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Study of -Computerized Maintenance Management System (CMMS) in Nanavati Hospital A Report submitted to Prof. J. M. Shah for the partial fulfillment of the requirements for the subject Information Systems for Management under NMIMS University Group 4: Shamsy Goyal 211 Anvesha Poswalia 228 Abhishek Singhal 237 Amar Bhartia 255 ShashanYagnick 259 Anand Madhusudan 260 ? Table of Contents

Nanavati Hospital – The Organization and its business activities4 Medical Equipment Maintenance – One of the hospital’s functions6 Computerized Maintenance Management System (CMMS) – The FIS9 Work order creation and viewing9 Preventive and Breakdown maintenance scheduling9 Asset management9 Inventory Management and Control10 Maintenance of Administrative records10 Report Generation10 CMMS Software Delivery Process11 End-to-End Process Workflow for typical maintenance activities in CMMS13 Other design considerations for CMMS14 Functional Requirements of the CMMS15

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Infrastructural Requirements16 System Network Architecture for Implementation16 Software Requirements17 Single User17 Multi User17 Hardware Requirements17 Single User17 Multi User17 Integration of CMMS with other Information Systems within the hospital18 Input documents used in the CMMS19 Samples of some input documents20 Benefits of CMMS to various parties22 Reports generated by the CMMS23 MIS Reports23 DSS Reports25 ESS Reports27 Input screens and validations29 Validation checks29 Sample Input screen31 Output Screens32 Testing the CMMS34 Training Methodology37 Project Implementation39

Issues and challenges in implementation40 Key Learnings and Points to Remember41 Post Implementation45 Scope for further improvement in CMMS46 ? Nanavati Hospital – The Organization and its business activities The foundation stone at Dr. Balabhai Nanavati Hospital was laid by the Late Prime Minister Mr. Jawaharlal Nehru in November 1950, and the hospital opened its doors to its first patient in May 1951. The hospital has since completed over 59 years of dedicated service, and prides itself on offering world class quality medical care and its infrastructure comprises of •5 Buildings Total number of beds – 400 •44 Multi-specialty, Ultra Modern, State-Of-the-Art Departments Day Care (Chemotherapy): 4 beds •Critical Care – 74 beds •10 Operation Theatres •1200 Full time employees •200 Eminent consultants •100 Skilled, Resident doctors, 406 Trained nurses The well-equipped hospital rooms, state-of-the-art Heart Institute and technologically advanced equipment and systems are all backed by the expertise and reputation of the Hospital’s consultants, resident doctors, nurses and paramedics. Dr.

Balabhai Nanavati Hospital prides itself on its attention to maintaining a high standard of quality and hygiene. Its 44 multi-specialty departments are manned by 170 consultants, residents, junior doctors, nurses and other paramedics that strive round the clock with the sole aim of delivering quality health care and improving the quality of life of each individual they come in contact with other OPD /In-patient. The medical services offered by the hospital include: •Outpatients- the OPD consists of over 27 dedicated departments for the consultation, diagnosis and treatment of all specialities.

In addition, the hospital also offers its OPD patients the facilities of another 20 departments including the new Advanced Centre for radiation Oncology with its high-tech Elektra Precise Digital Linear Accelerator. •Inpatients- A few of the many departments include Cardiology, Cardio Vascular and Thoracic Surgery, Dermatology, Endocrinology, E. N. T, Gastroentrology, Gynaecology, General surgery, Neurology, Oncology, Orthopedics, Osteoporosis, Paediatrics, Radiation Oncology, Rheumatology, Urology. Alternative medicine- Ayurvedic medicine and Homeopathy. •Support- Anaesthesia and Blood Bank. •Diagnostics- It basically has two departments ?Radiology- Digital Imaging( X-Ray), MRI, C. T. Scan, Sonography, Nuclear Medicine, Mammography, Interventional Radiology, Teleradiology ? Pathology- Hematology, Histopathology( Surgical Pathology and Cytology) •Specialized services- Bariatric, Otoneurology, Prenatal and Reproductive Medicine •Class I medical- Nanavati Hospital has been authorized by the Director General of Civil Aviation (DGCA) Govt. f India, as a Class I Medical Examination Centre for Commercial Pilots. Initial medical examination include Consultation and Investigation ? Medical Equipment Maintenance – One of the hospital’s functions Hospital equipment falls into an extremely wide spectrum ranging right from a hi-tech MRI and CT scanner to a simple patient trolley. All these account for a major part of any hospital project cost, which could go up to almost 60 per cent. Keeping this in view it is essential to ensure maximum utilisation of the equipment with minimum downtime.

Papers based systems work but are time consuming. The paperwork burden in hospitals is obvious. Unlike just about every other industry, health care still relies on an old-fashioned paper/fax/phone transaction process. These paper based systems •Make it difficult to organize information efficiently. •Have non-standardized nomenclature. •Create the possibility of documents being easily lost or damaged. •Make the search for the right documents a timely process. •Also make it very difficult to use data for subsequent analysis and HA compliance purposes.

In a hospital services are provided by various vendors and office staff. They include: •Third party maintenance companies •Equipment manufacturers, •Clinicians, •In- house engineers and •Equipment suppliers. Information and data is scattered across different departments like: •PURCHASING ?Vendor name ?Service contract •CLINICAL DEPARMENTS ?Equipment ?Manuals ?PM procedures ?Service contract ?Repair records •STOCK ROOM ?Consumables ? Equipment •MAINTENANCE ?In-house repair history ? Spare parts •ACCOUNTING ?Purchase date ? Vendor name Price •ADMINISTRATION ?Hospital asset number ? Warranty information Therefore, a system is required that basically helps to track and monitor asset maintenance in a hospital, to improve quality, reduce defects, optimise production and avoid costly downtime. For that, we have chosen a Computerized Maintenance Management System as the appropriate Functional Information System. The concept of maintenance, as practiced in several advanced environments covers preventive maintenance, breakdown maintenance and monitoring of system efficiency.

