risk management is important in preventing dangerous

occurrence in hospital. Healthcare facility management should focus on competency
in risk management as a main strategic planning.

Keywords - Risk management, competency, healthcare, facility management,

strategic planning, building maintenance

INTRODUCTION

Maintenance of hospital facilities requires skilled staff. Each damage needs to be

repaired immediately to prevent further damages or losses. Hospital facilities are used
by various stakeholders such as visitors, patients, politicians, authorities and so on, so
it is important to ensure their safety is assured, providing a conducive and clean
environment while inside the hospital premises. The maintenance of the hospital
facilities must meet the standards set by the Ministry of Health Malaysia as stipulated
in the concession agreement. This standard is enshrined in the Project Operation
Guidelines (POG) whereby the need to provide efficient and effective operations to
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ensure a conducive environment for treating patients by minimising disruption and
discomfort to patients, hospital staff, visitors and other stakeholders. Good
maintenance can increase customers satisfaction by reducing breakdown complaints.
Repeated breakdown will have an impact on the service of patients’ treatment and
more dangerous is that it can lead to loss of life. Therefore, the competency of
maintenance workers is expected to increase the customer satisfaction and value of
the government's hospitalised treatment and healthcare services.
The question is what is the importance of the competency of maintenance staff to the
hospital other than the matters discussed above?

FACILITY MANAGEMENT

Lomas (1999) featured in his research on the growing management of Asian facilities
especially in Japan where it is an important country in the business world. Facility
management is expanding into business and strengthening its position as part of an
organization in the business world (Mudrak, Wagenberg & Wubben 2005).
Kamaruzzaman, & Zawawi (2010) thinks facility management is a balance between
technical, business management related to operations and strategic planning.
Mustapa, & Jusoff (2009) formulates facility management as a combination
of management and service implementation that contributes to performance
enhancement of key processes in a changing environment. This definition is said to
have practical implications for key management, building occupancy, comfortness
and competitiveness capabilities in a changing environment. Various definitions of
facility management have been reported as stated by Mariah et al. (2011) quoted
from Mariah et al. (2010) as in Table 1. However, in this study, the definition of
facility management is as a support service for the main services of the organization
by playing a role in increasing customer satisfaction through specific competencies.

Authors Definition of facility management

Hamer, (1988) Facilty management as the planning, implementation,

maintenance, accounting for physical space and services
tailored to an organization, and at same time looking for ways
to reduce the total cost associated
Henly Centre, Facility management is an external management of all service
(1991) companies which not restricted to the main business activity
but also to building management, data management, catering,
security and distribution.
Williams, (1994) Facility management is a process where the organization
providing and maintaining services in a quality environment by
using which appropriate cost to meet the needs of an
organization.
Quah, (1998) Facility management including financial management, space
management, operations management and user management
for an organization
Springer, (2001) Facility management is a combination of various professions,
including proinciples and theories of engineering, architects,

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 design, financial management and humanities.
Barret, (2003) Facilities management as an integrated approach to
maintaining, improving and adapting, creating an environment
that supports the key objectives of the organization.
Pitt and Tucker, Facility management is the integration and alignment of non-
(2008) core services, including those related to location, needed and
maintain a business to fully support the main objectives of the
organization.
Kamaruzzaman Facility management is a balance between technical and
and Zawawi, business management that may be associated with the strategic
(2010) decision making process.
BIFM (2010) Facility management is the processes integration within the
organization to maintain and develop services which support
the approval and the effectiveness of key activities.
IFMA (2010) Facility management is a profession which encompasses
various disciplines to ensure functionality in built environment
by integrating people, place, processes and technology.
Table 1, Mariah et al. (2011) & Mariah et al. (2010)

4.1 Hospital Support Services (HSS)

Facility management plays an important role in infrastructure as it has an initial

