Facility management in the healthcare sector: analysis of the Italian situation

The aim of this paper is to analyse the current situation in the Italian public healthcare sector, with special attention to aspects of facility management, in the light of the reorganisation necessary for the application of decentralisation and ‘de-nationalisation’ policies that have involved hospitals in recent years. We have traced a profile of the situation, for 2004, with regard to facility management procedures and to the maintenance of installations, focusing especially on contractual typologies, the efficiency of the adopted solutions and their economic character. The sample used for this work consisted of 50 medium to large size hospital facilities with fairly homogeneous distribution over the Italian territory. Hospitals, having been transformed into health authorities from public corporations, are faced with a gradual change that should allow them to have modern enterprise features, in which efficiency and effectiveness become a ‘must’ for survival in the health business. To this end it should be normal, particularly in the administrative and maintenance area, to have a change in direction with new management models and the creation of a facility department exclusively dedicated to the supply, management and control of services. The results obtained through this study indicate that these expectations are still a long way from being reached in a satisfactory manner. The territorial structures responsible for supplying the health service are still bound to the past, at least concerning the bureaucratic procedures to follow in relations with the ‘outside world’, at any level.