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By Dan Hounsell
December 2003 -
Health Care Facilities Article Use Policy
If Edward Dudek isn’t quite on the cutting edge of maintenance management, he most likely can see the cutting edge from his desk.
Dudek is director of engineering and maintenance for the University of Pittsburgh Medical Center and Presbyterian/Shadyside hospitals. The 14-hospital system — with specialties ranging from cancer and psychiatric treatment to teaching and research-and-development facilities — encompasses about 6 million square feet and 1,574 beds.
Managing an operation with that size and scope might seem overwhelming. But Dudek’s 343-person department is meeting the challenge with a mix of non-traditional management strategies and technology applications that has contributed to the medical center repeatedly receiving national acclaim for its quality of care.
Dudek’s background has contributed to his management philosophies. While gaining hands-on experience working for a mechanical contractor, he finished school and went on to earn a master’s degree in public administration.
“A master’s degree gives you a different outlook on the department and helps you see the broader picture,” he says. “It gives me a viewpoint few people have, to see that our obligations are to patient care and research and the community.” He credits that broader perspective with helping him see something other that the usual view from the maintenance department.
“Lots of people think of maintenance only as maintenance, and they don’t think about it as including customer satisfaction,” he says, adding that he runs the department as a business, but more as a non-profit than a for-profit operation.
“I have kind of a different theory,” Dudek says. “I’ve built accountability into everything we do. We have to be as accountable as anybody else.” In his view, the maintenance and engineering department stands the best chance of success by partnering with other areas in the organization.
For example, the department’s Web-based computerized maintenance management system (CMMS) is accessible to the hospitals’ nurses. This access enables nurses to track work-order requests. It also strengthens the relationship between the two departments.
“More than most other hospitals, we’re partners with nursing,” he says. “It has made their jobs easier, and it has helped them understand maintenance better.”
Among the benefits of such cooperation is greater coordination of activities.
“We have a goal of providing preventive maintenance on every hospital bed annually and an overhaul every two years,” Dudek says. “This allows us to track bed maintenance and trend failure histories.” But the department has a far better chance of achieving the goal if nurses are aware of maintenance schedules and avoid using areas that are slated for such work.
Joe Crouse, the assistant director of engineering and maintenance, says the department’s success arises in part from non-traditional thinking and commitment to quality from the workers.
“We work outside the lines of traditional maintenance,” Crouse says. “For example, we try to avoid using contractors. Even if our guys have to work overtime, we believe they can do the job cheaper and can do as good a job, if not better.”
The department’s efforts in partnering and cooperation extend to other areas, as well. Dudek is chairman of the organization’s building system committee, which sets standards for the types of equipment and technology included in construction projects and develops the roster of capital projects for the hospitals.
One important goal of the committee — which also includes a construction manager and a consulting engineering — is ensuring both the proper coordination of priorities among departments and long-term facilities performance.
“We want to make sure first-time costs don’t offset operating costs,” Dudek says. He adds that support from hospital administrators is essential to make it all work.
“Maintenance departments have been their own worst enemies by not keeping administrators aware of their activities,” he says.
To complement these strategies, the department takes a forward-thinking approach to technology, and its potential to enhance productivity and customer satisfaction while at the same time lowering equipment life-cycle costs.
All of the department’s front-line technicians can enter information onto work orders, and some of the shops have made the transition away from paper worker orders and now are completely paperless.
“The maintenance guys have to be computer literate and even know some programming,” Dudek says.
Front-line technicians also have personal digital assistants (PDAs) that allow them to access work orders in the field and send data on their activities and resources to the CMMS database. The technology has been essential in making workers more productive.
For example, when it comes to performing preventive maintenance and major repairs on hospital rooms, technicians first scan each room’s bar code with a bar code reader. This step calls up information about all equipment and systems within the room and gives technicians access to related work orders and repair histories.
Nurses also can use the deferred maintenance module in the CMMS to flag a room for future repairs, ensuring the work is done before another patient moves in, he says.
“That was always something that fell through the cracks, but it doesn’t anymore,” Crouse says.
Bar codes on air filters also enable workers to check on filter replacement schedules, Dudek says but adds that technology is no replacement for the real work of maintenance.
“I believe we’re ahead of the curve with technology,” he says. “It’s easy to be focused on the exciting stuff, but we still have to pull the wrenches out there.”
The department’s “brain” — where its management strategies meet its technology applications — is a 24-hour-a-day, seven-day-a-week operations center. Staffed by an electrical engineer, a fire-safety-system technician, three operating engineers and a compliance manager, the center monitors the facilities’ four building automation systems.
Its staff also monitor all DDC, fire-safety, and pneumatic-tube systems, as well as generators and medical gas systems, Crouse says. Staff also monitor repair data and equipment histories stored in the CMMS database.
The operations center enables the maintenance and engineering department to address problems before building occupants know they have occurred, Dudek says.
“We initiated a Web-based CAD file,” he says. “It allows any of our folks, usually my guys in the operations center, to access any piping, electrical or duct drawings by picking them off our Web site electronically and immediately have them available on their computer. This has been a tremendous tool in responding to broken water lines and sprinkler piping to direct the responding technician via radio as to where to go to locate the appropriate shut-off valve.”
The management strategies that Dudek and Crouse have put in place, combined with the technology they’ve given front-line staff, supports the medical center’s mission in ways that are essential in a competitive and ever-changing environment.
“We’re not in the maintenance business as much as we are in the health-care and research business,” Dudek says. “The equipment we maintain is to carry out the mission of the health-care business.”
The power blackout that struck parts of the Northeast United States and Canada in August 2003 did not directly affect the University of Pittsburgh Medical Center and Presbyterian/Shadyside hospitals.
Even so, Edward Dudek, the center’s director of engineering and maintenance, took the opportunity to learn from the experience and make improvements to his organization’s emergency-power and electrical-distribution system.
“After the outage, I talked with my peers in facilities that were affected, and I took their experiences and held them up against our procedures.”
Among the changes he made as a result were these:
“This would be available for research freezers or refrigerators in the event that a researcher on campus may not have requested an emergency power supply or if there is a demand from another area of campus,” he says. “Preserving research in such circumstances is vital and could mean the loss of years of work if the contents of the freezers are lost.”
— Dan Hounsell