impact on core services, especially in hospitals. Core services will be disrupted due to
poor management of facilities. Lavy, & Shohet (2007) said the challenges faced in
the business were competition that caused organizations to cut costs, but at the same
time the need and expectations by consumers and owners increased. This crossing of
claims puts the management of the facility in a dilemma. Mudrak et al. (2005) was
of the opinion that in facing competition in the business environment, the organisation
decided to reduce operating costs for non-core services using external services.
Embleton, & Wright (1998) pointed out that external services refer to the concept of
using expertise to operate certain services that are beyond the firm's existing skills.
Saidin et al. (2010) stated that the MOH has decided to privatise the Hospital Support
Services on 1 January 1997. PSH consists of five services namely Facility
Engineering Management Services (FEMS), Biomedical Engineering Management
Services (BEMS), Cleaning Services (CLS), Clinical Waste Management Services
(CWMS) and Linen and Laundry Services (LLS). PSH has grown since its inception
in 1997, ranging from 127 hospitals and institutions to 148 hospitals and institutions
in 2009. This development also increases the total assets of FEMS, BEMS, floor area
and number of beds.
Assaf et al. (2011) in their study found that the use of external services
increases the speed of work execution, improves the quality of services and risk
sharing, and most importantly, the acquisition of external services is a long-term
objective (Okoroh, Gombera & Ilozor 2002). HSS is a highly critical service due to
the importance of the patient's life. All hospital major systems are responsible for
patient treatment activities such as medical gas system, water supply, air conditioning,
elevator, autoclave, uninterrupted power supply (UPS), electrical supply and others.
In addition, building maintenance services such as civil engineering also help in

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ensuring the safety and comfort of the hospital by ensuring that the building is in good
condition and its equipment. Lennerts et al. (2005) explained that this situation
shows the uniqueness of hospital operations.
Mohd Ali et al. (2005) described the facility as not only limited to physical
facilities but also to the aspect of services. Failure to provide quality services will
indirectly cause negative impact on quality of life and service performance. Shohet,
& Lavy (2004) quoted from Andaleeb (1998) states that 5 main factors that can
provide satisfaction to hospital users are the level of communication between staff and
patients, competence, skills and experience of maintenance staff, quality of facilities,
staff reactions to patients and treatment costs.

2.0 EMPLOYEE CAPABILITIES

Capabilities are defined as employees' abilities according to systems and routines

(Ljungquist 2007) and responsibilities (Vathanophas, & Thai-ngam 2007). Human
competency is classified as a human capability which helps organizations to achieve
competitive advantage (Chen, & Chang 2011). The ability of employees to
understand the strategy and mission of the organization through experience, expertise,
thinking ability such as analytical thinking and having emotional wisdom (EQ) will
help the company's development. Boyatzis (2008) divided competencies into two
parts, namely, ability and attitude that consists;

Ability
1. Skills & Experience
2. Knowledge
3. The basics of thinking skills
Attitude
1. Emotional intelligence
1. Self-management
2. Aware of your state
2. Social skills
1. Social awareness
2. Relationship management
3. Teamwork ability
Zingheim, Ledford & Schuster (1996) through their study found 8 types of
competencies needed, namely;
1. Communication
2. Team oriented
3. Technical expertise
4. Present results
5. Leadership
6. Ability to customize conditions
7. Innovative

This capability can help in terms of business strategy and increased organisational
competitiveness. Institutions of higher learning also see that the ability of graduates to
build competencies is a necessity. Ljungquist (2007) through its study stated that

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finding evidence that ability is a key feature that supports organizational activities and
processes, this statement supports the definition expressed by Winter (2003), that
ability is an activity that supports change. This is also stated by Baharom Mohamad et
al. (2011) in his article in Utusan Borneo that critical and creative thinking skills,
problem solving skills, communication skills, group working skills and leadership are
needed to make graduates coming out of higher learning institutions accepted at
employment. They can be evaluated through the skills highlighted such as self-care,
discipline, ethics, showcasing seriousness and being committed to the work done.
Boyatzis (2008) has identified how competency can help a person's
achievements with his or her own capabilities, the capabilities expressed are through
skills, experience, knowledge, while attitudes are influenced by one's thinking ability
to work through emotional intelligence, thinking skills and teamwork abilities.

3.0 COMPETENCE INTERESTS

The management of the hospital facilities requires skilled and dedicated staff, it needs
to be in line with the improvement of technology used to treat patients. Currently, the
development of employee competency is becoming an important issue (Sandberg
2000). Organizations need to know the key elements in the development of employee
competencies. According to Mariah et al. (2011),thereareimportant points in
competency that are knowledge, skills and attitudes.
Therefore, competency is an important issue as it involves directly between
individuals and jobs. The management of the facility is faced with a high complexity
and it requires a high level of employee competency, as Vazirani (2010) quoted from
Spencer & Spencer (1993) that in complex jobs, competency becomes essential for
identifying high performance in performing tasks. As the management of the facility
is hospitalised as the backbone of the patient care services besides providing comfort
to visitors and hospital staff. Competency of maintenance staff is important to ensure
that all systems such as medical gas, autoclaf, telecommunications, ambulances, air
conditioning, landscaping, water supply, electricity system etc. function properly and
to reduce service interruptions at optimum level.