In addition, hospital planners have to formulate systems whereby minimum effort would be required in maintenance/ repairs in terms of tools, manpower and time. Amongst other things, this requires standardisation, safety, location, standby units, etc. Standardisation improves maintainability and reliability of the equipment besides reducing cost of spares inventory. The expertise required from both in-house and vendor engineers is more focused and levels of interaction is reduced to limited persons. Safety is another important factor, both for the equipment perators/ technicians and maintenance personnel. This would mean providing exact power supplies, perfect grounding/ earthing at every electrical point, proper location of equipment, avoiding high voltage/ frequency areas and facilities. Very often hospital planners and project engineers overlook these factors with the result that subsequent modifications and rectification have to be carried out, adding to costs and disturbing other preconceived designs. Hence it is important to involve maintenance personnel in the project right at the planning stage.

Preventive maintenance is a popular concept in maintenance management. It has to be carried out routinely and before the need arises for repairs that would eventually interrupt the system service and could also prove expensive. Most of the time, preventive maintenance can be carried out by the user independent of the engineer. Breakdown maintenance takes place whenever equipment breaks down. Merely setting the equipment right alone is not important, but tracking down the cause of the breakdown is equally important as precautions could be taken to prevent the fault from recurring.

Just as doctors recommend annual health check-ups for individuals past a certain age, equipment too require such check-ups to obviate unexpected failures which could prove detrimental to patient care, the functioning of the concerned department and would be expensive. Such predictive maintenance detects trouble indicators in equipment, revealing any unexpected deterioration taking place. Following this procedure would definitely reduce the probability of breakdowns and extend the life of the equipment. All equipment requires that a record be maintained from the time it comes to the hospital.

First of all these records would cover the details of the manufacturer/ agent, configuration of the system, itemised list of accessories and spares supplied with the equipment, shelf life and record time and quantity of the same. Thereafter a detailed log of preventive and breakdown maintenance needs to be kept. These records are of great use when taking replacement decisions. They are also useful for improving system performance. ? Computerized Maintenance Management System (CMMS) – The FIS A CMMS is the core of medical technology management. It is required to manage nd control equipment maintenance in today’s hospitals. A CMMS is much more than just a way to schedule preventive maintenance (PM). By using a CMMS, one can create equipment logs to record events associated with a piece of equipment, record authorized uses of equipment, track scheduled services or PMs, training, maintenance history, employee time, downtime of a device, parts inventory, purchase orders, and much more. The set of functionalities provided by the CMMS are given below: Work order creation and viewing This deals with the ability to create, view and manage all maintenance activities.

Some of these activities are: Scheduling jobs, assigning personnel, reserving materials, recording costs, and tracking relevant information such as the cause of the problem (if any), downtime involved (if any). Work orders are created manually from service requests. Preventive and Breakdown maintenance scheduling Preventive maintenance deals with generating and scheduling jobs to service machines at regular intervals so that any breakdown is avoided. It involves keeping track of preventive maintenance jobs, including step-by-step instructions or check-lists, lists of materials required, and other pertinent details.

It helps protect the equipment investment and avoids untimely breakdowns that disrupt the smooth functioning of the machine. Breakdown maintenance involves the set of activities that are done to bring back the machine in working order. The set of activities could range from repairing the machine to replacing it if necessary. The details captured in the system include incidence of machine breakdown, details of repairs completed and repairs “to do” and so on. Asset management Asset management refers to the provision for recording and maintaining information about the hospital’s assets or medical equipment.

It involves recording data about equipment including maintenance activities, specifications, purchase date, expected lifetime, warranty information, service contracts, service history and anything else that might be of help to management or maintenance workers. Inventory Management and Control Inventory Management and control refers to the maintenance of data about spare parts, tools, and other materials including the reservation of materials for particular jobs, recording where materials are stored, determining when more materials should be purchased, tracking shipment receipts, etc. Maintenance of Administrative records

This helps to store the records related to external service suppliers/agents, manufacturers, their phones and e-mail addresses, as well as the names of hospital staff and the pieces of equipment under their care, with the corresponding inventory numbers. Report Generation Reports can be generated for operational activities and for decision making by the middle and higher management. Some of the reports include – showing the current operational status of all of the equipment, infrastructure and premises, i. e. , a breakdown of those items that are in service and those that are undergoing repair work.

Yet other reports provide information on repair and maintenance timeframes and costs, including accumulated costs, contributing to decision making in the implementation of policies of facility renovation and equipment modernizing. ? CMMS Software Delivery Process For creation of such a CMMS, one can either identify a software vendor for developing a customized application or go for a CMMS software product and customize it. In the case of Nanavati Hospital, it was decided to go for a customized application from a software vendor. The diagram below captures the process of developing the CMMS for the hospital.

During the project planning and initiation state, the equipment maintenance process was studied from start to finish with the help of consultants. A set of consultants engaged in detailed discussions with different teams of personnel (at the hospital) to get key feedback regarding the current process. They visited the entire hospital to look at the facility to help uncover areas that are unproductive, where delays are wasting time, and recommend improvements. The existing preventive maintenance and breakdown maintenance programs were reviewed keeping critical assets in mind.

The maintenance work process flow review went hand-in-hand with the review of planning and scheduling processes. The above activity yielded information about the current end-to-end process workflow that is currently in place for typical equipment maintenance activities. This formed the basis of the expected workflow of the CMMS and the rules to be incorporated therein. ? End-to-End Process Workflow for typical maintenance activities in CMMS As seen in the above process flowchart, 1. If a breakdown occurs, then the maintenance department examines it. If the machine is running, then the department tries to repair it.

