By: Rick Joslin, Senior Advisor, Healthcare Strategy
AEM programs can be key to improving your operations and increasing the usability, useful life, and resource utilization of your structures, systems and assets (SSA’s). That said, successful implementation of an AEM program is often easier said than done. The right CMMS system can help.
What Is an AEM Program?
The term AEM— whether you take it to mean, “Alternate equipment management” (CMS) or “alternative equipment maintenance” (TJC) — involves the alteration of manufacturer maintenance requirements to gain advantages in usability, useful life, resource utilization, or support on your structures, systems, and assets (SSA’s). In other words, it helps you modify your maintenance plans to optimize your SSA’s.
What’s more, although it’s not a primary reason for implementing an AEM, a successful AEM program will also use lean methodologies to help users identify activities that can be adjusted to maintain or increase safety of the SSA while reducing expenses (usually related to labor, materials or parts).
Unfortunately, implementing an effective AEM program is often easier said than done. In their 2011 publication Clarification of Hospital Equipment Maintenance Requirements (S&C: 12-07-Hospital), CMS provided more guidance on this topic, and AAMI published the AEM Program Guide with recommendations on establishing and maintaining an AEM program. Even with all this guidance, this topic is often, as many might say, “as clear as mud.”
Why? Remember, an AEM is meant to help modify a manufactures service requirements— usually a Preventive/Planned Maintenance check or service. It is not a plan to reduce or eliminate failures or breakdowns (that’s another conversation). To get it right, then, considerable time must be spent analyzing service history on the SSA under review, and specific attention must be placed on those service events that could have been prevented (or caused) by an alteration of what the manufacturer has defined.
This kind of legwork is difficult to get right, especially if you don’t have the right tools in place.
The Right CMMS Can Help
The right CMMS, such as Accruent’s TMS, can be used to record many of the documentation requirements for an AEM program. Here, we'll focus on a few key data values that make a compliant AEM possible while also ensuring your SSA inventory management needs are met.
The Data You Need to Record in Your CMMS
To build the data required to develop your AEM plan, your CMMS must be able to record several key data components in at least three areas of the program: work orders, inventory, and schedules. Here are key data values that should be available on each corrective maintenance-type work order:
- PM Preventable: Add a field used to identify if the service\issue could have been prevented by either modified or additional PM checks and services. There should be two choices—” yes” and “no” – and this field should be required.
- Failure Code: Failure codes are used to identify why the SSA was unable to perform its function (mission). Having standardized, concise failure codes is a critical data value for many types of analysis. AAMI has published a white paper, Optimizing the CMMS Failure Code Field, that provides excellent guidance on this topic, which you can view here.
- SSA Downtime: It’s imperative that service issues that result in SSA unavailability have that downtime recorded. This lends itself to criticality analysis later. The cost of asset downtime must be calculated into total asset cost and lost revenue and will impact service contracts if uptime metrics are involved.
- Failure Effect: Was there any system, personnel, or process negatively affected by the service issue? If so, it’s important to note.
Within the SSA inventory section, your CMMS should be able to assign values for these attributes on each record:
- Risk classification: CMS, accrediting bodies, and NFPA all require you to classify items in the inventory as critical/high, non-critical/non-high risk, and Category 1-4. Many HFM SSAs will need CMS risk and NFPA risk classifications, so the ability to develop and apply two specialized fields is essential.
- Risk assessment: This is a review of the risk to staff, patients, and surroundings in the event of failure as well as during use.
- AEM inclusion values: Has the SSA been evaluated? Is it included in the AEM? If not, why? If so, what has changed?
- Manufacturer & model values: Using standard and consistent values across SSA’s is a required documentation point for AEM, since the history analysis must be available for that type of SSA for benchmarking and industry review. Defining your inventory by manufacturer and model also promotes accurate procurement and performance analysis. Recall management is also critically dependent on identifying SSA’s by manufacture, model, and serial number.
- In-service dates: Without this critical data point, no accurate lifecycle analysis, mean-time-between-failures, or other service history analytics can be performed that returns defendable data values. You must know when an SSA went into service to determine all service-related data values.
Next, each SSA should have the original manufacturers' requirements recorded (i.e.: frequency and procedures), ensuring that specific documentation requirement is met. From there, any changes made to these requirements must be recorded as well. The original requirements can be documented in various ways:
- Uploaded and\or available from the SSA record as physical documents (i.e.: Word file, PDF, etc.).
- CMMS scheduled activity records that have been deactivated (i.e.: PM\IN schedules).
- Procedures that have been deactivated after changes have been made.
Finally, you will also need the analytics used in review and determination of AEM inclusion, including:
- The source of the work order\service history
- The records reviewed
- The name(s) and qualifications of those performing the review
- The name(s) and qualifications of the final authority for inclusion
- Mean-time between PM-preventable failures, etc.
A modern CMMS would have the ability to create all these fields and to store and/or access these documents on-demand in support of AEM procedures. If your CMMS can’t do these activities, contact Accruent and see what a modern-day, highly capable CMMS looks like.
About The Author
Rick Joslin is currently a senior advisor with Accruent, where he has helped healthcare systems navigate the ins and outs of managing maintenance activities within their organizations. Rick has 35+ years in the maintenance management industry, working closely with technicians, inspector/compliance surveyors, and directors. He is known for promoting continuous improvement, driving operational efficiency, increasing resource utilization, and ensuring regulatory success. Rick leverages LEAN thinking and Six Sigma processes to guide customers in short and long-term development. Rick can also deftly identify gaps and inefficiencies in business processes and drive operational excellence. His broad knowledge of healthcare operations and regulatory requirements, coupled with an intimate knowledge of CMMS systems, allow him to assist customers in developing easily implemented solutions to unique, and changing business needs.