Hospital Asset Maintenance Engineering for the Next Century

Contents

About the Author........................................................................................................ix

Chapter 1 Global Framework.................................................................................1

1.1 Framework..................................................................................1

1.2 Physical Assets KPI's..................................................................3

1.3 Physical Assets Around the World..............................................6

1.4 Political Options.......................................................................10

Chapter 2 Physical Assets....................................................................................14

2.1 Buildings...................................................................................14

2.2 Technical Facilities...................................................................16

2.3 Equipment.................................................................................17

Chapter 3 Physical Assets Maintenance..............................................................26

3.1 Framework................................................................................26

3.1.1 Transversal Concepts...................................................26

3.1.2 Maintenance Algorithms.............................................28

3.1.3 Metrology....................................................................30

3.1.4 Key Performance Indicators........................................36

3.2 Building Maintenance...............................................................40

3.3 Technical Facilities Maintenance..............................................42

3.4 Equipment Maintenance...........................................................46

3.5 New Maintenance Planning Approaches..................................53

3.5.1 Maintenance of Buildings...........................................54

3.5.2 Maintenance of Technical Facilities............................56

3.5.3 Maintenance of Medical Equipment...........................59

Chapter 4 Physical Assets Life Cycle Management............................................66

4.1 General Concepts......................................................................66

4.2 Public Private Partnerships.......................................................68

4.3 Main Life Cycle Models...........................................................71

4.3.1 Linear Depreciation Method.......................................71

4.3.2 Sum of the Digits Method...........................................72

4.3.3 Exponential Method....................................................73

4.4 A Holistic Model for the Physical Assets Life Cycle...............75

4.5 Life Cycle Investment Considering Maintenance

and Non- Production..................................................................75

4.6 Life Cycle of Physical Assets with Recovery...........................77

4.6.1 Basic Concepts to Support Math Models....................77

4.6.2 Behaviour of the Physical Asset Value Over Time......79

4.6.3 Production Economic Movements..............................79

4.6.4 Functioning Economic Movements.............................81

4.6.5 Global Movements Analysis.......................................81

4.6.6 Return On Investment..................................................82

4.6.7 Example of Lice Cycle of Physical Assets with

Recovery......................................................................82

4.7 Reserve Set................................................................................83

4.7.1 Reserve Set Example...................................................85

Chapter 5 Cross Infection....................................................................................89

5.1 Cross Infection Framework.......................................................89

5.2 Cross Infection and Hospital Design........................................92

5.3 Cross Infection and Logistics....................................................97

Chapter 6 Vertical Standards..............................................................................103

6.1 Standards for Buildings...........................................................103

6.2 Standards for Technical Facilities...........................................103

6.3 Standards for Medical Equipment..........................................104

Chapter 7 Horizontal Standards.........................................................................113

7.1 Physical Asset Management Standards...................................113

7.2 Maintenance Standards...........................................................118

7.3 Risk Standards........................................................................118

7.4 Energy Standards....................................................................120

7.5 Environmental Standards........................................................123

7.5.1 Circular Economy Standards.....................................125

Chapter 8 Stocks Management..........................................................................129

8.1 Spare Parts..............................................................................129

8.2 Pareto Analysis........................................................................130

8.3 Main Approaches....................................................................131

8.3.1 Supply Program.........................................................132

8.3.2 Order Point................................................................136

8.3.3 Procurement Plan......................................................138

8.3.4 Security Parts.............................................................139

Chapter 9 Acquisition Models...........................................................................142

9.1 Terms of Reference.................................................................142

9.1.1 Term of Reference to Purchase Physical assets.........144

9.1.2 Term of Reference for Acquisition of

Maintenance Services................................................148

9.1.3 Term of Reference for Leasing and Renting.............152

Chapter 10 Lean Management.............................................................................157

10.1 Lean Thinking.......................................................................157

10.2 A3 Method............................................................................169

10.3 GUT Matrix..........................................................................169

10.4 6 Sigma.................................................................................171

10.5 PDCA...................................................................................172

10.6 Ishikawa Diagram.................................................................173

10.7 Brainstorming.......................................................................174

10.8 SCRUM................................................................................177

10.9 SWOT Analysis....................................................................178

10.10 Hoshin Kanri........................................................................180

Chapter 11 Hospital Logistics..............................................................................183

11.1 Framework..............................................................................183

11.2 Algorithms for Logistics.........................................................187

11.3 Just- In- Time............................................................................193

11.4 Robots in Logistics.................................................................196

11.5 Other Approaches....................................................................197

Chapter 12 Hospital of the Future........................................................................199

12.1 Holistic Medicine....................................................................199

12.2 Naturopathy.............................................................................202

12.3 Acupuncture............................................................................202

12.4 Homeopathy............................................................................203

12.5 Osteopathy..............................................................................205

12.6 Ayurveda.................................................................................205

12.7 A Vision of the Hospital of the Future....................................206

Index.......................................................................................................................209