Then if the repair is completed, the incident is recorded in the history of breakdowns. If the repair is incomplete, then further corrective action such as replacement, servicing, invocation of warranty, etc. is performed. Once satisfied with this process and if the machine is up and running, then this incident is recorded in the history of corrective actions. 2. If preventive maintenance is to be carried out, then corrective action is taken by the maintenance department until the machine is repaired or fixed to prevent future breakdown. This activity is then logged in the history of corrective actions.

A new test record / maintenance form would be created for each maintenance process, which would contain some information space to be filled by the technician, like the nature of the problem, the work carried out, the measurement values, the results of the work done, etc. These maintenance records will be associated with the device being processed, and will totally constitute the repair and maintenance history of the device. Other design considerations for CMMS •While planning maintenance scheduling, the number and the availability status of maintenance equipment were taken into consideration. Similarly, the number, status, and expertise of technicians, availability of medical device to be maintained and its maintenance history were also required. •Keeping information of and evaluating the technical staff was especially important as a significantly large proportion of total human errors occur during the maintenance phase. Thus, based on the study of the work-flow and design considerations, the functional requirements of the system were finalized. ? Functional Requirements of the CMMS 1. Addition of : a. New Asset – technical ,commercial and insurance information b. Hospital Department . System User d. Asset Manufacturer e. Agent 2. Demand / Preventive Maintenance Form Generator a. Create job /log for asset maintenance- includes job type and equipment status i. Add spares used during job execution ii. View/Update Spares used during job execution b. View/Update the job log information 3. Alerts for : a. Assets whose AMC expires this month b. Preventive Maintenance scheduled for the month c. Pending maintenance jobs to be completed 4. Reports a. Department-wise asset list b. Detailed asset information c. Consolidated report of all assets under the maintenance dept. long with their status d. Regular maintenance Job – Log Report -Instrument wise -Engineer wise – Floor wise / Section wise -Weekly / Monthly / Yearly Reports. e. Equipment-wise Total running time / down time. (Monthly/Yearly ) f. Equipment-History report (Maintenance Cost History) ? Infrastructural Requirements System Network Architecture for Implementation The Server is accessed by hospital personnel and directives can be issued for data entry, management and reporting facilities. This is done by computers through internet or intranet. ? Software Requirements

The software requirements for implementing CMMS were as follows: Single User 1. Operating System: Win-98 upwards O. S. 2. Server : JavaWebServer 2. 0 Compatible web server 3. Database : Ms-Access 2000 Upward database or any RDBMS Multi User 1. Operating System: Win-NT 4. 0 / Linux6. 0 / Unix (IBM) or any N/W Operating System as software is platform independent. 2. Server : JavaWebServer 2. 0 Compatible web server 3. Database: Any RDBMS like Oracle/Sybase Hardware Requirements The hardware requirements for implementing CMMS were as follows: Single User 1. Pentium II or above Intel C. P. U. / A. M. D.

C. P. U. 2. 64 Mb RAM, 50 Mb Hard Disk Space 3. CD ROM for Installation Multi User 1. P II or above C. P. U. 2. 256 Mb RAM, 50 Mb Hard Disk Space 3. CD ROM for Installation 4. N/W Card (Ethernet Card) ? Integration of CMMS with other Information Systems within the hospital Since equipment maintenance is an integral part of hospital management, it is imperative that the CMMS is linked with other systems in the hospital. Prominent among them are: 1. Basic Human Resource Information: This contains basic maintenance and production personnel records. It also contains employee leave, vacation details, etc. hich help in assignment of a technician to a maintenance job. 2. Time collection system: This system enables clock records per employee per shift. It also enables assigning these individual records to different data objects for job cost tracking, etc. 3. Equipment Safety Data Sheets: These are basically online repositories of detailed data sheets of medical equipment containing information about the internal working of the equipment. This information proves useful in machine repair or preventive maintenance. 4. Major Maintenance and Capital Planning: This system is used for budgeting.

The information about maintenance cost incurred is fed into this system which proves useful for capital planning and budgeting. It also helps the upper management allocate resources among various departments. ? Input documents used in the CMMS Input to the CMMS system can be categorised into 2 types: 1. Data that is pre-loaded into the system database at the time of installation : This includes data about a. Existing departments in the hospital b. Users authorized to use the system c. Technician names d. Existing Asset information e. Inventory information

This involves forming databases of all devices, maintenance protocols, technicians, trainings, maintenance equipment, maintenance calendar, etc. Recording, update and deletion are main processes in terms of data management. 2. Data that is fed into the system during its normal course of usage: a. Asset/Equipment information – commercial, technical, insurance, warranty information,etc. – Sources: i. Purchase order, ii. Insurance document, iii. Warranty and terms of sale document, iv. Service agreement, v. Operating manuals b. New Hospital Department information – Source: i. Hospital administration records c.