3.1 Definition of Competence

Hospital is a complex institution, it covers medical activities, hospitality, customer

service, catering, social services, pharmacy, transportation, finance and many more.
What makes the hospital a special facility is a 24-hour service and in the event of a
system failure or a procedural error can result in death (Lennerts et al. 2003). Instead
of preventing this from happening, the competence of the employee should be taken
into account. Various studies on employee competency assessment were conducted by
the researchers.
The definition of competence according to the Dictionary is to be efficient,
qualified or able to carry out tasks properly while competency as the ability, skills and
knowledge to do things efficiently or successfully. Rowe (1995) argued that
competence and competency have different meanings. He stated that competency
means skills and performance standards while competency refers to the desired
attitude. Meanwhile Boyatzis (2008) stated that competency as an ability to compose

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behavior according to intention depends on the situation and time. There are various
definitions of competence as a result of their study. Boak et al. (1982) Through
Klemp (1980) defined competency as a character hidden within a person who
produces the best performance. Hoffmann (1999) listed competency definitions as
listed in table 3 below;

Definition Investigator Field

Measurement of abilities Sternberg & Kolligian, Psychology
1990
How the best goals of an Burgoyne, 1993 Management
organization can be achieved
through individual performance
enhancement
Strategic execution equipment Burgoyne, 1993 Human source
through worker recruitment
techniques, placements, training,
assessments, promotions,
individual planning and reward
systems
Ideas for job preparation and Bowden and masters, 1993 Education
extensive professional recognition
in the field of education
Improve workforce efficiency Burgoyne, 1993 Politics and
Unions
Development with experience Bowden and masters, 1993 Definition
adopted by
Australia and
the United
Kingdom
Table 2 Competency definition: Source from Hoffman 1999

Various definitions of competency have been stated, in line with the study. Facility
management is a labour-intensive service, therefore the efficiency of workers in
building maintenance is a priority. The management of the hospital facilities faced
many challenges as hospitals are complex institutions with various customer groups.
As such, maintenance workers play a key role in meeting customers' needs.
Competent employees understand the context in which they work, knowledgeable
about the specific strategy and cultural objectives of the organization(Chapman
&Lovell, 2006).
Competent workers become more productive and initiative and proficient in
problem-solving techniques without creating conflict and increasing levels of
customer satisfaction. Hoffman (1999) describes the deflation of competence to three
definitions:

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1. Focus on individual performance through established standards. A standard or
quality of performance that comes from one's person.
2. This second definition indicates competence as standard, or quality of work.
This definition can be used to continue improving productivity or efficiency in
the workplace.
3. Attitudes are hidden within a person and born through their behavior.

Competency refers to the skills and knowledge that lead to excellent performance. It
can be highlighted through knowledge, skills and attitudes and can be seen differently
through poor performance and good performance.
Competency can also be built through support and effort. According to Horton
(2000), competency can also change according to technological changes, increased
competition, decreased income or profits, seeking progress and to improve
performance. The authors noted that this began in the early 1990s when extensive
development within the organisation pertaining to work practices such as focusing
more on frontline workers so that they had diverse skills to deal with various
characteristics of customers. In facility maintenance, technical workers are front-line
workers, they are the first to interact with customers, therefore they need to have good
competency to deal with various redheads from users such as language, race, position
and position other than having technical skills. This situation is in line with the
definition of competency by Baharom Mohamad et al. (2011) that competency is the
efficiency to decide or to do things.
Hospital is one of the government organizations, Ilhaamie (2008) quoted from
Sharifuddin (1999) stating that quality services will help improve the government's
reputation and meet the people's needs. Therefore skills, knowledge and attitude are
the priorities for the organization to achieve its planned strategic goals.

3.1.1 Skills

Skills are defined as abilities acquired or built through training or experience (Dada,
& Jagboro 2012). Employee skills are a requirement for organizations to improve
service performance, increase profitability, be competitive and provide customer
satisfaction. Employee skills are able to increase productivity and reduce product
defects during the production process or reduce the risk of damage from recurrence.
Therefore, quality (Zingheim et al. 1996; Martin, & Pope 2008) Quality improvement
(Ulrich et al. 2010),quality assurance (Rowe 1995),time management (Robinson et
al. 2007) and efficiency (Chapman, & Lovell 2006) and (Robb 1995) are elements
that need to be in the skills. In addition, Yao-Fen (2013) explained that one of the
skills of self-management is the ability to learn new skills that demonstrate the
capabilities of an employee.
The use of appropriate skills and competencies is important in development
and is always relevant in any field (Dada, &Jagboro 2012). Forcada, Macarulla &
Love (2013) quotes from Mills et al. (2009), Love et al. (2010) and Forcada et al.
(2012) agree that the weaknesses of sub-contractor workers are from skills
weaknesses, supervision, non-fulfillment of customer requirements as well as
weaknesses in carpentry registration and certification. This shows that technical skills
in building maintenance are necessary in competencies as well as other soft skills such
as management, certification and communication skills. Basic skills are necessary for
a person before entering the realm of employment. These basic skills include critical

