The 7 Magic Metrics

How One HTM Shop Cut Aging Work Orders 97%

By Dallas Sutton, BS, CRES

Every biomed has found one: the work order that went into “Awaiting Parts” in June and was still sitting there at Halloween. Nobody dropped the ball on purpose. The ticket just slid out of view behind a few hundred others, and the first time anyone noticed was when a nurse manager called to ask where her equipment went.

At WakeMed Health & Hospitals, a three-hospital system with about 980 beds, our 20-technician clinical engineering team got tired of finding those surprises at the end of the month. So we built a scorecard of seven metrics, which I call the “7 Magic Metrics,” rolled them into one 0-100 score for each technician, and started reviewing it at every morning huddle. It isn’t fancy. It runs in a spreadsheet. But it changed how our shop talks about work, and any healthcare technology management (HTM) department with a computerized maintenance management system (CMMS) can build one.

The Problem Isn’t a Lack of Data

Our CMMS holds more information than any of us could review by hand. The problem was turning it into something a technician or supervisor could act on before the coffee got cold. Without a short, consistent set of numbers, the same three patterns kept showing up: preventive maintenance (PM) completion lagged until the last week of the month, work orders aged quietly in hold states, and work order notes drifted until they no longer told anyone who owned the job or what came next.

We wanted three things from a fix: catch problems daily instead of monthly, hold every technician to the same clear standard, and give the morning huddle a real agenda.

The Seven Metrics

Each metric targets one specific way work slips through the cracks:

1. Daily PM Completion %. Our goal is 100% PM completion every month. With about 20 workdays in a month, that works out to roughly 5% per day. Any technician who falls more than 10 points behind the daily goal is flagged Red, and we talk through the barrier at the huddle.
2. Actionable Work Orders Older Than 7 Days (+7). These are jobs waiting on the assigned technician that haven’t moved to a legitimate hold status (Awaiting Vendor Service, Awaiting Parts, Hold for Information or Pending Equipment Availability). Tolerance: zero.
3. Notes Not Updated in 30 Days (Notes +30). This is our checks-and-balances metric. Every open work order gets reviewed and updated at least every 30 days, with no copy and paste, so the notes reflect the current who, what, where, when and how. Tolerance: zero.
4. Awaiting Vendor Service Over 90 Days (AVS +90). This keeps us following up on vendor and depot repairs instead of assuming they’re on the way back.
5. Awaiting Parts Over 60 Days (AVP +60)[CL1]. This surfaces backorders early and prompts a look at third-party sourcing.
6. Pending Equipment Availability Over 30 Days (Pending +30). This keeps technicians circling back on devices that were in use when the original request came in.
7. Hold for Information Over 30 Days (HFI +30). This covers work that depends on someone else, such as a field service report or networking details from information services (IS), so it doesn’t drop out of sight.

One Score, Weighted on Purpose

Seven numbers per technician are useful. One number is easier to act on. Our scorecard rolls the metrics into a 0-100 Tech Score, weighted to match what we care about most:

The weighting is deliberate. Work order hygiene, meaning current notes and no stale actionable work, carries half the score. When those two habits are in place, nearly everything else in the shop becomes visible and manageable. PM completion earns proportional credit, so steady daily progress counts even before the monthly goal is met. The four aging metrics are all or nothing, which encourages technicians to clear each category completely instead of trimming it down.

“Get current notes and fresh actionable work right, and almost everything else in the shop becomes visible.”

Here’s how it plays out.[CL2]  A technician at 60% PM completion against a 75% daily goal earns 16 of 20 PM points. Add one work order sitting in Hold for Information past 30 days, and the Tech Score lands at 88.5. That technician knows exactly what to do next: knock out a few PMs and chase down that missing information.

Inside the Morning Huddle

The scorecard was built for our huddle. Instead of scrolling through every open work order, we focus on three questions:

• Who’s Red, and why? Anyone more than 10 points behind the PM goal walks us through what’s in the way, whether that’s equipment availability, a heavy repair load or an install project. Then we decide together how to clear it.
• What’s costing the most points? A single Notes +30 or +7 item is the biggest hit to a score, so those get handled first.
• Where is aging piling up? Team averages and category totals show whether aging is concentrated with a few people or spread across the shop. They also tell us where to escalate with vendors, parts suppliers or IS.

Because technicians see the same scorecard, many problems get fixed before the huddle starts. Nobody wants to explain a stale note they could have updated in two minutes.

“Using the 7 metrics has made monitoring technician progress much more efficient. These metrics provide the opportunity to catch issues before they become problems.” – Shannon Hunter, biomedical site coordinator

Early Warning: A Dashboard for Every Technician

The huddle shouldn’t be the first place a technician learns about a problem. So we built dashboards in our CMMS that let each technician check the status of their own work orders at any time. Instead of waiting for the morning scorecard, technicians can see which jobs are getting close to a threshold, such as a work order that needs its notes updated or a hold that is about to age out, and take care of it first.

In other words, the dashboards forewarn technicians of impending doom. The scorecard tells us where we stand. The dashboards help technicians stay ahead of it. That shift from reaction to prevention is a big part of why the numbers keep falling and stay low.