New Equipment Manufacturer information-Source: i. Internet, ii. Visiting cards, etc. d. Maintenance Job Details – Source: i. Ad-hoc , based on the maintenance required e. Details of used spares – Source: i. Purchase order for spares ? Samples of some input documents 1. Purchase order: 2. Insurance and Warranty Information: Installation Date Equipment NameCost(Rs. )Warranty DateInsured DateInsured Sum 15-08-1998TRANSRECEIVER RT 41 400015-08-200115-08-19984000 15-08-1998BEDSIDE MONITOR L MINIMON 200015-08-200315-08-19982000 15-08-1998VENTILATOR AMBULANCE 300015-08-200215-08-19983000 15-08-1998ECG SIMULATOR 450015-08-200115-08-19984500 5-08-1998PHOTOTHERAPY RADIOMETER 1000015-08-200315-08-199810000 15-09-1998OSCILLOSCOPE 100MHZ TEKTRONIX 500015-08-200015-08-19985000 3. Medical Equipment Information: ? Benefits of CMMS to various parties A computerized maintenance management system (CMMS) can help add efficiency to an organization’s operations. Study after study has shown both short term and long term improvements in over all organizational costs by using a computerized maintenance management system. To Employees- •Organize the maintenance personnel database including shift work schedules. Strong reporting and Integrated Process flow. •Strong Interface design To the Organization- •Most CMMS programs track assets related maintenance costs and help organize maintenance operations. A good CMMS program is able to track several types of assets such as facilities, rooms, machines, vehicles, and grounds. •The true value of a CMMS program is in the information it collects. As long as the program is used and information is collected, managers can make good decisions and good decisions lead to efficient organizations. Management of a hospital involves interaction among its staff and professionals of other disciplines in dealing with equipment, infrastructure, etc, to fulfil the objective that has been set; that of maintaining the overall hospital system at an acceptable operational level. All these repair activities must be coordinated by a centralized management, and one of the key tools for this task is a computer system offering specific features for this type of management. •Efficient storage of large amount of historical maintenance & repair information. •Data can be analyzed effectively and reports can be generated automatically. Scheduling of planned preventive maintenance routines and documentation of planned and unplanned maintenance work. •Increased Equipment Uptime •Reduction in store inventory •Reduction in emergency and critical maintenance To Customers- •By tracking what types of work orders the hospital was receiving, the hospital was able to discover that room temperatures were the main source of complaints. Shortly after that discovery, the hospital was able to come up with a solution that fixed the problem. In return, the patients were happy and the hospital cut its work orders in half. Reports generated by the CMMS

The CMMS generates 3 kinds of reports, each catering to a different set of recipients – 1. MIS – For transactional activities 2. DSS – For middle management decision making 3. EIS – For upper management strategic decision making Some report samples and their intended usages are given as follows: MIS Reports MIS 1 This report gives the equipment status department wise. This would help the low-level management people to keep track of all the equipments in each department and would ensure smooth running of the organisation. MIS 2 This report shows the maintenance jobs that are pending.

This report assists the low level managers in supervising the regular maintenance operations. MIS 3 This report gives the Department wise, equipment wise engineers responsible for the operations. It assists the low level managers in tracking the personnel as well as in planning the job roster. Department Asset No. Equipment NameEngineer I ResponsibleEngineer II Responsible Ambulatory Care 130TRANSRECEIVER RT 41 Rohan SPravin A Ambulatory Care 191BEDSIDE MONITOR L&T MINIMON Vinay PNishant S Ambulatory Care 142VENTILATOR AMBULANCE Amar BMadhu K Biomedical Eng. 223ECG SIMULATOR Sourav GAnanya B

Biomedical Eng. 312PHOTOTHERAPY RADIOMETER Ashish RPrasenjit R Oncology 311INFUSION PUMP TERUFUSION Judhajeet CAmitava B Oncology 322LINEAR ACCELERATOR Sheela KPiyush M DSS Reports DSS 1 This information would enable the management to decide whether it should re-negotiate the contract with the existing maintenance service provider or it should look for other service providers. DSS 2 This report helps to track the schedule for the preventive maintenance of the equipments. It thus helps the management to plan effectively to ensure that the operational activities are unaffected during maintenance of equipments.

DSS 3 The report shows the machine breakdown cost and the preventive maintenance cost for each machine in the respective department. This gives an insight to the middle level managers to take an informed decision whether to go for the preventive maintenance for the equipment or not. Department Asset NoEquipment NameCost of Machine Breakdown Repair ( based on average historical costs) in Rs. Preventive Maintenance Cost in Rs. Ambulatory Care 130TRANSRECEIVER RT 4120001000 Ambulatory Care 191BEDSIDE MONITOR L&T MINIMON800600 Ambulatory Care 142VENTILATOR AMBULANCE40004000 Biomedical Eng. 23ECG SIMULATOR400200 Biomedical Eng. 312PHOTOTHERAPY RADIOMETER50003000 Biomedical Eng. 156OSCILLOSCOPE 100MHZ TEKTRONIX500200 Oncology 311INFUSION PUMP TERUFUSION30001000 Oncology 322LINEAR ACCELERATOR70002000 ? ESS Reports ESS 1 This report gives the information about the average breakdown hours per equipment and thus it reflects on the quality of equipments supplied by the supplier. This report could be used to compare the performance of the Suppliers with respect to standards and thus take decisions whether to continue with the existing supplier or switch to a new one.

Department Equipment NameSupplierTotal Number Of BreakdownsAverage Breakdown hours per day Ambulatory Care TRANSRECEIVER RT 41 R&S Equipments271. 5 Ambulatory Care BEDSIDE MONITOR L&T MINIMON Shriram Electronics Ltd. 331 Ambulatory Care VENTILATOR AMBULANCE HealthPlus Ltd. 252. 35 Biomedical Eng. ECG SIMULATOR ABC Equipments180. 62 Biomedical Eng. PHOTOTHERAPY RADIOMETER R&S Equipments320. 3 Biomedical Eng. OSCILLOSCOPE 100MHZ TEKTRONIX Shriram Elctronics Ltd. 122. 4 Oncology INFUSION PUMP TERUFUSION Singhal Enterprise. 201. 65 Oncology LINEAR ACCELERATOR HealthPlus Ltd. 353. 5

ESS 2 This report gives the total breakdown cost and the total preventive cost incurred each year. This gives an indication for the future costs and thus helps in budgeting purposes. YearTotal Number Of EquipmentsTotal Breakdown CostTotal Preventive maintenance CostTotal Cost 20052958,57,8773,27,65011,85,527 200633512,35,6875,23,46717,59,154 200746714,34,5546,54,78020,89,334 200851715,00,3517,42,15022,42,501 200954317,89,9648,62,15026,52,114 ESS 3 This report gives the department wise cost and the number of new equipments required. This helps in cost allocation and planning purposes.