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and creative thinking skills, problem solving, communicating and teamwork
(Baharom Mohamad et al. 2011).
Quality service is identified, it is stated by Mohd Ali, Baba & Abang Selamat
(2005) referring to Alexander (1993) that among the criteria that must be in the
maintenance of the facility is to have competency which are knowledge and skills,
other things include communication skills, courtesy and trustworthy in doing work
without error.

3.1.2 Knowledge

The most important thing to organizations in the 21st century is worker

knowledge(Drucker 1999). Organizations have grown in line with technology, new
hardware and methods of improving productivity have also changed. In line with
these developments the organization also offers incentives such as a knowledge-based
pay system (Ledford 1995) where these incentives are given to a worker who has
demonstrated his competence through knowledge, skills and attitudes by highlighting
high performance. Korsten (2003) stated that competence is a specific knowledge or
skill possessed by an individual or group or organization and it belongs to a class of
its own and it is also accompanied by values, creative and productive translated
through knowledge and experience, self-confidence and perseverance.
Lustri, Miura & Takahashi (2007) in their research stated that competent
people are able to demonstrate their level of professionalism through knowledge
obtained from past experience and capable of acting according to situations.
Knowledgeable individuals are able to do strategic thinking and combine a diversity
of skills as well as possess analytical, remote-looking and conceptual thinking skills
(Nuntamanop, Kauranen & Igel 2013). Solving problems are among the soft skills
(Jindal-Snape, & Naulty 2008) that employees need to have to help the organization
achieve its objectives and be competitive.
Abdul Karim (2007) in his paper explains that the competency requirements
include education, knowledge, recognition of professional skills, skills and other
trainings. Inexperienced workers are novie (Sandberg 2000). This statement is in line
with the IceBerg Theory, since the most prominent is the skill and
knowledge(Garavan, & Mcguire 2001b),both of these items are considered as a
specific set that highlights the attitude to performing tasks (Sandberg 2000).

3.1.3 Attitude

Organizations make the basis a worker takes to work is through attitude, aside from
knowledge and abilities (Serpell, &Ferrada 2007). This is explained through the
profile competencies that have been developed by them where the characteristics that
highlight the necessary attitudes are as follows;
1. Mission oriented, vision and strategic project objectives
2. Committed to organizational values
3. Committed to safety and health
4. Flexible and capable of adapting when dealing with critical situations and
environments
Sandberg (2000) argued that attitudes have no fixed meaning, but it depends on how
the work is done. Doing work and making decisions while working requires self-
confidence. Vazirani (2010) described being defined as self - confidence and belief

8
that reflects one's self - worth. Yao-Fen (2013) set an example of a good attitude in
the work such as being ready to face challenges, zealous and energetic, working
diligently and hard, resilient, integrity and always displaying a professional
appearance. In the concept of courteous and trustworthy, it is influenced by attitude,
besides being shown through honesty and responsibility in carrying out tasks.
Mohamad Amin (2004) conducted an in-depth study of workers'
competencies on intellectual intelligence (IQ), emotional intelligence (EQ) and
spiritual intelligence (SQ) in the electronic government sector. This study has found
that high levels of IQ, EQ and SQ can provide a high level of work performance to
government employees. From this discovery, it can be seen that the skills and
knowledge represents IQ and attitude is translated through the much needed EQ and
SQ for the development of competencies.

