By Jim Burke

For the healthcare industry, deferred maintenance has been both a conscious risk strategy intended to extend an organization’s infrastructure investment and a response forced by dwindling resources.

Either way, there’s a price to be paid. Whether it’s big projects or small repairs delayed, equipment failures can result, creating a ripple effect of damages. A balky boiler goes down, affecting a hospital’s heat and water supplies. Or an air handler in the operating room malfunctions, delaying surgeries. Revenue is lost. Staff is disrupted. Capital budgets are negatively impacted.
When a backlog of maintenance issues is created, it’s a function of resources – a lack of them: Not enough people on the maintenance staff to keep up with the work. Lack of needed parts or equipment, a function of poor inventory management and inventory errors. Insufficient budget allocated to maintenance because other investments are a higher priority.

The negative consequences of deferred maintenance make the case for avoiding the practice, even when resources are limited. The 2022 Hospital Construction Survey found that in the previous three years, 35% of the nation’s hospitals were forced to undertake emergency repairs in the wake of delayed work on equipment. And it cost. Repairs in such circumstances resulted in charges that averaged 18% greater.

Four strategies to manage the issue
Deferred maintenance is a financial metric that reflects limited investment in a facility. Reversing the trend takes a strategy built around the institution’s priorities, first in terms of its needs, but also in terms of asset management. Which projects best reflect the biggest needs and money that will be spent right? Here are four best practices to manage the risk:

1. Prevent problems with predictive maintenance. When a failing anesthesia machine is flagged weeks before a scheduled surgery – not minutes – this makes a big difference in repair costs (and also helps with budgeting).

Predictive technology is invaluable for maintenance of high-risk assets. Investing in software and sensors that monitor equipment performance 24/7 facilitates analytics that signal when maintenance is needed. Vibration and oil analysis and thermal imaging are examples. At the same time, computerized maintenance management software is invaluable for everything from shift schedules to contractor management.

2. Digital solutions cure many inventory/asset management ills. Materials bottlenecks and shortages of crucial spare parts are unacceptable for an institution that is responsible for patients’ health and well-being. Inventory management software offsets materials outages as well as wasteful storage habits. It’s also smart to register and track assets to be better prepared to handle issues like theft and duplicate purchasing.

3. Prioritize patient-critical assets. Wheelchairs, emergency generators, infant incubators and anesthesia machines all are important, but some more than others. Setting up a value hierarchy, combined with OEM recommendations, can guide testing and inspection schedules.

4. Audit and assess maintenance performance. Done regularly, this has a number of benefits. Not only does it reinforce a culture that supports maintenance, but tracking performance measurements is helpful to satisfying external auditors with reliable data.

About the author: Jim Burke is a vice president/sr. risk consultant on Hub International’s Risk Services team. He has over 30 years of experience in professional safety and risk control consulting with direct, practical experience in a broad range of diversified business operations. He specializes in safety management process development, risk minimization and mitigation strategies and development of best practices across the broad range of risk considerations.

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