DepartmentNumber Of EquipmentsNumber Of New Equipment RequiredTotal Breakdown CostTotal Preventive Maintenance CostTotal Cost Of Department Ambulatory Care 6591,57,84565,3262,23,171 Biomedical Eng. 43151,98,63542,5622,41,197 Oncology 57142,10,12575,1522,85,277 ENT3281,25,14253,5641,78,706 Intensive Care7552,65,87442,1353,08,009 ? Input screens and validations The input screens available are as follows: •Asset – To add new equipment, this option is required when the hospital purchases new equipment (latest technology). •Department – This option is used when the hospital comes up with a new department.

E. g. a Cancer special ward. •User – This option enables to enter/ create a new user. Through this option one can give access to new users. •Manufacture – The hospital purchases equipment from a new manufacturer. All required information about the manufacturer would be stored through this option. •Add Agent – This option is used to enter details of agent through whom the equipments were purchased. Agents are required when equipments are faulty or repairs are to be carried out or new equipment needs to be purchased. Validation checks The basic validation checks to be performed would be Data type checks- Checks the data type of the input and give an error message if the input data does not match with the chosen data type, E. g. In an input box accepting numeric data, if the letter ‘O’ was typed instead of the number zero, an error message would appear. •Presence check: Checks that important data are actually present and have not been missed out. E. g. rupee value cannot be blank. The equipment value should be provided. •Range check: Checks that the data lie within a specified range of values. E. g. – the month of an installation date should lie between 1 and 12. Control totals: This is a total done on one or more numeric fields which appears in every record. E. g. add the total payment for the entire purchase (including taxes, shipment). •Cross-system: Consistency Checks: Compares data in different systems to ensure it is consistent. E. g. The Purchase order number is mandatory information. The purchase order number should match with the entry made by the purchase department. •Logic check: Checks that an input does not yield a logical error. E. g. an input value should not be 0 when there will be a number that divides it somewhere in a program. The currency value cannot be zero. Uniqueness check: Checks that each value is unique. E. g. Purchase order cannot be same for two different types of assets. ? Sample Input screen This input screen enables the management to maintain effective control of machinery. The form requires complete information about the machine to be entered. The information required is Basic (Serial No, Cost etc), Commercial (Insurance value) and Technical information (Equipment status). Output Screens Annual Maintenance Contract This output screen helps the management to take a complete stock of maintenance contracts expiring within a particular time frame.

This would enable the management to effectively negotiate new maintenance contracts, plan expenditures or decide on purchasing a new machinery/equipment. Pending Maintenance Jobs This output would enable the management to take prompt action on the pending maintenance jobs. Since each and every instrument is critical in a hospital, a break down due to failure in maintenance could result in a casualty or delay in treatment. The management can contact the maintenance service provider initiating prompt action. ? Testing the CMMS Software Testing is the process of executing a program or system with the intent of finding errors.

Or, it involves any activity aimed at evaluating an attribute or capability of a program or system and determining that it meets its required results. Software is not unlike other physical processes where inputs are received and outputs are produced. Where software differs is in the manner in which it fails. Most physical systems fail in a fixed (and reasonably small) set of ways. By contrast, software can fail in many bizarre ways. Detecting all of the different failure modes for software is generally infeasible. Most of the defects in software are design errors, not manufacturing defects.

Discovering the design defects in software is equally difficult, for the same reason of complexity. Because software and any digital systems are not continuous, testing boundary values are not sufficient to guarantee correctness. All the possible values need to be tested and verified, but complete testing is infeasible. A further complication has to do with the dynamic nature of programs. If a failure occurs during preliminary testing and the code is changed, the software may now work for a test case that it didn’t work for previously. But its behaviour on pre-error test cases that it passed before can no longer be guaranteed.

To account for this possibility, testing should be restarted. The expense of doing this is often prohibitive. Functionality (exterior quality)Engineering (interior quality)Adaptability (future quality) CorrectnessEfficiencyFlexibility ReliabilityTestabilityReusability UsabilityDocumentationMaintainability IntegrityStructure Typical Software Quality Factors Good testing provides measures for all relevant factors. The importance of any particular factor varies from application to application. Any system where human lives are at stake must place extreme emphasis on reliability and integrity.

Classified by purpose, testing for CMMS was carried out at 4 levels: Correctness testing Correctness is the minimum requirement of software, the essential purpose of testing. Therefore, either a white-box point of view or black-box point of view can be taken in testing software. The unit-testing of the CMMS application was carried out to ensure that basic functionalities are performing their intended operation correctly. Further, integration testing was carried out to ensure that the various functionalities worked in tandem as one integrated application. Performance testing

Not all software systems have specifications on performance explicitly. But every system will have implicit performance requirements. The software should not take infinite time or infinite resource to execute. “Performance bugs” sometimes are used to refer to those design problems in software that cause the system performance to degrade. Typical resources that need to be considered include network bandwidth requirements, CPU cycles, disk space, disk access operations, and memory usage . The goal of performance testing can be performance bottleneck identification, performance comparison and evaluation, etc.

