by Bob Foster and Jekaterina (Kat) Shelley
For many facilities directors, one of the most common struggles with Computerized Maintenance Management Systems (CMMS) is an inability to derive relevant and reliable key performance indicators. These indicators help measure program effectiveness, campaign effectively for budget increases, or present their program performance to the Executive Committee and other administrators. But too frequently, facility directors struggle to identify crucial statistics or demonstrate compliance, and many feel data entry is too large a burden for existing staff. In many cases, these struggles lead professionals to consider replacing the software.
However, replacing software can be an expensive and time-consuming process. Annual support fees, transferring inventory and Preventative Maintenance (PM) schedule data, training, and the software itself can be cost-prohibitive for many. It’s often worth evaluating more cost- and time-effective solutions to improve or get the most from your current software. Following these four steps can help you better understand where you can improve use of your existing CMMS, improve data accuracy and generate meaningful performance reports. If you determine that new software is indeed needed during the process, you’ll have become a more informed buyer.
Step 1: Review and Prioritize Your Inventory
At the core of any well-functioning CMMS is an accurate, prioritized equipment inventory. Many inventories contain outdated equipment, fail to include new equipment from expansions or renovations, or include equipment better tracked in an asset management systems, such as salt spreaders or socket adapters (no maintenance required). Every CMMS needs a compliant critical equipment inventory as the basis for improved metrics and efficiency.
At a minimum, you will need to inventory your critical equipment. Per Joint Commission requirements, all equipment critical to fire and life safety must be identified, characterized, and maintained either per manufacturer recommendations or a properly documented Alternative Equipment Maintenance schedule (EC 02.05.01). An accurate record is crucial for maintaining compliance, and regardless of classification, 100% compliance with scheduled maintenance is required for all critical equipment. Your CMMS should record and classify this inventory (per EC 02.05.01 EP 3 and 4). From there, you can move on to Priority 2 level equipment based on your needs and history.
Step 2: Review and Update PM Schedules
One of the primary purposes of a CMMS is to ensure equipment maintenance schedules are followed by generating regular work orders for staff. In combination with review of maintenance schedule and task descriptions, these work orders can not only help demonstrate compliance, but can also improve group efficiency and provide key performance indicators.
Using the critical inventory developed in the first step as your guide, begin to review the related equipment maintenance schedules, task descriptions, and manufacturer’s recommended schedules. As you perform this review, align schedules in your CMMS with manufacturer’s recommendations or create a properly documented Alternative Equipment Maintenance (AEM) schedule (EC 02.05.01 EP 7 and 8). It is often difficult to find and interpret recommended schedules for older equipment, and an AEM schedule can be a helpful alternative in these cases. To help with an AEM schedule for this older equipment, start with the Maintenance Management for Healthcare Facilities manual published by ASHE. Compare and contrast your existing checklists with those in the manual, then take steps to appropriately update your checklists where needed.
The practical results of this step should be threefold:
- A higher level of demonstrated compliance (EC 02.05.01 EP 5);
- Maximized staff efficiency through an optimized PM schedule;
- An accurate critical equipment PM completion rate data – a key metric for measuring program success.
With newly reviewed and updated equipment maintenance schedules and task descriptions, your CMMS should better help you demonstrate compliance and generate work orders more reflective of you current inventory. By screening and prioritizing work orders, you can also maximize staff efficiency. With regular feedback on work orders from staff, you can make gradual adjustments to the workflow over time, balancing more demanding maintenance schedules for older equipment with less demanding schedules for more modern equipment and better distributing work.
Consider the timing of work order generation within your CMMS. For instance, if your system generates all PMs on a monthly basis, (opening work orders at the beginning of the month with month end due dates), monthly completion reports should be simple to generate. If your CMMS generates work orders weekly, especially if completion dates overlap months, it will likely require additional effort to generate accurate periodic reports.
With this review and update of work order generation, maintenance schedules, and reporting, you should begin to have the necessary data to determine if your existing CMMS can work for you.
Step 3: Review Your Corrective Measure Work Order Process
There are numerous methods of implementing an effective, efficient Corrective Measure (CM) process, but the best method depends on your individual hospital and program needs. Reviewing the CM process both positively impacts client satisfaction and allows you to better judge your current CMMS’s capabilities.
At the outset, consider the CM process as a workflow; create a workflow diagram, then walk through each step to identify opportunities for improved data collection and efficiency. Begin with data input and consider how your clients—hospital staff—enter work orders. Do they use an interface, or do they call your facility group directly? From there, examine how work is assigned, tracked, and whether requesters provide feedback. Granularity is key, as details you note now will help you identify possible improvements in efficiency.
If you have not historically segmented work orders by priority, look into doing so at this point in the process, as well as setting response times for each level of priority. Many hospitals that have successfully implemented work order priority levels set 4 or 5 levels with default response times ranging from mere hours for life safety issues to 30 days or more for less urgent priority types. This sets up an additional key performance indicator and efficiency improvement tool as you review the entire workflow from initial request to closeout.
As you develop your workflow diagram, interview stakeholders involved at each step. This provides useful feedback regarding the most useful aspects of the CMMS and helps identify which aspects are creating unnecessary hurdles. Hospital staff often provide insights into interface ease of use, and feedback on response timing and closeout. For insight into the accuracy and necessity of information collected, facility administrators will be an ideal resource, while technicians can provide additional observations.
Your contributions are also crucial in this step as you consider the key performance indicators you want to see as you develop long-term process improvements. For example, you might consider a method for regularly reviewing open work orders, determining which ought to be escalated, or transferred to your capital list, or even eliminated. As some work orders can actually cause unintended compliance issues (add doorstops to fire doors), this is an oft-recommended step. As you review how the workflow and system can collaboratively facilitate more accurate data more efficiently, remind yourself and your staff that all options are on the table.
Once you identify the metrics you’d like to track, prioritize them and break down the necessary data components to determine what information you must collect and to understand the accuracy and reliability of those metrics. This should help you gain a sense of the process (or processes) for generating your key performance metrics. You may eliminate some as unrealistic, thereby fine-tuning your list.
With the completion of Step 3, you will have improved efficiency by streamlining workflow, created a list of client interface improvements, and optimized data collection requirements. This last step many find to be the most time-intensive, but often the most valuable, in improving overall group performance and gaining an internal reputation for efficiency and transparency. It also ensure you have all the information you need to thoroughly evaluate your CMMS and determine its viability when tracing your key metrics.
Step 4: CMMS Software Requirements
Steps 1 through 3 should have given you the information required to evaluate your existing CMMS or a proposed new system. This includes answering the following key questions:
- Can it regularly demonstrate compliance?
- Can it capture operation-critical information?
- Can it generate regular reports with this information?
- Does it have the necessary features to support and streamline workflow?
- Can staff interface with the feedback mechanism?
- Is there mobile device support for work order completion?
- Is the system reliable?
Whether working with your current vendor to review your existing CMMS or evaluating a new system, you should now have all the necessary information to decide on the best tracking and reporting option for your hospital.
Bob Foster is business development manager at EBI Consulting.
Jekaterina (Kat) Shelley is senior director of facilities support services at Carney Hospital in Dorchester, Mass.