Integrating the Healthcare Facilities Management Department
By Rick Joslin
Most Healthcare Facilities Management (HFM) departments utilize multiple computer programs to monitor the environment of care (EoC). Building Automation Systems (BAS), tube system monitoring, fire system monitoring, water system monitoring, capital planning, time keeping and more, are all utilized daily to monitor the EoC and critical utility systems.
However, these systems are usually not digitally connected, requiring workers to perform the manual supervision. When there is an issue, manual actions are also required to get the right team member(s) activated.
Today’s healthcare organizations are providing services and seeing razor-thin operating margins, which averaged only 1.7% in 2018, according to Modern Healthcare.1 Every manual process a HFM department employs increases costs and impacts this already-thin margin. While the modern world is always moving towards digital connectivity and electronic infrastructure, most HFM departments are still relying on physical, manual labor to accomplish their missions.
A major focus for HFM departments over the next five years must include connecting the electronic systems used by their departments in an effort to reduce the manual processes in play. There is no “one-size-fits-all” software product that combines every application used to monitor and maintain the EoC, and it is likely not going to emerge anytime soon. There are too many diverse, critical systems in use, each employing complex algorithms to monitor specific aspects of the EoC. However, connecting these systems through trusted integrations provides an avenue for decreased costs.
Reasons to Integrate HFM Systems
Without compelling reasons, people, processes and organizations do not change. Let us look at some compelling reasons to integrate critical HFM systems.
1. Speed of Response
When a utility system has an issue, it impacts spaces, staff and patients. If a supply fan develops an issue that causes an alarm in your BAS, it generates a record of the event, the asset, the time and date, and, depending on severity, a visual and audible alarm.
In its native installation, responding to this event requires a person to be present to review the alarm, determine if it is critical enough to dispatch a repair technician, contact that technician to convey the specifics of the event and then manually create a repair ticket in the computerized maintenance management system (CMMS).
All of this takes invaluable time. Conversely, connecting the BAS to your Healthcare CMMS could allow this to happen almost instantly. The BAS can be configured to identify events requiring a technician, send the events to the CMMS, generate a work ticket on the affected asset, assign the job to a pre-determined technician, and send an electronic notification of that assignment all within one minute.
The manual process for this takes anywhere from 5-10 minutes. If you do the math, assuming there are 10 events a day requiring this process to be followed, your organization would save up to 1 hour and 40 minutes a day, or 6 hours and 40 minutes a week by configuring the BAS to your CMMS. If we consider $25 an hour, that is about $166 a week, or about $8,667 a year. In my experience, it is more likely your organization has more than 10 events a day generated by your BAS alone.
2. Accuracy of Records
Today’s healthcare regulatory world is all about data and compliance documentation. There are regulations concerning airflow, infection control, fire safety monitoring, medical gas manifolds, water quality and testing and asset maintenance. The more accurate the data and clearer the compliance documentation, the better the results from inspections and surveys. Each manual process in a HFM department introduces new chances for errors in data and documentation. To make matters worse, it is quite common for these errors to go un-documented within the CMMS due to outdated processes.
Most HFM departments still use a paper-log system, where each shift a staff member enters events, details and actions into a hand-written logbook. Rarely does every actionable event receive a correlating work order in the CMMS. When they do, these events are rarely tied to the affected asset. Often, the entry in the logbook is difficult to read, leading to potential issues when reviewed by inspectors, surveyors, or management.
A digital integration would eliminate issues surrounding paper logs. Incorporating Authorities Having Jurisdiction into the planning and conversion to electronic processes, plus demonstrating the safety and compliance improvements, will likely win stakeholders over. Additionally, logbooks can still be used to track shifts, while the bulk of operations go digital
3. Historical Analysis
As HFM departments are constantly driven to do more with less, the ability to review the history of assets and identify areas for reducing maintenance costs becomes increasingly important. This means the HFM department must have the ability to identify, analyze and trend both preventive and corrective maintenance data on their assets.
One area where costs can be reduced is preventive maintenance activities through an Alternate Equipment Maintenance (AEM) program. However, in order to determine if and how preventive maintenance can be altered, the HFM department must have complete and accurate records of corrective activities. Current manual processes introduce errors and lapses in data, leading to inaccurate assessments and analytics.
Connecting your utility system monitoring applications to your CMMS dramatically increases the historical records associated with your assets. This, in turn, increases the accuracy of analytics leading to better AEM decisions and improved EoC maintenance.
4. Reduce Costs
Connecting your healthcare CMMS to your purchasing application can lead to tremendous savings in parts and material management, shipping costs and contract costs. When a repair requires a part, knowing what is readily available and where can save hundreds of dollars. An example of this would be if you needed to replace a chemical feed pump on a reverse osmosis unit. Since this is a critical system, parts will likely be shipped express or overnighted at the cost of hundreds of dollars.
On the other hand, what if your digital system could see that a sister hospital 30 miles away has one on-hand? Now, you can retrieve that on-hand unit and ship the replacement via general ground shipping, saving time and money. Having your CMMS and purchasing systems integrated also reduces the ordering of wrong parts due to incorrect part numbers or ordering duplicates of items when there are already several on-hand.
If you add in the ability to analyze contractor costs across each of your organization’s hospitals, you could save millions. It is not uncommon to find a single vendor charging different rates for similar services at each hospital. Unless each HFM management team got together periodically to discuss those costs, it would be difficult to know this. However, using common records resolves this issue.
Want to take it even further? Require all service orders to be tied to records within your CMMS and you can easily eliminate waste, fraud and abuse.
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The Bottom Line
An integrated HFM department can make a dramatic, positive improvement to any healthcare organization through reduced costs, higher accuracy, faster response, better healthcare asset management and increased customer service.
Today's technology leaves little reason to keep HFM systems disconnected, and the implicit cost savings of integrating multi-tenant healthcare systems makes it hard to ignore. HFM departments must follow the path of their HTM and IT counterparts and take advantage of integrating their platforms to embrace the direction the industry is heading.
About the Author
For more than 18 years with Accruent, Rick Joslin has helped healthcare systems navigate the ins-and-outs of managing maintenance activities within their organizations. With over 30 years in maintenance management industry, at levels from technician to director, to inspector/compliance surveyor, he is known for promoting continuous improvement, driving operational efficiency, increasing resource utilization, and ensuring regulatory success. As the Senior Advisor, Healthcare Strategy and as a Senior Solutions Architect, Healthcare, Rick leverages LEAN thinking and Six Sigma processes to guide our customers in the development of short- and long-term goals for measurable, continuous results across a wide variety of healthcare environments, while also helping them to identify gaps and inefficiencies in business processes and driving operational excellence. His broad knowledge of Healthcare operations and regulatory requirements, coupled with an intimate understanding of the TMS systems, allow him to assist customers in developing easily-implemented solutions to unique, and changing, business needs.