3.2 Development of Competency Model

Evidence of empirical studies on competency development movements has taken

place in several countries, among them the USA, UK, Australia, Scandinavia and
Israel (Garavan, & Mcguire 2001). This culture is related to the government's
proactive efforts to recognise and lift standards of competence. Malaysia has also
taken steps to recognize and uphold workers' standards in order to achieve the
aspirations of developed countries. The National Occupational Skill Standard (NOSS)
(Department of Skills Development 2014) states that in order to reach developed
countries by 2020 in the country, they have set a target of fifty per cent of workers
must be from among the skilled and have a wide range of skills with high
competency. Boak et al. (1982) stated that the expectation of the competency model
is;
1. Improving performance
2. Supporting company growth
3. Help become an agent of cultural change
According to Homer (2001), employee competencies are the most important
foundation for the company as it covers the whole aspect of the process especially
related to organizational profitability. This situation is in line withthe hospital
services which have evolved in line with the developmentof technology with various
modern equipments and systems in the building, this development also increases the
demand and needs of the consumers (Lavy, &Shohet 2007). The efficiency
assessment of maintenance workers began to be taken into account as a result of the
condition of the equipment and the hospital building.
Baharom Mohamad et al. (2011) writes that competency refers to personal
knowledge, skills and characteristics for performing tasks and this is also stated by
Chen, & Chang (2011), Cardy and Selavarajan (2006) and Tovey (1994) where the
core competency is to refer to professional needs such as knowledge, skills and
abilities. The IceBerg Theory by Spencer and Spencer (1993) is a popular theory used
in competency references as in garavan, & Mcguire (2001a) studies, Butler, &
Fleming (2002), Shamsulkhairi Md Salleh (2006), Yang et al. (2006), Vathanophas &
Thai-ngam (2007), Vazirani (2010) and Ryan, Spencer & Bernhard (2012).
Competency theoretical framework as Figure 1 below.

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 Can be
External factors:
seen
Easy to develop
Skill through training
Knowledge and guided
1. Commited
2. Quaity Strategy
Self- 3. Responsible
Internal factors:
concept Most difficult to
Attitude Ledford (1995) Boak et.al. (1982)
develop. Need to be
Motive
filtered during
Hidden
recruitment
interview.

Figure 1 Competency theorietical framework, Vathanophas, & Thai-ngam (2007) and Spencer &
Spencer (1993)

The IceBerg Theory states that skills and knowledge are visible characteristics of a
person while the hidden characteristics are self-concepts, traits and motives.
Employees with competencies are considered more committed to their work and
prioritise the quality of work due to their responsible attitude. In addition, they are
also capable of adapting changes in the environment and technology as well as being
more flexible and consistent in maintaining work performance. Ledford (1995)
described hidden competence as abstract, one example of innovation skills, this
competency is difficult for outsiders to see, and it can only be measured in a certain
period of time when it already shows results.
Berge et al. (2002) quotes from Mirabile (1997) by placing competency as
knowledge, skills and abilities, or a character that is intertwined with high
performance tasks such as problem solving, thinking analytically or being capable of
leadership. He also added there is an opinion that competence also includes motive,
beliefs and values. In dealing with all these things, Boak & Diane (2001) stated that
the need to improve strategic thinking skills and leadership is a priority.
However, the use of the competency model at work is considered problematic
due to the difficulty in identifying and separating effective performance components
for employee selection using the competency framework (Garavan, & Mcguire 2001);
Townley, 1994). They also state that employees should be entrusted to perform tasks
with minimal oversight and decision-making as a basis for employees committed to
work to meet organizational goals. Dada & Jagboro (2012) in their study has
identified the continuous training and development required for quantity surveyors in

10
Nigeria. The development of a competency model is aimed at maximizing human
resources to achieve the organization's objectives (Rodriguez et al. 2002).
Robinson et al. (2007) in their study to predict the need for future competency
found twenty-eight core competencies from forty-nine predicted competencies.
Continuous training will strengthen the competency of the employees in carrying out
their duties and will be able to meet the needs of the organisation. Improvements in
training, performance management, talent development and recruitment need to be
improved (Measures, & Bagshaw 2009). Therefore, the skills in performing tasks are
the main requirement to achieve organizational goals. According to Dada, & Jagboro
(2012),skills are the cornerstone of the development of competence and should be
developed in the early days of education or through self-development. Vathanophas,
& Thai-ngam (2007) quotes from Spencer and Spencer (1993) identifying five types
of competency charismatic that lead to effectiveness in performing tasks namely
motive, nature, attitude, knowledge and skills. All these features lead a person to act
on certain things or perform tasks effectively.
In Malaysia, the Public Service Department also uses competency as an
Penilaian Tahap Kompetensi (PTK) for employees in government departments
(Ahmad, & Haji Ahmad Khalid 2009). This assessment is used as a determinant of
salary movement in the Sistem Saraan Malaysia (SSM). In addition, they also stated
that PTK considers skills, knowledge and attitude as a key component in measuring
the competency of employees of government departments.