“Using the 7 metrics has helped relieve the stress of backlogged work orders by making visible the ones that need immediate attention versus those awaiting others. Now I find myself chasing 0’s on my work order dashboard.” – Rich Richardson, CBET, biomedical engineering specialist

A Coaching Tool, Not a Leaderboard

Any scorecard can turn into a weapon if it’s used the wrong way. We made a point of using the Tech Score to start conversations, not to rank people. A low score isn’t a verdict. It’s a signal that something is in a technician’s way, and our job as leaders is to help remove it. That might mean rebalancing workload, pushing a vendor for a repair status or getting IS on the phone. When technicians see the score leading to help instead of blame, they trust it, and they use it to manage their own work.

Lean at the Core

None of this was invented from scratch. Drawing on my training as a Lean Six Sigma Green Belt, we built the scorecard on the same principles that manufacturing and other healthcare departments have used for years to make work flow. Each piece of our approach maps to a familiar Lean idea:

• Eliminating waste. A work order sitting in a hold status is waiting, one of Lean’s classic wastes. For a clinician, it means a device out of service. The aging metrics put a time limit on that waiting and make it visible.
• Standard work. Clear definitions of “actionable,” “legitimate hold” and “current notes” give every technician the same expectations and the same playbook.
• Visual management. The scorecard and the technician dashboards show the condition of the work at a glance, so problems are seen instead of discovered.
• Stopping to fix problems. The Red flag works like an Andon signal. When a technician falls behind, the team pauses at the huddle to find and remove the barrier rather than letting it carry forward.
• Daily management. A short, structured huddle reviews the same measures every morning, turning the scorecard into a daily habit rather than a monthly report.
• Respect for people. Using the score for coaching instead of blame reflects the Lean belief that problems usually come from the process, not the person, and that the people doing the work are best placed to improve it.

Lean is also about continuous improvement, and the scorecard follows a simple plan-do-check-act cycle. We set the measures, work the plan every day, check the results each morning, and adjust when something isn’t working. The technician dashboards came out of that same cycle: once the scorecard showed where work was aging, the next step was to give technicians a way to see it coming.

Results

When we ran our first scorecard on November 13, 2024, it flagged 1,133 work orders in at least one violation state: actionable work older than 7 days, notes not updated in 30 days, or a hold status past its age limit. That was our honest starting point, and it was a sobering number to put in front of the team.

Today, that same report shows 32 work orders in those states, a 97% reduction in just under two years. We got there one huddle at a time, by making aging work visible every morning, both on the scorecard and on each technician’s own CMMS dashboard, and clearing it before it could pile up again. The remaining 32 aren’t forgotten. Each one is on the scorecard, and the team reviews it daily.

“From 1,133 work orders in violation to 32: a 97% reduction, one huddle at a time.”

Lessons From the Shop Floor

• Define every metric before you score it. Agreeing up front on what counts as “actionable” and which statuses are legitimate holds prevented arguments and made the scores credible.
• Weight what you value most. Putting half the score on notes and responsiveness changed daily habits more than any reminder email ever did.
• Keep it short. Seven metrics cover the main ways work stalls and still fit in a quick huddle. Resist the urge to add an eighth, ninth and tenth.
• Borrow from Lean. You don’t need a formal improvement project to start. Make waiting visible, standardize the work, and review it daily, and the results will follow.
• Lead with help, not blame. The scorecard only works if technicians trust it.

Sidebar: Build Your Own Scorecard

You don’t need special software. A spreadsheet and a few CMMS reports will get you started:

1. Map your statuses. Sort your CMMS work order statuses into “actionable” and “legitimate hold” groups (vendor service, parts, information, equipment availability).
2. Build your reports. Create one CMMS report per metric that returns a count for each technician: actionable over 7 days, notes not updated in 30 days, and each hold category past its age limit.
3. Set the daily PM goal. Divide the workdays elapsed by the total workdays in the month and multiply by 100. In a 20-workday month, that’s about 5% per day.
4. Score it. PM points = the smaller of (PM % ÷ goal) or 1, times 20. Notes +30 and +7 earn 25 points each, only at zero. Each aging metric earns 7.5 points only at zero.
5. Flag Red. Mark any technician whose PM completion is more than 10 points below the goal.
6. Add team views. Include per-technician averages and category totals for the aging metrics.
7. Give technicians their own view. Build a CMMS dashboard for each technician that shows the status of their open work orders and highlights jobs nearing a threshold, so they can act before an item shows up on the scorecard.
8. Review it daily. Refresh before the morning huddle and save each snapshot so you can track trends over time.

The Bottom Line

HTM teams already have the data they need. The hard part is turning it into action every day. Seven well-defined metrics, one transparent score and a few minutes each morning have helped our shop protect PM compliance, get equipment back to clinicians faster, and give every technician a clear picture of where they stand. Most of all, the work orders don’t quietly age out of sight anymore.

Dallas Sutton, BS, CRES, is manager of clinical engineering at WakeMed Health & Hospitals in Raleigh, North Carolina, and serves on the board of directors of the North Carolina Biomedical Association. A certified Lean Six Sigma Green Belt, Sutton brings 37 years of experience in healthcare technology management.

[CL1]Please confirm “AVP” is the CMMS’s status code for Awaiting Parts. The other abbreviations track their names (AVS, HFI), so readers may expect “AP +60.” Leave as is if AVP is what technicians see on screen.

[CL2]Math checks out: 60/75 × 20 = 16 PM points; 25 + 25 + 16 + (3 × 7.5) = 88.5. One thing a sharp reader may notice: at 60% against a 75% goal, this technician is 15 points behind, so they’d also be flagged Red under the 10-point rule. Consider noting that, since it reinforces the huddle section.