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The purpose of this research is to provide a theoretical and practical theory and application that provides understanding and means to manage complex infrastructures.

In this research, complexity, nonlinear, noncontinuous effects and aleatoric and data unknowns are bypassed by directly addressing systems' responses. Graph theory, statistics and digital signal processing (DSP) tools are applied within a theoretical framework of the theory of faults (ToF). Motivational complex infrastructure systems (CISs) are difficult to model. Data are often missing or erroneous, changes are not well documented and processes are not well understood. On top of it, under complexity, stalwart analytical tools have limited predictive power. The aleatoric risk, such as rain and risk cascading from interconnected infrastructures, is unpredictable. Mitigation, response and recovery efforts are adversely affected.

The theory and application are presented and demonstrated by a step-by-step development of an application to a municipal drainage system. A database of faults is analyzed to produce system statistics, spatio-temporal morphology, behavior and traits. The gained understanding is compared to the physical system's design and to its modus operandi. Implications for design and maintenance are inferred; DSP tools to manage the system in real time are developed.

Sociological systems are interest driven. Some events are intentionally created and directed to the benefit and detriment of the opposing parties in a project. Those events may be explained and possibly predicted by understanding power plays, not power functions. For those events, sociological game theories provide better explanatory value than mathematical gain theories.

The theory provides a thematic network for modeling and resolving aleatoric uncertainty in engineering and sociological systems. The framework may be elaborated to fields such as energy, healthcare and critical infrastructure.

ToF provides a framework for the modeling and prediction of faults generated by inherent aleatoric uncertainties in social and technological systems. Therefore, the framework and theory lay the basis for automated monitoring and control of aleatoric uncertainties such as mechanical failures and human errors and the development of mitigation systems.

The contribution of this research is in the provision of an explicatory theory and a management paradigm for complex systems. This theory is applicable to a wide variety of fields from facilities and construction project management to maintenance and from academic studies to commercial use.

Maintenance management of health care facilities is one of the more complex subjects in the field of maintenance. The performance of hospital buildings is affected by numerous factors, including quality of hospital maintenance, actual occupancy vs standard occupancy, age of buildings, surrounding infrastructures, etc. The purpose of this research was to quantify the effects of users, building parameters and systems on the performance and maintenance of hospital buildings. The following factors were investigated: overall performance of the building; age of the building; level of building occupancy; and extent of labor outsourcing. The effects of the above parameters and variables were examined and quantified, employing coefficients and diagrams, using analytical and statistical analysis. The coefficients and diagrams developed were integrated into four key performance indicators for hospital buildings. The model was tested on six case studies, one of which is presented here.

Increasing demand for healthcare services world‐wide creates continuous requirements to reduce expenditures on “non‐core” activities, such as maintenance and operations. At the same time, owners, users, and clients of healthcare expect a high level of built‐facilities performance and minimized risks. The objective of this research is to develop an integrated facilities management (FM) model for healthcare facilities.

The paper presents a case study analysis of an Israeli acute care hospital, in which the integrated healthcare facilities management model (IHFMM) was implemented, and the findings were examined and evaluated three years later. The case studies investigated the effectiveness of the developed model in terms of maintenance and performance management. The robustness of the model was also examined by applying sensitivity analyses to its parameters.

Both of the case studies show significant results in predicting FM‐related aspects, such as the level of performance and the required maintenance budgets. The findings reveal a high correlation between the two phases of the case studies in terms of financial outcomes and performance predictions.

The core of the model is based on the strength of identified effects of certain parameters, such as maintenance expenditure and actual service life, on the performance and maintenance of healthcare facilities. The proposed IHFMM addresses two core topics of FM: maintenance and performance, for strategic FM decision making.

The increasing competitiveness in the business sector forces facilities managers in reducing expenditure on “non‐core” activities. Consequently, the integration of different domains related to facilities management (FM) motivates the development of a quantitative model, which may contribute both to the planning of FM activities and to the improved effectiveness of FM units. Three methodologies were used in the research presented in this paper: a structured FM survey conducted among acute care facilities in Israel; a statistical analysis of the data; and the conceptual development of an FM model. The proposed model is divided into three main phases that deal with the following five main FM domains. The outcomes of the model produce a set of variables, which can be analysed according to a given facility. In addition, the model provides guidelines for the methodological design and management of healthcare facilities from a life‐cycle perspective.

Following increases in national demands on healthcare facilities and services, healthcare facilities management (FM) has gradually matured to become an established research and development topic. This paper reviews the state of the art in the main domains related to healthcare FM and defines the central themes in the development of a healthcare FM model. FM, maintenance management and performance management are reviewed in a wider context, and the main domains of healthcare FM are discussed. The five salient topics included in healthcare FM are maintenance management, performance management, risk management, supply services management, and development. These five core domains are interrelated, and can be integrated using information and communications technology, which provides the desired environment required for the challenging decision making and development prevalent in healthcare FM.