Bertus Janse van Rensburgbertus.jvr@mediclinic.co.za

Equipment Stability and the Effect Thereof on Service Delivery: Case Study - Medi-Clinic

MCC is here

and here

and here

Medi-Clinic Southern Africa Overview• 53 Hospitals in South-Africa and Namibia• Over 7000 Licensed beds• 258 Theatres• Over 600 ICU and High Care beds• Replacement Value of Physical Assets:

R 3.446 Billion• Replacement Value of Buildings:

R 9.305 Billion• Total Staff of 13 300• Projected Revenue of over R 8 Billion

On Key Overview before Project

• Introduced in 1998 at Panorama (version 1.4)• Re-installed three times at Panorama due to

development work• Installed at 28 hospitals with access by regional and

head office• Covers ± 80% of beds in group• On Key Version 3• Individual databases at each site

EAMS Project Overview

• Version upgrade to On Key 4 – Central Database• Assets identification and verification• 3 Teams deployed consisting of 5 members each• Each team is allocated a hospital• Estimated average duration per

hospital of 6 weeks• 26 Hospitals and 5 Office complexes

completed• 59 % of Operational beds installed

Equipment Stability – Categorise Assets

CATEGORY # 1 – LIFE SUPPORT

All equipment where a failure would create a risk to the patients’ life whether directly or indirectly. Maintained

according to the manufacturers instruction by the agent or an authorised representative or a person

appointed by Medi-Clinic

Medi-Clinic PolicyMedi-Clinic Policy

Equipment Stability – Categorise Assets

CATEGORY # 2 – STRATEGIC

All equipment where a failure would cause gross inconvenience to our clients, large negative financial

impact or significant effect on the service we provide. Maintained according to Medi-Clinic policy in-house by

our staff, the agent or a contractor appointed byMedi-Clinic

Medi-Clinic PolicyMedi-Clinic Policy

Equipment Stability – Categorise Assets

CATEGORY # 3 – GENERAL

All equipment not falling in the preceding categories.Failure of this equipment still has an overall effect on

the service we provide and will be maintained according to Medi-Clinic policy in-house by our staff, the agent or a contractor appointed by Medi-Clinic

Medi-Clinic PolicyMedi-Clinic Policy

Equipment Stability – Asset Classification

• Operational requirements• Civil projects – New hospitals or upgrades• ICT Requirements – Bulk purchasing and technology

change• Insurance Claims• Third party equipment:

– Placement / Hired / Loan– Externally Owned

Serviced for a fee– Service Exchanges– Evaluation Equipment

Equipment Stability – Asset Classification cont.

• “Virtual Assets”– Facilities – Detailed Attributes

• Number of Theatres• Square meters of buildings or land• Number of parking bays

– Floor coverings / Wall coverings– Clinical power tools– Instrument sets

• Resource Assets– Electricity– Water– Medical Gas

Equipment Stability – Using an EAMS (On Key)

• Asset Register – Details of the assets you have and where these assets are in order to maintain it– Capture all assets > R1000 (Comprehensive baseline)– Financial details for depreciation and value– Warranty dates for work order control

• Asset Care Plan Developer– Single view of scheduling– Management of risk by using profiles such as:

• Schedules with a blank due date – Per category• Unconfirmed schedules

Need to know what must be replaced and when

Life Cycle Costing Report

Links to Asset Register

Equipment Stability – Using an EAMS (On Key)

• Maintenance Manager– Work history

• Work in progress reports• Closed work analysis

– Productivity• Staff utilisation

– Facility Red Flag – Reported incidents by:• Patient Red• Nursing Green• Management Blue

Technical Service LevelFeedback and Average Age in Days

Select periodSelect number

Run report to identify problem children(Excludes planned maintenance)

Effective Closed Work Analysis

Staff Utilisation & Productivity Measurement

Equipment Stability – Using an EAMS (On Key)

• Maintenance Manager– Condition based monitoring using

the following methods:• Manual – Hardcopy capture• Electronic monitoring of:

– Generators– Uninterruptable power supplies– Air handling units– Total hospital electricity usage

750 kVA 1 MVA500 kVA Essential Load

Standby Generator 1

700 kVA Non Essential Load

Standby Generator 2

Electrical Reticulation

Kitchen Laundry Hot Water Air-con Doctors

ICU Theatre Neonatal

UPS

Cath-lab

!! !

OpenOpen

ClosedClosed ClosedOpenOpenClosed

! Lock-Out !

Do Manual Bus Coupling

Do Load Shedding

! Power Failure

Essential Load Generator Failure

Essential

UPS

Equipment Stability – Using an EAMS (On Key)

• Identification and Assessment– Calculate expected replacement date based on:

• Commissioned date• Expected life per asset type

– Assess assets “due” for replacement– Generate provisional

replacement budget– Confirm assessment– Agree replacement budget

EAMS Data - Asset

• Master Database Management– Single version of the truth– Align other systems– Standard configuration – Asset description– Ward allocation stickers – Recognise your assets

• Define Business Processes and Documents– Review documentation

• Standard reporting – SSRS conversion• Analyse the data – Does it make sense

Use for your 2010 Capital BudgetFollow MediCode TipsHow to create your Capital Budget

Available MediCode Datasets MediCode Dataset Owner

Items - Capital and Direct Purchases including printed stationery

Business Unit

Division

Company

General Ledger

3 Letter Code

Items - Nico Venter

Business Unit - Karen Barkhuizen Neetling

Division - Lourens Botes

Company - Lourens Botes

General Ledger -Marie-Elise Stofberg

3 Letter Code- Eugene Manoek

MediCode News

MediCode is based on a universally accepted coding structure. This is important to enable all the software applications currently in use and any future applications to be able to interface successfully and ensure accuracy of data in the database.

© 2008 Medi-Clinic

MediCode Manual

How to........SearchCopyPasteExportUse Descriptions

MediCode Tips

Ward Allocation Stickers

WISDOM

DATAON KEY ON KEY

INFORMATIONSSRS Reports Analyser ToolProfiles

KNOWLEDGEApply

Blender 2 Yearly ServiceChanged interval to 3 yearly Saving: R135,000 per year

EAMS Future

• Integration with other systems– Central procurement

• SSRS Reporting Development– Availability of information to different

management levels

• Grow data maturity in order to createmore focus on equipment

• Expanding scope of electronic conditioned based monitoring - Energy initiatives

• Installation of On Key 5

Closing Thoughts

• Aspects that would differentiate a company from the norm will be one that will have:– Quality data– Available to the end user– In the correct Format for the end user for Immediate use

• Do you spend 80 % of your time extracting or compiling information and 20 % analysing?

Thank You

Bertus Janse van Rensburgbertus.jvr@mediclinic.co.za