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AN ASSESSMENT OF MAINTENANCE MANAGEMENT PRACTICE OF PUBLIC HOSPITAL BUILDING.
(A CASE STUDY OF FEDERAL MEDICAL CENTRE KEFFI)
ABSTRACT
The research aims at assessing the maintenance management practice in public hospital building. The research objectives are to investigate the current state of public hospital building in federal Medical centre Keffi (FMC) and also to determine the Factors responsible for the mismanagement of the public hospital building. Simple percentage rating was used to analysis the data collected. The research reveals that the study area adopts direct labour method of contracting a frequency of 77%. Similarly the absence of maintenance strategy, poor workmanship are the most factors responsible for the current defect in the study area with 25% each. Major causes of defects in public hospitals were identify as negligence and poor workmanship with rating of 56% and 29% respectively. Research concludes that lack of maintenance culture, poor workmanship, negligence, absence of maintenance strategies are the most factors that affects the maintenance culture in the study area.
CHAPTER ONE
1.0Â Â Â Â Â INTRODUCTION
Maintenance management of hospital buildings is one of the complex subjects in the field of facilities management (shohet, 2005) contributing to this is the complex nature of hospitals buildings the delicate mechanical and electrical systems and inadequate maintenance budgets. The qualities of physical environment in which patients receive care affect patient recovery rate, staff satisfaction, and organisation productivity. Such effect can be positive or negative (Malkin and Wiley 1992).
Public hospitals are usually large buildings that have significant impact on the environment, and the economy of the surrounding community the physical surroundings in hospital constitute health problems in public health delivery (Dilani, 1999). Patients in a healthcare facility are often fearful and uncertain about their health, their safety and their isolation from normal social relationships.
The performance of hospital buildings and their components depends to a large extent on continuous and planned periodical maintenance (Shohet 2003). Maintenance is the art of controlling the rate at which structure deteriorate towards a state of unservicability and collapse (smith, 2003).
Government owned hospitals are confronted with unique challenges that threaten their existence, through an examination of the history, characteristics, and structure of public hospitals it is found that such institutions by their nature lack the capacity to complete in a market- driven economy (stobzenberg, 2002). This deficiency is further found to originate from the institutions inherent government structure, which promotes inefficiencies and inflexibility through the imposition of bureaucratic impediments to operational effectiveness. according to Onifade(2003), Installed health facilities are as old as the hospitals themselves. Some of the medical equipments are unserviceable and need outright replacement.
The need for maintenance arises because buildings inevitably deteriorate with time due to effect of various causes. In Nigeria maintenance is given very little priority. A more progressive attitude should be to conserve the existing building stock through proper maintenance because it is a major national asset (Hutton and Lloyd, 1993). Therefore the principal proposition of this research is on an assessment of maintenance management practices in public hospital building in Nigeria and in the process identify the essential skills for maintenances managers for executing an assessment of maintenances programme in a hospital built environment. The colonial architecture in some of the old hospitals, which were tither to famous for their sturdiness and functionality, has now become less attractive because of the neglect of building maintenances. Over crowding has also led to deterioration of these facilities, patients in a healthcare facility are often fearful, uncertain about their health and society. Â Â Â Â Â
1.2  Statement of the problem     Â
 Government owned hospital are confronted with unique challenges that threaten their existence in Nigeria installed health facilities are as old as the hospitals themselves some of the medical equipment are unserviceable and need out right replacement.
The state of maintenance and the physical surroundings in public hospitals buildings are present health problems in public health acre delivery, patients in a healthcare facility are uncertain about their safety. This deficiency is further found to originate from the institutions inherent government structure, which promotes inefficiencies and inflexibility through the imposition of bureaucratic impediments to operational effectiveness. The quality of the maintenance manager is another factor found to be affecting the execution of maintenance operations in public buildings. This has a direct impact on staff performance, productivity, satisfaction and turnover, management is a living force and it is the force that gets things done to acceptable standards.
1.3Â Â The need for the study.
Many Nigeria public hospitals are often inadequately maintained, windows, doors, and others building elements are facilities frequently show evidence of maintenance and repair. Some public hospitals have not seen any signs of maintenance since they are constructed; this has resulted to such buildings to be dilapidated and abandoned. in view of these, it has been considered necessary to study the maintenance of public hospital buildings in Nigeria. The study is important in the since that it would not only contribute to knowledge and theory will also contribute to good maintenances practice in the public buildings in Nigeria as a whole.
1.4Â Â Aim.
The aim of the research is to assess the maintenance management practice of public hospital building in Nigeria, to achieve this aim the following objective were pursued.
1.4.1 Objectives
–Â Â Â Â Â Â To investigate the current state of maintenances of public hospital in the study area.
–Â Â Â Â Â Â To determine the factors responsible for the mismanagement of the public hospital building in the study area.
–Â Â Â Â Â Â To determine an alternate measure of maintenance practice on the public hospital building.
                                                          Â
1.5Â Â Research methodology.
For the purpose of these study which reviews  relevant literature was done on the basis of which information were gathered and is been used to structure a research questionnaire for the survey other sources of information related to the topic were obtained through verbal interview.   Â
1.6Â Â Â Â Scope and de-limitation.
v   The study focus on the maintenance management public hospital buildings, the current condition of maintenance management and the strategies to be adopted in improving maintenance management in the study area.
v   De-limitation of the study is an assessment of maintenance management of health care and the facility used in the hospital.
CHAPTER TWO
LITERATURE REVIEW
2.0Â Â Â Â Â INTRODUCTION.
This chapter reviews literature on the issues of an assessment of maintenance management practice of public hospital building in Nigeria, it is cover secondary aspect assessment of maintenance management and the factors affecting the maintenance in the public hospital building in federal medical centres with the method will need to carry out the assessment of maintenances in the (F.M.C) keffi.
2.1Â Â Â Â Â Defination of building
A building is an edifice erected by art, and fixed upon or over the soil composed of stones, brick, wood, or other proper substances connected together, and design for use in which it is so fixed (Wikipedia) according to Cobbinah 2010. building are require to provide a conducive and safe environment for various human activities this essentially is the question of function the extent to which the building provide the required environment for the required activity is a major of functionality of the building ( Oladapo 2005) according to ( Olumide Adenuga ) maintenance management of hospital buildings is one of the complex subjects in the field of facilities management ( Shohet 2005) contributing to this, is the complex nature of hospital buildings, the delicate mechanical and electrical systems and inadequate maintenance budgets. Hospitals are the most complex of building types ( Veliment 2000) each hospital is comprise of one wide range of service and functional units such as diagnostic and treatment function, hospitality function, and the fundamental inpatient care or bed related function.
Hospital building as a healing indoor environment needed in healthcare to prevent infection control. Describe the hospital building to be the healthcare environment that should measurable improve patient outcome reduce or eliminate environmental stressors, support positive distractions, enable social support and give a sense of control the goal of every health institution is to provide patient care and produce medical and health man power.
Hospital buildings are places were care and cure should be available to the public, but due to lack of maintenance public hospital building have become a place were people working in the build environment ( Iyagba 2005) according to Olumide Adenuga vital documents of this public hospital building have not been spared due to poor or non maintenance of the building the dilapidated nature of the public hospital building facility has also left the properties of the occupants at the mercy of the weather. These problems, arising out of the present situation as far as maintenances of building in the public sector is concerned lowers morale of the labour force and goes a long way to reduce the efficiency of the personal.
In view of these it has been considered necessary to study the maintenances of public hospital building in Nigeria to identify the factors contributing to the current states of building.
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