The typical method of doing performance testing is using a benchmark — a program, workload or trace designed to be representative of the typical system usage. For CMMS, performance testing was carried out under conditions of multiple users logging in simultaneously to test the load-bearing capacity of the system. Also, the response time of the various screens were tested to ensure that there were no undue delays in screen refreshing and that the screens exhibited a fast response time. Reliability testing Software reliability refers to the probability of failure-free operation of a system.

It is related to many aspects of software, including the testing process. Directly estimating software reliability by quantifying its related factors can be difficult. The network, hardware and software infrastructure was thoroughly tested to ensure that the downtime due to infrastructural issues is minimal and that the CMMS application can function smoothly. Security testing Software quality, reliability and security are tightly coupled. Flaws in software can be exploited by intruders to open security holes. With the development of the Internet, software security problems are becoming even more severe.

The purpose of security testing of these systems include identifying and removing software flaws that may potentially lead to security violations, and validating the effectiveness of security measures. Simulated security attacks can be performed to find vulnerabilities. Under simulated conditions, security testing was carried out and it was ensured that third-party users are not able to access the CMMS. Access was allowed only to authorized users. ? Training Methodology Having the right computerized maintenance management system (CMMS) is far from the last step in the implementation process.

End-user training also is essential for the application’s ultimate success. For that reason, maintenance and engineering managers must consider their department’s training needs, as well as training options, well before the decision is made to upgrade an existing system. 1. Setting a Budget Even though most organizations plan for some type of end-user training at the time they specify a CMMS, many managers underestimate the need for training. While most CMMS software can be relatively easy to use, it is imperative that managers and employees fully understand how to use the system so it meets their organization’s specific needs.

In some cases, an organization’s top executives might question the value of CMMS training after comparing its cost with that of less-expensive computer training initiatives the organization has undertaken. As a result, managers often need to justify CMMS training costs by showing its return on investment. 2. Selecting a Site ON SITE : Organizations implementing a new CMMS most often arrange for training at their facilities On-site training also is often the most productive method of training because the trainer can talk to a larger group of people during the training sessions.

Being at the customers’ site also gives the vendor a chance to provide more focused training based on specific needs, resulting in more benefits for the end user and the organization. OFF SITE: Many vendors also offer training at their facilities. Because training at the vendor’s location often is more general than on-site training, such training might be more appropriate for a system’s existing CMMS users looking for a refresher course than for users of a new system. E- Training: Web-based sessions have become an increasingly popular training format among CMMS users.

Usually, the people interested in Web-based options are looking for training on specific CMMS features and functions. 3. Setting Realistic Goals Managers also need to give careful thought to the amount of time to allocate for training. While doing an initial training on an application as complex as a CMMS and trying to cover every feature and function, it does take at least a week to go through it as people won’t be able to remember everything that the course covered.

Rather than give end users a crash course in every function in the application, managers might want to specify that the initial training cover only the basic areas front-line technicians will need to know, such as writing corrective maintenance work orders. Let them use those features for a while and get comfortable with them and then maybe schedule follow-up training three to six months after that to show them some features that are more complicated.

The benefit of this approach is that end users will tend to use these key features more effectively when training is broken down into separate sessions than when they take a single crash course, he says. 4. Showing the Benefits To help the system’s new users understand the decision to implement new software, CMMS training should emphasize the benefits the new software offers to the organization, the department and the front-line technicians who will use it most often.

CMMS training should not only include how to use the software and how to push the buttons and it should include a review of how the maintenance technicians do their job now and how they can use CMMS to improve on those results. By focusing on how the system will help making technicians’ jobs easier and benefit the organization, managers can create a more positive attitude about the new system and help employees better understand the decision to upgrade the CMMS. This strategy can be particularly helpful when employees have questioned the need for a new system. 5. Measuring Effectiveness

Once a training session is complete, managers should get immediate feedback on its effectiveness by talking with the trainer. By identifying a problem quickly and learning how to use the system correctly, organizations can eliminate wasted time re-entering data. The true indication that training was successful is in improvements made in the performance of building systems. Improvements in efficiencies don’t just come from buying the CMMS software. It is on comparing the downtime on the building systems before and after training and measure how much productivity has increased. ? Project Implementation

While the manufacturer helped a lot with the database and the server issues, the transition took more time and resources than anticipated. About two months were spent in compiling a list of medical devices and categorizing them. In part because of this up-front work, the implementation phase itself was very efficient. Wizards and other automated entries made the implementation fast and easy, and the software was up and running in no time. Two half-day sessions were spent in training the technicians on the system, and another four half-day sessions training the managers and administrators.

This training was done in the course of two weeks and was very demanding in terms of time, attention, and effort. Once the training was complete, the technicians felt somewhat confident using the system; however, it was soon realized there was need for another training session. This was provided about three weeks after the original training. After the last training the technicians were much more at ease with the system and could understand most of the features it offered. One lesson learned is that extensive and targeted training is key to a smooth transition and is well worth the expense.

Also, the spacing between training sessions is very important. We need to give ourselves some time to absorb the information and use the features we learned in one training session before jumping into the next. Another lesson is to ensure that the price of extensive training is included in the software package. Most manufacturers will have something included, but it will likely not be enough. Make sure additional training is included in the package, as training can get very expensive. ? Issues and challenges in implementation The search is over.

The decision has been made, and the check has been signed. Now, the only step left before reaping the benefits of the new computerized maintenance management system (CMMS) is installing it. But, the challenges at that point are far from over. The roadblocks managers and their departments encounter in implementing a CMMS can be numerous, and while they might be able to foresee some problems early on, avoiding them is another matter. Some problems that could typically be encountered are: 1. Managers can become overwhelmed by the amount of work involved in implementing a CMMS. 2.

