WATER SAFETY MANAGEMENT, LEGIONELLA PREVENTION AND RISK MANAGEMENT IN HOSPITALS: A FRAMEWORK FOR ESTATES AND FACILITIES MANAGEMENT IN ENGLAND

Abstract

This study is the first to evaluate water safety and Legionella prevention from a management level perspective. It is an organisation’s duty to prevent any harm or risks potentially threatening the health of people. For that, certain processes are essential to be applied. They should be known by the people responsible and those, who are involved in any process serving to maintain health and safety, and to reduce known hazards. This thesis’s purpose is to create a significant contribution to knowledge by creating the first ever suggested framework for England. It makes a distinct and original contribution to knowledge as it is easy to understand and provides schemes and docu-ment templates for reference and for application. The specific aim of this research is to systematically identify the present situation of water safety and Legionella prevention in water systems in healthcare organisations, i.e. hospitals and hospital trusts in England. It seeks to create a framework guiding management processes to people re-sponsible to identify and better understand roles and processes to properly take action for the prevention of water system related infections caused by Legionella. The focus of the research lies in organisational structures from the point of view of Estates and Facilities Management. It anal-yses the current state of the process of Legionella prevention with a focus in England and with a different way of looking at the problem. In research papers the topic is neither very prevalent nor easily accessible at management levels. Methodology is built on a mixed methods research de-sign and a multilevel triangulation approach. An embedded design applies cases for analysis, that have been empirically collected during an exploratory first phase with cases in the UK, Germany and Switzerland. A consecutive country-specific phase fosuing the research more specific was applied for England. Data from interviews and documents was collected and analysed during the exploratory phase, which had a focus on taxonomy and to explore job descriptions and factors in hospitals that have a thematic connection to Legionella, risk management and water systems for the purpose of water safety management. This phase was also necessary to test the fluency of the procedures selected for data collection and verify and confirm the case strategy chosen. Re-search of the following phase collected and analysed data from interviews, a survey and docu-ments. The specific focus of this phase was to find patterns, define coding structures, build cate-gories, analyse and compare content by applying cycles of content analysis to find levels of ab-straction to create a draft version of a framework, which underwent a validation step in a final fo-cus group by experts in the field of risk management and water safety. Throughout the research process, the findings present a systematically reviewed and analysed picture of procedures of water safety management. It applies stakeholder analysis as well as pro-cess analysis, demonstrating levels of collaboration, risk management procedures, process man-agement, quality management, environmental management and knowledge management. The dissemination of the research’s output is a framework titled “Water safety management, Le-gionella prevention and risk management in hospitals: a framework for Estates and Facilities Man-agement in England”. It aims at closing the gap between theory and practice and complies with best practice. It translates given obligations into the professional field of Estates and Facilities Management and should be made available for transferring knowledge.