Construction Management and Economics ISSN 0144-6193 print/ISSN 1466-433X online © 2004 Taylor & Francis Ltd http://www.tandf.co.uk/journals DOI: 10.1080/0144619042000186031 *Author for correspondence. E-mail: ishohet@techunix.technion.ac.il Integrated maintenance management of hospital buildings: a case study SAREL LAVY and IGAL M. SHOHET 1 * Faculty of Civil and Environmental Engineering and 1 the National Building Research Institute, Technion – Israel Institute of Technology, Haifa 32000, Israel Received 26 June 2002; accepted 17 January 2003 Over the course of the past three decades, facilities management has become the subject of an increasing number of research and development efforts. The main objective of the present research was to examine the efficiency of maintenance under alternative maintenance policies and different sources of human resources. The research focused on the maintenance of public hospital buildings in Israel, with the objective of providing a model for multi-system facilities operating in a dynamic environment. This paper describes the last three stages of the research: the establishment of key performance indicators, the implementation of these indicators in a case study in order to appraise them, and the validation of the indicators. Four key performance indicators were developed, as follows: the Building Performance Indicator (BPI), the Manpower Sources Diagram (MSD), the Maintenance Efficiency Indicator (MEI) and the Managerial Span of Control (MSC). This paper illustrates a case study in which the four developed indicators were implemented in practice. Characteristics of the case study hospital are presented and analysed. Finally, the conclusions and recommendations drawn from the analysis of the hospital case study are discussed, validated and deliberated upon. The approach presented in this paper integrates performance, financial, human resources and organizational aspects to facilitate an improved evaluation method of the parameters affecting the execution of maintenance activities. Keywords: Facilities management, key performance indicators, maintenance, outsourcing, performance-based building Background With the beginning of the 21st century, property is recog- nized as a large capital-centre which can contribute to competency and profit and, as such, needs to be effec- tively managed (Douglas, 1996). Facilities management (FM) is perceived as the management of non-core company assets (Nelson and Alexander, 2002). It includes the built space, services, technology, maintenance, modifica- tion and adaptation, function and use, security, comfort, environmental health, costs and benefits of occupancy. FM provides procedures to integrate decisions across the physical, human and financial areas of concern, all for the improvement of use, performance and productivity of facilities (Nutt, 1999; Atkin and Brooks, 2000). FM is therefore taken to be the co-ordinating management function that concentrates on the interface between the physical workplace and people and, as a consequence, successful FM highly depends on cost and efficiency. Managers of these facilities are dictated to be capable of dealing with a wide range of issues, such as round-the- clock operation, high performance, composition of human resources and limited budgets (Tay and Ooi, 2001). The first part of this paper describes the develop- ment of maintenance indicators for the examination of the performance and efficiency of the work patterns of maintenance departments in healthcare facilities. These indicators are based on the findings of field surveys conducted on hospital campuses in Israel. The second part of the paper introduces a case study in which the developed indicators are examined on a specific hospital campus. In this case study a hospital characteristics are Construction Management and Economics ( January 2004) 22, 25–34