Improved Patient Care Through Better Maintenance


A 500-bed hospital with a large outpatient volume had recently moved into a new building. With the move, the hospital acquired substantial capital equipment to support the new building systems and address growing patient needs.

Upon moving into the modern facilities, the medical staff and the patients experienced an increase in procedures interrupted or postponed due to malfunctioning equipment. Hospital leadership was unhappy with the opportunity cost of missed revenues, the actual cost of additional time spent by employees, and the unexpected risk.

The maintenance group responded by focusing on fixing broken equipment. However, response times left the staff and patients unhappy.

Some preventive maintenance was done when there were no break/fix demands.


The supervisors had no analytical basis for staffing levels. There was no effective job control system estimating repair time and resources or comparing actual work to expected work.

There was no rational or objective system for prioritizing the hundreds of repair requests received every day. Maintenance people would repair equipment when there were spares available while critical but broken machines waited.

Requests to the maintenance shop were phoned to one clerk dispatcher. It was the clerk who assessed the need and assigned work to the maintenance staff.

Most maintenance workers were generalists who could repair most equipment but lacked high-level expertise to manage the more sophisticated equipment in the new facility.

Some of the staff had training on specific pieces of equipment. The training was poorly documented and not consistently used in work assignments.

Much of the high tech equipment repair was contracted to outside vendors who were expensive and less responsive than needed.


The consultant worked with the organizational leaders to implement a repair requisition process. The user could now specify the urgency of the request, and the maintenance manager could verify or adjust it.

Managers assigned maintenance people based on the estimated staff time for each request. Estimates were based on experience and were improved continually by the growing history in the database.

Preventive maintenance was assigned monthly with managers being allocated the necessary hours to perform the work.

The PM was interspersed with more urgent needs. If maintenance people in one section got behind on their PM due to more urgent requests, staff from other sections were assigned to cross-over and help them get caught up.

The Maintenance Department created a Biomedical Engineering Department whose staff were trained to maintain sophisticated and expensive equipment.


The Maintenance Department was able to schedule staff to meet preventive maintenance needs and to respond in a timely and organized manner. Each mechanic was accountable for daily work performed and evaluated for both quality and productivity. Maintenance standards were implemented to schedule commonly requested equipment maintenance and also to schedule routine building maintenance.

Labor reduction due to reduced downtime in the radiology and cardiology suites alone saved the hospital more than $1 million annually.

Expensive outside maintenance contracts for high technology equipment was reduced while response time improved due to efficient use of in-house trained staff.

Overtime was reduced due to the organized system resulting in a more accountable, productive, and satisfied work staff.