The challenge of “preventive maintenance” is complicated in the healthcare market and one of the elements that was made clear to me at Interact 2012 was the distinction in healthcare between the maintenance crews for facilities (buildings and grounds) and the biomed machinery. Folks we spoke to talked about the segregation between crews that have their own specialties. The reality is that the skilled tradesman (carpenters, electricians, plumbers) don’t work on biomed devices, and the biomed techs don’t work on the facilities.
Everyone seems to recognize the importance of preventive maintenance, yet few know how to tackle it. Sometimes you don’t need a bigger bulldozer to move the mountain. There was discussion around the three phases of maintenance activity: Reactive (run to failure), Planned, and Preventive. Unfortunately, those three modes also tend to indicate an organization’s strategy towards maintenance. And, I discovered that Reactive (run to failure) represents the bottom of the mountain. Not many organizations are making it to the top where they spend an equal amount of time (or more time) focusing on preventive maintenance so they can properly manage the equipment and the corresponding downtime. They recognize the correlation of the phases to downtime, but putting plans in place is proving difficult. Downtime will never disappear, but are you better to plan for it or just wait for a failure and react to it? And, if the answer is to plan for it, are you willing to invest in systems to achieve that goal?
In one session, I heard a speaker say that maintenance costs are the 2nd largest cost after direct labor. That is substantial, yet the systems to properly address those issues are rarely integrated with other critical systems. An attendee pointed this out by describing a situation where her organization was looking to track which machines were used on a patient. Their goal was to match patient “risk events” to the machines that were used for monitoring and diagnostics. Now I ask you, how much keypunching (or bar coding) would it take to ask a practitioner to not only set-up the biomed device for a patient, but then record WHICH device it is? This example illustrates the difficulty of gathering critical information from disparate systems that can’t link a common element such as a patient ID.
Interestingly enough, that discussion digressed into a discussion around work order history and the ability to track every maintenance event (reactive, planned, or preventive) on a piece of equipment. Simultaneously, folks wanted to be able to analyze failures, maintenance costs, or just plain discrepancies in the promises made in the procurement cycle with the realities of field use. One attendee in particular was quite skeptical of the things they hear in the procurement process. Unfortunately, it seems they have no way to measure the cost of the maintenance over the life of a particular asset. “What is the true cost of this equipment and why I am not achieving the use you promised?” (This is akin to buying a car that gets 41 MPG on the sticker, but you never get more than 34 MPG). Interestingly enough, the PeopleSoft solution that we implement provides a complete work order history with the ability to capture all maintenance costs. I enjoyed sharing that message.
Finally, the work order discussion turned into an audit discussion. Audit is a fearful word. It makes people afraid. If you don’t know what EC 6.10 and EC 6.20 from the Joint Commission require from your organization, then fear is an appropriate term. Maybe it is time to do some research. In fact, I’ll tackle that in my next blog.
If you came by at Interact and chatted with us, thanks a ton. We had a fun and insightful time at the show. Stay in touch!
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