3.3 Post-Competency Research

Competency plays an important role in the organisation, the priority of competency is

to achieve the goals by increasing customer trust, increasing the profitability of the
company and making the organisation viable in line with its vision and mission. Past
research has stated that competency is related to skills, knowledge and attitudes.
Therefore, the elements required in these three points are mentioned in post-
competency research such as quality, time management, problem solving, creativity,
initiative, analytical thinking, communication, teamwork, compromise and others.
Table 3 below shows post-competency research.

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 Research title Author Element
(Abdul Ghani Quality, integrity, teamwork
Amalan pengurusan sumber Azmi 2008)
manusia berteraskan kompetensi
dan kualiti perkhidmatan dalam
organisasi awam di Malaysia:
Kesaling bergantungan tugasan
sebagai penyederhana.

Constructing Career (Yao-Fen 2013) Time management, problem solving,

Competency Model of communication
Hospitality Industry Employees
for Career Success

Talent management – (Sharma, & Innovative, analytical thinking, decision

competency development: key Bhatnagar making, communication, teamwork
to global leadership
Hubungan antara kompetensi (Mohamad Amin Time management, problem solving,
pekerja dan prestasi kerja di 2004) communication, polite, integrity, teamwork
kalangan kakitangan agensi
kerajaan elektronik
A competency-based model for (Serpell, & Ability to plan, quality, communication
construction supervisors in Ferrada 2007)
developing countries
Knowledge-Worker (Drucker 1999) Knowledge, quality, innovative
Productivity: The Biggest
Challenge
Facilities Management (Mariah et al. Skill, knowledge, attitude,
Competency Imperatives To 2011)
Realise Polytechnic
Transformation Goals
The influence of corporate (Md Zabid Abdul, Ability to plan, creative, innovative,
culture and organisational Sambasivan & decision making, teamwork
commitment on performance Johari 2003)
Paying for the skills, (Ledford 1995) Skill, knowledge, problem solving, creative,
knowledge, and competencies innovative
of knowledge workers

Table 3 Post-competency research

Based on post-competency research in Table 3, competency conceptual framework

can be classified into three parts as Figure 2.

1. Strategic planning
2. Development of human resources
3. Customer satisfaction

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 Competency

Human resources Strategic planning Customer satisfaction

External factors
IQ
Customer
Iceberg theory

Relationship satisfaction in
between skills, facility
knowledge and management
attitudes services
Internal
factors
EQ & SQ

Figure 2 Healthcare facility management competency Conceptual Framework

Post-competency research can be classified into strategic planning, customer

satisfaction and human resource development. The description is as follows.

3.3.1 Competency in human resource development

Dai, & Liang (2012) has discovered how the competency model has evolved within
the organisation and has shown significant improvements in the importance of human
resource management in strategic strategic involvement of the organisation. Human
resources are the most important asset in the organization, hence, the demand for
quality workers is increasing in the public and private sectors (Vathanophas, & Thai-
ngam 2007). They quote from the Human Resources Association (2003) which states
over the past thirty years that a growing competency approach and a new model of
competency is necessary as the business world is changing.
Zakaria et al. (2010) explained the need for human resources to provide
skilled and semi-skilled workers to carry out facility management tasks, this is aimed
at improving human resource skills in the future by training in-work methods where
skilled workers train semi-skilled workers while they are done. Competency is also
referred to for the purpose of job offer and as salary offer criteria. According to
(Ledford 1995),paying wages to knowledgeable workers through knowledge, skills
and competencies is common to organisations that use a skills-based wage system.
Talent development in careers is also a necessity in human resource
management, as stated by (Ulrich et al. 2010),which are three things that impact the

13
business are organization, talent and administration. Their research found that talent
and organization have a high correlation to business success.

3.3.2 Competence as strategic design

Organizational competency will be built when individual knowledge, skills and

capabilities are shared amongst employees (Dai, & Liang 2012). Tovey (1994)
adopted 5 strategic approach methods as a tool to detect competencies namely
strategic understanding, strategic competency space, identifying competency &
evaluation needs, applications and work & business performance. Vathanophas, &
Thai-ngam (2007) in their study found 23 competencies needed to improve work
performance where it can be developed as an excellent work performance model.
Chen, & Chang (2011) gave two different views on the core of competency,
first the view from a Master of Strategic Management who uses the core competency
as an organizational competitive advantage, while the second view through a Master
of Human Resource Management uses the core competency as a work performance
excellence. Among the findings of core competency studies are strategic thinking
(Bonn 2001) (Nuntamanop et al. 2013),organizational capabilities and human
capabilities (Chen, & Chang 2011), capability, competence and resources
(Ljungquist 2007) and competency management (Vakola, Soderquist & Prastacos
2007). From these studies, it is clear that competency is used as a strategy for
organizations to achieve objectives through human resource development that
ultimately meets customer satisfaction.

