Is your job secure? Is it as secure as it was five years ago? Healthcare is changing. We see it all around us. When driving a car, there are warning signs to tell us of upcoming things that could wreck our lives and careers. Not so in the hospital.
Administration always tells us that things are wonderful, until that time that they announce that the management of the department has been turned over to ACME Biomedical. It’s nothing personal, just a business decision. Because there are no warning signs, we must be proactive and prepare for whatever might happen. When it is foggy outside, don’t we slow down and ride with our foot ready to hit the brake? We must build a similar safety system for out HTM departments. Most HTM departments and technicians do not do this. They do only what is asked of them. For example, if administration does not care about cost reports, they do not keep the records to generate them. This is a major mistake.
In order to prove our worth to our employers, we need to keep meticulous records of every activity that we engage in. Every day, every week, month in and month out. Year after year. It is only through the complete records of HTM activities that future reports can be created. If the basic day-to-day documentation of time, activities, parts, and other costs are not in the system, it is impossible to create an answer to questions from administration.
I am shocked by the frequency that I visit what are obviously high-performing HTM departments to find that they cannot drill down into their inventory to create reports, charts, spreadsheets, etc, related to individual equipment failures, costs and uptime. They cannot compare themselves to other HTM departments. They cannot know if they are truly better or worse than their neighbors across town or in the next county.
It is really very simple. Here are the steps:
1. Use your computer system (CMMS) to tie every cost related to an individual asset to that asset. This means all internal labor, all external labor, all purchased parts, all service contract costs, all PM labor and parts, and anything else that goes into keeping an individual asset in operation, safe and reliable. Each technician must be especially careful to record everything about every item. And they must do this every day. It takes a year of careful daily documentation to create enough information to be able to begin meaningful analysis. And every service contract must be split up and the costs entered into the system for each asset that is covered. For example, if you have a contract for six anesthesia machines for $66,000, an entry should be made once per year to log $11,000 to each of those anesthesia machines. This is the only way to allocate costs to individual assets for future analysis.
2. Fill in the acquisition cost for each and every asset in your computer system. When using Cost of Service Ratio (COSR), the acquisition cost is the only other number that you need other than a full year’s maintenance costs. If you do not have all of these filled in, use my technique: Download a spreadsheet from the HTMA-SC website (www.HTMA-SC.org). It has the average price paid for many hundreds of equipment types. You can use these numbers to fill in the missing information in your database. It may take a while, but it is vital. (By the way, it will also help you clean up the non-standard names that your BMETs call things in your inventory).
3. Determine the actual charge-back cost for an hour of labor of one of your technicians. It should be in the neighborhood of $100 per hour. Note: The chargeback cost is the hourly labor rate that you load into your CMMS to convert the hours spent by your in-house technicians into dollars. This is needed to make item-to-item comparisons of costs to maintain. The hourly cost is totally unrelated to the hourly rates your technicians are paid. The charge-back labor rate is the total cost of running your department, minus parts and service contracts. This number should include all personnel costs, calibration services, minor equipment purchased, tools, training and any other costs to keep the HTM department running. This cost is then divided by the total annual labor hours available for actual equipment service or PM. This is significantly less than the annual full-time hours of 2,080. After subtracting vacation, holidays, sick time, meetings, and adjusting downward by an additional 15 percent for normal unproductive time, the average for a fulltime BMET is in the range of 1,420 to 1,600 hours per year. Managers and supervisors will be even less, since their daily work is not chargeable to individual assets. Secretaries have zero chargeable time.
4. Educate your guys (and gals) about the importance of minute-to-minute documentation. Emphasize that the goal is not to critique them, but to build an information resource that can be used in the future to protect all of their jobs. If they do not provide the initial documentation, the manager does not have the data to prove their worth to administration.
Look at your CMMS. Are all the fields filled in? Why not? If you are doing only what is required today, your ability to protect your job from unforeseen threats in the future are severely limited. Get busy, or get your resume dusted off.