Life Cycle Management’s Role in the Healthcare environment

By Donald Macdonald, Director Macdonald Lucas

Good communication has been a key plank in the war with COVID. The success of lock downs, testing and vaccine roll outs all rely on good communication to work well, and have helped the health care sector in their front line fight with the virus. A fight that has commanded the attention of the health care sector since early 2020. As the pandemic tide begins to ebb, thoughts will turn to the funding needs that occupied us before.

Whilst the funding needs of core business will, of course, be front of the queue. From an asset maintainers point of view, the role of biomedical assets in the care and treatment of patients is fairly clear, thus the link between maintaining these assets and good patient outcomes is relatively easy to make. The part played by non- core business assets, like chillers, boilers and lifts, in achieving good health outcomes, however, is not so obvious. All of this means that whilst it can be harder to get funding for asset management than for core business activity. Of the funding that is available, it is likely to be easier to secure for the maintenance and replacement of biomedical assets than for the maintenance and replacement of non- core business assets.

Spending on planned and reactive maintenance of non- core business assets, is typically seen as an unavoidable cost of ‘keeping the doors open and the lights on’. And thus tends to be fairly simple to secure funding for (though perhaps not at the levels that the maintainer feels is needed).

On the other hand, securing adequate and timely funding for the replacement of non- core business assets (life cycle works), is another ball game entirely. The reasons that this tends to be such a challenge are many and varied and include: • Where an assets appears to operate effectively, the case for replacing it can be hard to make, and. • When an asset fails in service slowly over time, stakeholders can get used to ‘living with’ its unreliable operation. Where the link between a non-core business asset and effective health care is not clear, in order to secure funding, the maintainer needs to be able to make a compelling business case to the executive, regarding: • The importance of the asset to the business, • The reality that the asset is reaching the end of its design life and requires replacement, • The time required to replace the asset, and, • The true cost of the assets replacement. Where a health care engineer fails in the above and is unable to secure support (and funding) for timely asset replacement, the organisation runs the risk of: • Increasing incidents and costs of reactive repairs, • Increasing incidents of unplanned service interruptions, • Having to deploy inefficient ‘work arounds’, • Negative impacts on downstream assets, and, • In extreme cases, a catastrophic failure of critical services. The global pandemic that we are all living through highlights the ‘global village’ in which we live and the international nature of the supply chains on which we all rely. This is a situation which has major implications for life cycle works, particularly in areas like asset availability, lead times and the limited capacity of the major logistics providers to distribute and deliver supplies including new plant and equipment.

The joined up nature of the modern world complicates life cycle works. It makes the need for a pro- active, well planned approach critical. It challenges the engineers ability to manage expectations effectively and to positively influence outcomes. Thus a robust, comprehensive, intuitive approach to life cycle management is key, including: • The ability to quantify and rank asset criticality from a number of points of view, for example, the potential for an asset failure to impact: – Accreditation, – Patient safety, – Compliance, – Service interruption,

– Downstream asset failure, and, – Replacement availability. • Regularly capturing, analysing and reporting the condition of the asset base, over time, • A full appreciation of the implications of asset replacement works, such as: – Cost, – Modifications of existing services, – Temporary supply arrangements, – Goods inwards and outwards routes, and, – Lead times. A life-cycle management approach that reflects the above, and includes regular reporting to senior management helps to ensure that expectations are managed over the life cycle of the asset base. There are of course an increasing number of tools available to assist with life cycle management such as: • Asset condition audits, • Analysis of BMS and CMMS data, • BIM, • Digital twins, and, • IoT technology. However when it comes to securing funding for life cycle works, in depth analysis of asset data will count for nought, if one is unable to communicate the need to the wider organisation in a manner that makes it relevant to them and in a way that they can readily process and understand. Unless they achieve this, those responsible for the management of non- core business assets in the health care environment shall struggle to secure funding for life cycle works. As in the battle with COVID, effective communication is key.