3.3.3 Competency to meet customer satisfaction

Most organizations always try to give customers satisfaction with the services
rendered. As such, many organizations have developed or improved their services
(Dean, 2004). Customers will give suggestions (Johnson, et al, 1998) to their partners
if they feel satisfied or dissatisfied with the services received. Grandinetti (2001) said
studies on satisfaction should begin by investigating causes that are untrecial to
dissatision. By reaching out to customers, understanding their needs and needs will
not only improve their services but also increase the company’s revenue (Limehouse,
D. 1999). By understanding and meeting their needs, customers will feel closer and
friendly (Brock, K. and Zhou, J. 2012) and thus be able to give a good image of the
service. The management of HSS takes into account customer satisfaction as a
priority, hence the need to assess the condition of hospital buildings in order to
identify the needs of customers is indispensable.
Myeda, Kamaruzzaman & Pitt (2011) explained that increasing customer
satisfaction will give the organisation an advantage as it will increase positive reviews
and in turn bring new customers to the organisation. ‘Frontline’ employees are very
important and have a huge impact on customer satisfaction especially the quality of
service as it enhances the image and reputation of the business (Tucker, & Pitt
2009a). Mohd Ali et al. (2005) in their paper stated that customer satisfaction is a
goal that should be achieved as an indicator of quality facility services as quality
refers to the extent to which the services provided can meet the satisfaction and needs
of the users.
Mariah et al. (2011) is of the opinion that individuals involved in facility
management should be competent persons in the field specifically within the facility.

14
This is due to the performance required to perform the task as expected. Therefore, in
this research competency is considered important in providing services that satisfy
customers. This research on the development of this competency model aims to find
the competencies required by customers as well as to track the level of satisfaction of
the services provided.

4.2 HOSPITAL SUPPORT SERVICE CHALLENGES

Failure of the hospital facilities will cause discomfort to staff and visitors. This
situation may result in a lack of concentration of work by hospital staff and may cause
visitors to be dissatisfied with the services rendered (Mohd Ali et al. 2005). Among
the challenges in PSH services are avoiding incidents involving damage to property
and human beings. This is because hospitals are becoming the focal point of the
community. A slight mistake will surely invite panic to the public and worse is
resulting in death. Eighteen incidents have been reported since 2011 to 2020, most of
the incidents are fire in hospital, three involving an ambulance and the others ceiling
collapsed. Among the incidents involving assets and hospitals in Malaysia are as per
the Table 4.

Incident Year Hospital Reference

Ceiling 30 Jan 2011 Hospital Serdang, http://www.sinarharian.com.my/siling-
collapsed 13 Aug 2012 Selangor. hospital-kerap-runtuh-di-mana-silapnya-
14 Nov 2013 1.226897
Ceiling 19 Jun 2017 Hospital engku http://www.astroawani.com/berita-
collapsed Ampuan Afzan, malaysia/siling-wad-hospital-tengku-
Kuantan, Pahang. ampuan-afzan-runtuh-waris-pesakit-cedera-
ringan-146755
Ceiling 8 Sept 2016 Hospital Tengku http://www.mstar.com.my/berita/berita-
collapsed Ampuan Afzan, semasa/2016/09/09/siling-htaa-jatuh/
Kuantan, Pahang.
Fire 25 Sept 2016 Hospital Sultanah http://www.astroawani.com/berita-
Aminah, Johor malaysia/wad-icu-hospital-sultanah-
Bahru, Johor. aminah-terbakar-6-meninggal-dunia-
120424
Fire 5 Jan 2017 Hospital Bahagia Ulu http://www.hmetro.com.my/node/194582
Kinta, Perak.
Fire 12 Apr 2016 Hospital Taiping, http://www.bharian.com.my/node/143025
Perak.
Fire 26 Mac 2013 Hospital Umum http://ww1.utusan.com.my/utusan/
Sarawak, Kuching, Sabah_&_Sarawak/20130327/wb_01/
Sarawak Hospital-Umum-Sarawak-terbakar
Fire 15 Feb 2014 Hospital Umum http://ww1.utusan.com.my/utusan/
Sarawak, Kuching, Dalam_Negeri/20140216/dn_07/Hospital-
Sarawak. terbakar
Fire 11 Julai 2016 Hospital Pakar KPJ, http://www.astroawani.com/berita-
Sabah malaysia/bilik-kawalan-kuasa-terbakar-
pesakit-terpaksa-dipindahkan-di-hospital-
pakar-kpj-sabah-110673
Fire 17 Mei 2015 Hospital Tuanku http://www.hmetro.com.my/node/51541
Ja’afar, Seremban,
Negeri Sembilan.
Fire 10 Nov 2016 Hospital Raja http://www.sinarharian.com.my/mobile/
Perempuan Bainun, semasa/cemas-hospital-tiba-tiba-terbakar-