Adapting the CMMS to department operations, entering or transferring data, and getting system administrators and users up to speed. 3. Some managers also come to the process with unrealistic expectations about how quickly implementation can occur. 4. A lack of support within the organization also can quickly undermine specification and implementation. That support starts with facility executives, but it also must include front-line technicians who will use the system most frequently. In too many cases, managers leave workers to form their own opinions on the goals of the upgrade by failing to involve them in the process. . Technicians tend to be nervous (about software), especially if they haven’t had a system before. 6. In some cases, technicians might believe the CMMS is little more than a tool to monitor their performance. 7. There will be issues where individuals do not wish to change from the old system or in many cases change from the spreadsheets they have developed. The new system will not work in the same way and will not be as intuitive as their spreadsheet solution. 8. Bad data can affect the integrity of the new CMMS system.

If the technical information about a spare part is wrong, then the users will assume that probably the stock balance information is also wrong and faith in the new system can be totally undermined. Key Learnings and Points to Remember Whatever the client’s situation, developers often step into the middle of a host of challenges including customers who expect software to solve the problems. While that might happen, developers say customers can prevent, or at least minimize, the problems well before implementation begins, by keeping the following points in mind: 1. Consider the importance of setting goals.

Before requests for information or proposals go out, discussions within an organization can help developers more fully understand customer needs and goals. 2. Taking a bigger-picture, longer-term view of the situation also can help all parties involved in the preparation for the task ahead. 3. When it comes time to talk with CMMS developers, managers also should be ready to ask tough questions. E. g. Managers also should ask questions about the developer’s implementation team — who they are, their experience. Doing so can help managers feel more comfortable with the developer’s team. 4.

Customers also benefit from talking with a developer’s sales people at length about the organizations’ needs and goals. In some cases, developers have been known to turn away potential clients because the company’s software doesn’t match the customer’s needs. 5. Among the most important strategies developers stressed in minimizing the problems that commonly occur during implementation is breaking down the process into manageable pieces. 6. CMMS developers warn managers to think twice before they pursue CMMS customization. The system opens up a host of potential pitfalls for both developers and maintenance departments.

Not the least of the difficulties created by customization is cost. If you customize it too much, it can be difficult to upgrade later. There should be focus on the following areas: 1. Defining Corporate directions and rules 2. Highlighting areas of mass data requirements 3. Defining training required 4. Implementation and embedding processes There are several pre-requisites for success: 1. Senior Management Commitment During the implementation engineers or middle managers will inevitably reach a hurdle that can only be cleared with the support of a senior manager.

Someone also has to make decisions on the release of resources to work on the project. So ensure that you have the required project team available and the senior manager’s blessing before the project begins. At the other end of the spectrum some work may be required beforehand to convince trades people, particularly in a unionised plant, of the advantages of CMMS. 2. Project must be led by Engineers CMMS implementation cannot be left solely to IT people. This is not meant as a criticism of them but they are not well placed to understand engineering issues or the detailed requirements of a maintenance department.

Being skilled in their own discipline, they will often assume a level of expertise in your maintenance and production personnel that is just not available. There should also be a project champion, whose task it will be to champion the cause of CMMS and to ensure that everyone is pulling in the same direction. The project manager may double in this role. 3. Manual Maintenance System Some kind of manual maintenance system should be in place (or at least defined) before the project starts and an asset register or equipment list must be available.

It is difficult to implement a CMMS where there is no existing structure to the manual system. This does not exclude small companies with no manual system from using CMMS. It does mean that some kind of manual system should be defined as a first step in the move to a computerised system. Many small companies purchase a CMMS and try to implement with this with no initial or base data. At the very best systems installed in these circumstances can have only very limited success. 4. Definition of Requirements Before you begin you must prepare a detailed definition of requirements.

Allow plenty of time for this and involve all parties including crafts, production, purchasing, finance and anyone else who will have any involvement in the new system. Take advice on this and try to enlist the assistance of people who have been involved in similar projects before. If you don’t have the knowledge on site, consider the use of a qualified and experienced CMMS consultant at this stage. The cost of a couple of day’s consultancy is a lot less than that of a failed system. •Know the reasons why you want to computerise your maintenance. Within your organisation consult other prospective users for their opinions. •Be completely clear on what you are trying to achieve. •Do not lose sight of this. •Make “goals” an agenda item and revisit this regularly at your project meetings. 5. Planning appropriately Planning is one of the keys to a successful implementation; step by step and department by department. Generally the failure is not due to the software, it is due to planning and project control, or to be more accurate the lack of planning and lack of project control. 6.

There is no “I” in Team One of the biggest challenges facing any CMMS implementation is people problems. The success of the project is tightly bound together with the support and commitment of the people who will use the system. These people will also be expected to keep doing the ‘day job’ while the new system is being implemented. From the very start of the project there needs to be open and continuous communication between all of the different people involved: senior management, maintenance, production, finance and finally the IT department.

An experienced project manager or implementation consultant can help mediate, explain and show the advantages that the system will bring for the company as a whole, even if there needs to be sacrifices made by some individuals. Everyone needs to understand that implementation of a new system means extra work, over and above the normal every day work. And the only way the project will be successful is if all of the employees pull together as a team. 7. Garbage in – Garbage out For the first few weeks the most hated thing about the new software will be the new user interface, which is never as friendly as the old system.

But when everyone gets used to it, the new interface will be seen as being far better than the old system. Probably the second thing people hate most about any new system is when the information or data is wrong. Inaccurate data in the old system would have been acceptable, after all it was the old system, but in the new system it is totally unacceptable. This thought may not be logical but it is a reality. So as part of the implementation the data from the old system needs to be extracted, checked and cleansed before it is transferred to the new database.

