An easy-to-use computerized maintenance management system (CMMS) can create efficiencies in the workplace. Some biomed shops have grown their own software solution in-house. This approach could very well work for smaller shops, but as the hospital equipment inventory grows, it may become necessary to move to a supported platform.
Selecting the best fit for your particular hospital can be challenging because there are so many different products on the market. In recent months, the clinical engineering department at my facility, Lake Regional Health System in Osage Beach, Mo, underwent the selection process for a new CMMS program. Below are some guidelines I found helpful on our journey.
Our search for the right CMMS began when we discovered that our old system, which we had been using for the past 7 years, was not going to be supported any longer. In addition, our IT department needed to migrate any software programs running on Windows 2003 to Windows 8. At the time, we were hosting our CMMS software on an internal server, which was not capable of running on Windows 8.
Another driver was that our senior leadership wanted all engineering departments to share one database. We therefore needed to look at programs that were versatile enough to handle the equipment and preventive maintenance (PM) schedules for those departments as well. Our quality office, which is often the liaison with state and federal inspectors, also wanted the ability to look up equipment, run reports, and generate documentation from the system to provide to inspectors as needed.
Thirdly, the Joint Commission requires hospitals to maintain an equipment inventory with risk categories and an alarm inventory of biomedical equipment. As a requirement of the Joint Commission National Patient Safety Goal on alarm fatigue (NPSG.06.01.01), hospitals must also prepare an inventory of alarm-equipped medical devices used in high-risk areas and for high-risk clinical conditions. Facilities also need to identify the default alarm settings and the limits appropriate for each care area.
To address these requirements, LRHS developed a multidisciplinary alarm committee composed of clinical, quality, and clinical engineering staff. By using the CMMS software, we wanted to be able to identify a piece of equipment as alarm-producing or nonalarm-producing. This would allow us to focus on the equipment that contributes to alarm fatigue on the nursing units. At the same time, we needed to be able to easily meet the Joint Commission NPSG.06.01.01 requirements by having a readily accessible, manageable inventory within the CMMS program.
Asking the Right Questions
With these requirements in mind, we began to assess some products. Most software companies are willing to conduct demos and answer questions, so as a team, we requested demos on five different software products. This in itself was a learning process, and helped us further refine what we wanted in a CMMS program. Before beginning your own selection process, you will want to consider several factors.
Determine if you plan to host the program on internal servers or use the cloud-based option from the company. The cloud-based option will give you the ability to log in to the system from any internet connection, including from smart devices, while a hosted system will require access to the hospital’s intranet. Most systems we reviewed had both options available.
When choosing a system, conduct a lengthy demonstration prior to buying the program. Once you have narrowed down your choices, do another in-depth demo on the handful of systems you have selected. At this stage, evaluate how well both staff and administrators interact with the software. After all, the goal of the program is to make maintenance activities more efficient, by reducing the amount of manual documentation of hardcopy work orders and preventive maintenance. Ensure all questions are answered for all staff that will be using the system. If facilities and HVAC will be using the same program, be sure to involve them in the selection process.
Find out if the system allows for active directory input so that your customers can request repair work, get instant email feedback, and follow up surveys after work is completed. Using the hospital’s active directory autopopulates many of the data fields when work is being requested. This feature will make it easier for customers to get the information to the engineering departments as accurately as possible, reducing the need to call the requester back to get more information.
If your facility uses mobile devices or barcode asset tags, you will need a CMMS that can integrate this information. Most of the time, these modules can be purchased separately. Even though you may not be currently using these features, you need to find out if they are available for future expansion.
Consider whether you need software designed specifically for the hospital environment. There are very good programs out there that are not specific to healthcare. However, if they require you to change your processes too much, why not pick a product that is tailored to your industry?
Ask how responsive the company is when it comes to training or troubleshooting issues related to its software. Do you get a live person, or will you have to wait for a call back when you encounter problems?
Do your research—call your counterparts and peers across the nation. Ask what system they are using, what they like about it, and what they don’t like. Use this information during the more in-depth demo to see how the program actually works. Keep in mind that sometimes your colleagues may be on an older version of a program and may not have received upgrades that address the problems.
Once you have narrowed down your selection, request formal proposals that include training, data conversion, basic program costs, and annual software support fees.
Finding a Fit
During our research process, two CMMS programs that rose to the top were AIMS from Phoenix Data Systems and TMS from Accruent (formerly Four Rivers). Most hospitals that we contacted were using one of these two products. Both are healthcare industry-specific programs, and they develop their program around the Joint Commission on Accreditation of Healthcare Organizations requirements. This makes it easy to look up equipment and run reports to satisfy state and federal guidelines. The systems also have many built-in features that make navigating an inspection easier.
In addition, both programs are asset-driven, meaning that the primary sort function is based on the unique asset tag number for each piece of equipment. Medical equipment could be anywhere in the hospital at any time, so biomeds generally use index tags that are tied to the equipment data record. On a tracer survey, you may be asked to produce the electronic maintenance record for a device using this asset tag number. (Other industries often use location to track equipment, usually because the items—such as HVAC units, motors, or generators—don’t move around a lot.) For this reason, it’s helpful if the system uses the unique identification number to navigate through the different screens of the CMMS program.
Understand that there will be a learning curve with any system you adopt. When starting from scratch, you will face a lot of data entry. It will take time to get all the equipment items into the system and adjust preventive schedules to the proper intervals. Hospital staff will also need training to master new processes for requesting work through the system. Sometimes this process takes years, but once you have mastered the software, you will find it difficult to do without it. Your payoff will be a much more efficient department.
Ken Ervin is director of clinical engineering at Lake Regional Health System in Osage Beach, Mo. For more information, contact Jenny Lower at [email protected].
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