AAMI: Improved preventive maintenance can save technician hours
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“We devised an evidence-based PM strategy, based on equipment history,” said Jerry Krueger, manager of corporate clinical engineering at Aurora Health Care, which is a 15-hosptial system with more than 100 clinics and imaging centers, and a clinical engineering team of more than 100 members.
He suggested there were four “driving forces” pushing the development of such a strategy: patient safety, regulatory compliance, healthcare reform that has been shifting resources where they are most needed, and the corporate administration objective that is pushing the CE department to minimize operational expenses.
Prior to the implementation of this new PM plan, Aurora had all its medical equipment device categories standardized to ECRI; UMDNS naming conventions; equipment histories utilized to calculate required technician hours per device on an annual basis; and its FTE staffing model was developed based upon total available hours and hours per device metrics.
“We also had to determine technician availability. We determined that each technician dedicates about 1,400 hours annually to that aspect of the profession, when travel, training and vacation times are subtracted,” said Raymond Ongirski, who helped develop this model at Aurora before re-locating to become director of system clinical engineering at Alexian Brothers Health System in Arlington Heights, Ill.
“Despite the increasing level of devices that we had to assess and monitor, we had pressure from our administration to keep staffing at the same level,” Ongirski said.
To develop this new model, the CE team used risk data, equipment histories and failure rate information to develop an assessment process for all equipment device categories which will enable a reviewer to establish planned maintenance frequencies. Based on this information, they developed a risk category matrix and a universal formulation to measure the results of planned maintenance activities.
Also, Krueger and colleagues separated devices into three categories:
- Life Support, which includes ventilator, anesthesia and defibrillators;
- Mission Critical, which includes MRI, CT and hematology analyzers; and
- Routine, which includes SPO2 monitors, centrifuge and NIBP monitors.
The PM model develops a metric to measure failure rates and establishes baseline from which to measure. Also, Ongirski noted that all new device categories with established maintenance histories are to be included in the failure rate assessment formulation and identified device categories outside the established baseline to be evaluated for potential changes to planned maintenance frequency or depth.
Overall, the Aurora CE team analyzed 528 device categories. They found that 78.9 percent of PMs remained unchanged, while 2.3 percent of PMs were increased (radiology equipment, instrument washers and sterilizers). However, 18.8 percent of PMs were reduced (including for patient monitoring equipment, aspirators and electrosurgical units).