"Can a Psych Facility Plant Ops Director Transition to Med-Surg?"

I recently had a discussion with a friend who asked whether my experience as a Director of Plant Operations at a psychiatric facility would translate well to a Director of Facilities at a medical-surgical (med-surg) facility. My answer was a confident yes—with a few minor exceptions that would be relatively easy to get up to speed on.

Core Facility Management Skills Are the Same

At their core, both roles require strong leadership in plant operations, compliance, safety, and infrastructure management. Whether in a psychiatric hospital or a med-surg facility, a Director of Facilities must:

• Maintain building systems (HVAC, electrical, plumbing, fire protection, and medical gases)

• Ensure regulatory compliance (CMS, Joint Commission, NFPA, and OSHA)

• Lead emergency management planning

• Manage vendor contracts and capital projects

• Develop preventive maintenance programs

• Oversee budgets and operational efficiency

These fundamental responsibilities do not change significantly between facility types. A well-run hospital, regardless of specialty, relies on the same critical support systems to function safely and efficiently.

Key Differences Between Psychiatric and Med-Surg Facility Operations

While the core competencies remain the same, there are a few key differences in focus areas:

1. Medical Gas Systems

In a med-surg facility, oxygen, vacuum, and other medical gas systems are more extensive and critical to patient care. A psychiatric facility may have some oxygen distribution, but it is not as complex as in an acute care setting.

Learning Curve: Understanding the nuances of medical gas compliance (NFPA 99) and system maintenance would be a priority. However, this is a technical aspect that can be learned quickly with proper training and collaboration with clinical staff.

2. Infection Control & Sterile Environments

A med-surg hospital has operating rooms, sterile processing departments, and intensive care units—all of which demand higher levels of infection control measures. Facility leaders must work closely with infection prevention teams to maintain air quality, pressurization, and waterborne pathogen prevention programs (e.g., Legionella management).

Learning Curve: While psychiatric facilities follow infection control protocols, they do not deal with surgical suites, sterile corridors, and negative-pressure rooms. Understanding these environmental requirements would be an adjustment, but working alongside infection control experts would ease the transition.

3. Emergency Power & Life Safety

While psychiatric facilities have emergency power requirements, med-surg facilities are more dependent on uninterrupted power supply due to critical life support equipment (ventilators, surgical lights, etc.). NFPA 110 and NFPA 99 requirements for generator testing, fuel storage, and automatic transfer switch operations are more stringent in acute care settings.

Learning Curve: An experienced facilities leader already understands emergency power systems but may need to adjust to the higher redundancy expectations and stricter testing protocols in med-surg environments.

4. Security and Ligature Risks

Psychiatric facilities have enhanced security protocols to prevent self-harm and patient elopement, which is less of a concern in med-surg settings. On the flip side, med-surg hospitals focus more on infant abduction prevention, emergency department security, and workplace violence concerns.

Learning Curve: Security strategies differ, but the principles of risk assessment and incident response remain the same. Adapting to new security risks would be straightforward.

Transitioning from Psychiatric to Med-Surg Facilities

While there are some differences, a strong facilities leader can bridge the gap quickly. The ability to manage teams, optimize building systems, ensure compliance, and drive operational efficiency is what matters most. The specific nuances of med-surg environments can be learned with targeted training and collaboration with clinical and infection control teams.

For anyone considering a similar transition, I’d recommend:

1. Cross-training with med-surg facility teams (especially in medical gas, infection control, and emergency power)

2. Networking with other facility directors in acute care to gain insights into operational challenges

3. Staying up to date with NFPA, ASHE, and Joint Commission standards specific to acute care settings

In the end, the core skills of a facilities leader are universal—the setting may change, but the mission remains the same: providing a safe, efficient, and compliant healthcare environment.