The project is complete, all of the activities have been signed off; even the customised user manuals have been praised by the users. However the project is not complete and will not be really complete for the next few months i. e. until the metrics and measures defined at the start of the project are checked and the ROI calculated. It could be argued that at the end of the project the ROI is largely irrelevant as the money has been spent and the new system is in place and will not be thrown out, especially as the users seem to be happy and seem to be working more efficiently.

But it is important for the people who worked on the project to know what their efforts have achieved; the company shareholders and executive management will also have an interest in the ROI. Open and continuous communication should not end when the CMMS project ends; not if you want the employees to commit to the next project which could be; TPM, six sigma, Reliability Centred Maintenance, Condition Based Maintenance, Mobile Technologies etc. in the future there may also be CMMS Phases 2 and 3 to consider. 8. System Configuration

The bulk of the work that goes into a CMMS implementation is the collection of data, data migration, system configuration and testing. It is essential that the data entered in the system follows consistent naming standards. The identification numbers should be recognizable. If you’re implementing a new naming convention, label assets in the field and provide hierarchy or plot plan diagrams next to maintenance workstations. The data should be as complete and accurate as possible. Incorrect or inconsistent data is the quickest road to frustration for your maintenance users.

The system should be configured to provide the most intuitive user interface available 9. Training Training is where the rubber meets the road. Your end users are getting their first hands on experience with the system and are developing first impressions. Don’t use “canned” data for training. The training environment should mirror the production database. The format of training should be role and process based. Make sure that one or two implementation team members are available to help users that fall behind during training.

Follow-up with those users during “go-live” and provide auxiliary training. Provide a “play” environment where users can exercise and reinforce what they learned in training without corrupting production data. 10. “Go Live” Schedule “go live” when you will have plenty of support for the users and lower than average work order volume. Have a back-up plan for managing the flow of information in case the system goes down unexpectedly. If users have to fall back to the paper system for a few hours, have them create work orders in the CMMS at the end of their shift.

Have quick reference or “how to” sheets available as well as diagrams that will help them enter the proper values into the system. At the end of every day review what went right and where changes are required. Update and re-post the work processes the following day. Track and prioritize configuration issues and system “bugs”. Provide a daily update to your vendor or consultant. Reviewing the work orders daily is an excellent way of seeing how successfully each maintenance user is interacting with the system, or who needs extra help. Post Implementation

Following “go live” and prior to the transition from the project team to normal operation, review all the defined requirements and whether they have been fulfilled. Ensure that the mechanisms to facilitate and measure business processes are in place. If a vendor or consultant was utilized make sure all their deliverables have been completed. Develop a support and issues escalation path. Have users go to their supervisor or resident “power user” with issues. If the issue can’t be resolved, escalate it to a site or company administrator.

The company administrator should be the sole point of contact between your organization and the vendor. The administrator should be responsible for logging and tracking all open issues and enhancement request. ? Scope for further improvement in CMMS The growth of the CMMS will never stop. It will always evolve as your use and understanding grows. Inventory is at times the largest challenge in CMMS, but it is one of the most important aspects of a CMMS system. For the CMMS system to function correctly it must be continuously updated. The system is only as good as the data that you put in it.

You have heard of the term “garbage in garbage out. ” It is true with CMMS also. You must keep up with any changes made in your plant and with any new information that you have about your equipment. Your CMMS work order flow then becomes a continuous cycle of improving the CMMS database. Breakdown analysis and PM modifications are essential to a good operating system. The failure report is one very important tool to constantly update the CMMS. A Handheld or PDA Besides affordability, other advances associated with CMMS that are being implemented in today’s hospitals include the use of personal digital assistants (PDAs).

These personal computers help facility workers maintain their hospital’s 24/7 schedule. PDAs were originally designed as personal organizers. It is expected in the near future that the use of these devices will increase as they gain acceptance in the marketplace and their cost decreases. Radio Frequency Identification (RFID) tags RFIDs are already in use in many areas such as large shipping crates and security applications but these tags have not yet reached the hospital arena. RFID is a method of identification through the use of radio waves.

Typically, a RFID tag would be attached to a particular asset and would be identified by a unique ID number. As these devices or ‘tags’ “listen for a radio query and respond by transmitting their unique ID code”, very large amounts of information about that asset can be recorded and accessed. Similar to a barcode application where the RFID tag is “read”, the antenna is excited and transmits the unique number associated with that to the reader device. Thus all sorts of information about the asset can be accessed including its repair history and condition reports of that asset.

For instance, due to strict state regulations, hospitals must continuously monitor generators as part of their life/safety aspect of facility management. A RFID tag for a generator could contain the history of that generator so that an inspector equipped with an RFID reader could instantly access that information to evaluate the asset’s functionality and its repair history since the last inspection last inspection. This information could then be updated to ensure it is current. Predictive Maintenance

Traditionally preventive maintenance has consisted of a technician lubricating and physically inspecting a machine. This physical inspection can include partial or complete disassembly of the machine for inspection or to change parts. There are several problems with this: • There may be nothing wrong with the machine, operating time has been lost and failure is more probable when it is put back into service after re-assembly; • Some problems may not be discernible by physical inspection; • Some problems may only be discernible when the machine is in operation.

Predictive maintenance consists of a series of technologies that can be used to detect future problems thus ensuring the machine remains in operation until the optimum moment to stop the machine for service. Typical of these would be: • Vibration Analysis – These identify vibration parameters that vary from the baseline norm that has been established for that machine • Infrared – This identifies, for example, hot spots on electrical connections that are a precursor to failure and/or fire • Noise Detection – Leaks and other related problems can be detected through ultrasound techniques.

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