15
 Ipoh, Perak. 1.584360
Fire 22 Jun 2012 Hospital teluk Intan, http://ww1.utusan.com.my/utusan/
Perak Dalam_Negeri/20120623/dn_14/Pesakit-
kakitangan-panik-Hospital-Teluk-Intan-
terbakar
Gas leak 8 Feb 2017 Hospital Teluk Intan, http://www.mstar.com.my/berita/berita-
Perak jenayah/2017/02/08/gas-bocor-makmal-
hospital/
Ambulance 26 Okt 2016 Hospital Kuala http://www.hmetro.com.my/node/177202
caught by fire Kangsar, Perak
Ambuance 3 Jun 2016 Hospital Sarikei, http://www.theborneopost.com/
caught by fire Sarawak 2016/06/04/ambulans-milik-hospital-
sarikei-rentung-terbakar/
Fire 28 Jun 2020 Hospital Sultanah https://www.bharian.com.my/berita/kes/
Aminah, Johor 2020/06/705087/wad-hospital-sultanah-
Bahru, Johor aminah-terbakar
Fire 9 April 2021 Hospital Raja https://www.sinarharian.com.my/article/
Permaisuri Bainun, 133040/EDISI/Insiden-kebakaran-tak-jejas-
Ipoh, Perak. operasi-HRPB
Ceiling 19 Mac 2019 Hospital Enche Besar https://www.sinarharian.com.my/article/
collapsed Hajah Kalsom, 18998/EDISI/Johor/Siling-hospital-tiba-
Kluang, Johor tiba-runtuh
Table 4 Incident report in Malaysian hospital

The worst incident happened in Hospital Sultanah Aminah in 2016 when six people
died in the incident. Therefore, Minister of Health has instructed the MOH to conduct
audits on forty-eight hospitals over fifty years old (Astro Awani 2017).

RISK MANAGEMENT

Based on reports of incidents that took place in hospitals, the main factors that need to
be looked at are safety against life and property damage. Thus, competence in
facilities management has an impact on safety. Risk management is one of the
priorities in the management of healthcare facilities apart from maintenance
management, performance management, supply services management and
development (Lavy, & Shohet 2007). Zakaria et al. (2010) stated that at present many
of the incidents that occur reflect weaknesses in quality and safety and health factors
resulting in damage, fire, collapse and failure to comply with the law.
Hospitals are institutions that are always active at all times, so damage to
buildings and equipment is inevitable. The increasing patient attendance each year
necessitates renovations and additions to the building. This will increase the defects
and damage, so the more repair and development work the more incidents that occur.
Occupied buildings need to be inspected periodically, Preiser & Schramm (2002) list
nine performance criteria in post-occupancy inspection where health, safety, security
control, functionality and efficiency are key elements. Therefore, safety in
maintenance should be given top priority (Hon, Chan & Yam 2014).
Developing competency framework in healthcare facility management is a
crucial part in increasing customer satisfaction and the important things is to ensure
hospital in a good and safe condition to carry out patient treatment activities.
Therefore, as mentioned by Che-ani, & Ali (2019), customer satisfaction can be
increase through workers competency, responsibility, maintenance quality and
leadership style to make a hospital as a safest place to the patients.

16
7.0 CONCLUSIONS
Hospitals are the main place for people to seek treatment. The hospital activity never
stops for 24 hours to treat the patient. The Malaysian government has spent a
significant allocation to ensure the health of the people. The success of the country
depends on healthy citizens and increases confidence in foreign investors to do
business locally. Ministry of Health has privatised 5 support services to obtain quality
services with established contracts. Hospital activities are supported by PSH through
engineering maintenance services that ensure all support systems such as electricity,
water, medical gas, central air conditioning, ambulance and building are function
properly without affecting patient treatment activities. Risk management is a proactive
measure in achieving this goal is through assessing the safety level of the building and
support systems. Theories of competency are comprehensively discussed in this paper
as a means of finding the crucial parts of competency in Malaysia healthcare facility
management.

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