Investigating the current state of infection control practices in domestics services in the national health service in Scotland: A case study approach

Healthcare Associated Infection (HAI) remains a worldwide problem. This paper is based on an on-going research project which aims to develop a Performance Management Framework for Facilities Management services in the control of Healthcare Associated Infections (HAI). With a focus on the area of FM, an attempt is made to understand how FM practices contribute the control of HAI. In the context of HAI, the research also attempts to explore the importance of both knowledge sharing practices (among the FM and clinical practitioners) and Performance Management (PM) practices in FM services. The arguments of contracting out versus in-housing domestic services in the control of HAI are presented. Domestic services in two hospitals were selected as case studies. The types of domestic services in the two hospitals are: (1) a totally in-house service and (2) a Private Finance Initiative (PFI contract). The main purpose of choosing the case study approach was to explore, in-depth, the practices of control of HAI in domestic services. The choice of two cases allowed for a comparison of these practices. Some findings of the case study approach carried out as part of the aforementioned research will be presented. The paper explicates the findings of the case studies in two parts; first it examines the context of control of HAI in the two cases and then identifies its similarities/ differences. Although both cases have identified the importance of control of HAI in domestic services, there were differences in practices mainly in terms of application and update of standards, integrating with the infection control teams and application of performance management approaches. For the reason that FM has a significant role in the control of HAI, it is concluded that there is a need to prioritise the profile of FM services in the HAI agenda. The crucial lesson from the study is the importance of better collaboration and co-ordination between infection control and facilities management teams. This provides significant efficiency gains from the contractual arrangements whether it is in- house or outsourced.