A hospital can be a daunting, difficult place to run.
And the COVID-19 pandemic certainly put that reality into perspective for many hospitals worldwide.
In the words of the German novelist, Eric Maria Remarque: “A hospital alone shows what war is.”
While those words may seem extreme, it is a valid point considering the management of a hospital may be one of the most-complex and challenging professions in any society.
There are only a few workplaces as unpredictable on a daily, or hourly, basis as a hospital.
Hospitals require physical and working environments with stringent protocols for everything from hygiene to machine safety and security access.
The hospital industry has specific requirements, which, in turn, require maintenance management and technicians with the necessary expertise
Therefore, it is not surprising that maintenance is critical for ensuring a hospital runs like a well-oiled, secure machine.
The hospital industry has specific requirements, which, in turn, require maintenance management and technicians with the necessary expertise.
Thus, there are maintenance jobs unique to hospitals, as well as more ‘generic’ ones that are typical for many workplaces.
Maintaining equipment
Medical equipment maintenance is probably the maintenance class most specific for hospitals.
Even in an average-sized hospital or clinic, a person becomes aware of the enormous number and variety of medical machines and equipment they are typically equipped with.
And the breakdown of any equipment can have grave, even mortal, consequences for patients.
Medical equipment can encompass an array of machinery needed for the diagnosis, treatment, and monitoring of patient health.
Numerous studies have shown the leading cause of medical equipment glitches or breakdowns is caused by poor planning and poor maintenance management.
Medical equipment maintenance can be done as a part of pro-active measures or sudden, corrective actions.
This maintenance is typically triggered by any of the following:
- Statutory or regulatory compliance: A given jurisdiction may have specific laws, regulations, or guidelines regarding mandatory maintenance of hospital equipment and machinery; and non-compliance may result in fines and/or other punitive measures
- Manufacturers’ guidelines: Medical machinery often comes with manufacturer specifications regarding maintenance. This can include maintenance factors such as optimal frequency, needs for specialised or licensed expertise, and the required type of maintenance. For example, the calibration of medical testing equipment to ensure its precision
Internal factors can also necessitate the maintenance of medical equipment:
- Corporate procedures: It needs to be stressed that legal requirements, or manufacturer specifications, are only the minimum standards and may not be considered the ultimate benchmarks by proactive maintenance departments. Some hospitals may opt for higher, more-stringent maintenance-related standards
- Cost considerations: Medical equipment can be very expensive. For example, in the UK a Magnetic Resonance Imaging (MRI) machine can cost anywhere between £600,000 and £1.9m, depending on the strength of the machine’s scanner
The heat is on!
Heating, ventilation, and air-conditioning (HVAC) is another challenging area for hospital maintenance.
HVAC is critical for infection prevention and control (IPC), which is a central issue in any healthcare facility.
This becomes acutely obvious during times of immense stress on hospitals, like with the COVID-19 pandemic.
Other typical maintenance jobs in hospitals are related to electrical systems and installations.
Electrical safety maintenance, for example, includes electrical machinery such as lifts.
The maintenance of electrical distribution boards is especially important in hospitals; including proper insulation, given how much critical medical equipment runs on electricity, and needs to be available or on standby 24/7.
Illumination has paramount importance in any hospital, too, both in critical areas such as surgery rooms or the ICU/emergency wards and for security.
At all times, maintenance professionals should take pride in the invaluable contribution they make to a hospital’s viability and safety and the public good that it ensures
Power outages can cause mayhem in a hospital, as in August 2019 when lightning strikes caused major power outages across large areas of the UK.
This resulted in a complete outage at Ipswich Hospital in East Anglia when a back-up generator failed to work due to battery failure.
There are numerous other maintenance jobs required in hospitals, including:
- Maintenance of the built environment: Encompassing any building-related safety maintenance, including staircases, access ramps, roofing, parking bays for medical vehicles, and various other physical parts of the hospital building and its environs
- Security-related maintenance: Including maintenance of means of entry at security control points and entry into restricted areas
- Fire equipment maintenance: This includes the maintenance of portable fire extinguishers (PFEs) and fire hoses, as well as checks on fire management controls, such as fire escapes and other means of egress
- Janitorial services, including waste management services, linen care, and vermin control, which are highly regulated and often-inspected factors in UK hospitals
- Landscaping and gardening services
How to streamline hospital maintenance
Streamlining hospital maintenance can occur by acknowledging the challenges faced by hospital maintenance departments, and then providing solutions to these challenges.
The most-typical challenges that impede hospital maintenance include:
Budgetary constraints
The challenge: The lack of adequate budget for the many (and often unique) maintenance tasks in hospitals can be a major challenge for maintenance departments.
The solution: Careful planning based on maintenance priorities will be needed. Furthermore, a computerised maintenance management system (CMMS) can be immensely beneficial in providing a maintenance department with the logical structure and intelligent planning of maintenance work with a less-than-optimal budget.
Work processes
The challenge: Healthcare facilities are complex, diverse workplaces; this invariably leads to maintenance departments being under enormous pressure to perform. The growing (and worldwide) lack of maintenance professionals places further stress on maintenance managers and teams.
The solution: The maintenance function needs to be as efficient and cohesive as possible. This can be accomplished by ensuring that maintenance workers are as professional and expert as possible. Continuous job-specific training, backed by annual training analyses will help, as will a mentorship programme in which more experienced maintenance workers mentor and guide newbie technicians. Furthermore, a CMMS can ensure that work systems are themselves better planned in terms of resources and time allocations.
Ageing infrastructure
The challenge: Not every hospital or clinic is brand new or filled with modern equipment. Maintenance managers often need to grapple with old or ageing buildings/infrastructure, machinery, and equipment.
The solution: Forewarned is forearmed, as the saying goes, and so every defect within an ageing facility needs to be assessed and understood. A risk profile for ageing infrastructure and equipment then needs to be compiled based on this assessment. Thereafter, prioritisation must occur in which the most-pressing infrastructure-related issues and defects are addressed in a viable, progressive order.
Security matters
The challenge: Healthcare facilities are always under threat from unlawful entry into the premises. In particular, there is an ever-growing risk of unauthorised people gaining access into sensitive locations within hospitals, such as drug dispensaries and equipment storage areas.
The solution: The maintenance department needs to be an integral facet of the security management system of any healthcare facility. That means that maintenance issues must be taken into every aspect of security management, from risk assessment and risk profiling to implementation and the required corrective actions regarding any, and all, infrastructure, equipment, and machinery related to security.
The work of a maintenance professional may be varied and multi-faceted in any hospital.
And, at all times, maintenance professionals should take pride in the invaluable contribution they make to a hospital’s viability and safety and the public good that it ensures.
