Nebraska Medical Center

Every hospital faces the twin challenges of maintaining its facilities from both a strictly operational as well as regulatory compliance standpoint. The challenges just get bigger the larger the institution in question happens to be, and they don’t come much bigger – or better – than The Nebraska Medical Center (TNMC) in Omaha, Nebraska. TNMC, in fact, was recently named to the list of “100 Great Hospitals in America” by Becker’s Hospital Review.

Formed in 1997 through the merger of University Hospital and Bishop Clarkson Memorial Hospital, TNMC is that state’s largest health care facility with 621 acute care beds. It is the teaching hospital for the University of Nebraska medical school and boasts 6,000 employees, including 350 resident physicians. Those doctors help train 1000 students each year at a facility with an international reputation for organ and bone marrow transplantation, in addition to providing comprehensive oncology, neurology and cardiology programs.

TNMC’s enviable reputation is supported in part by the expertise of that healthcare provider’s facilities department. The facilities team is responsible for a nearly 4 million square foot main campus with an additional 600,000+ square feet at other educational, hospital and clinic facilities in and around Omaha, points out Michelle Stalker, TNMC’s Senior Systems Engineer. That means placing added emphasis on preventive maintenance that complies with state and professional regulatory requirements.

To track the space inventory and allocation of its multi-million square foot campus portfolio, TNMC implemented ARCHIBUS Space Management, which is essential in transacting chargebacks to departments based on location. It is also a key technology for Medicare reimbursement reporting.

ARCHIBUS Service Desk was also introduced as an intake point for maintenance, space/construction, furnishings, floor plan, and requests and reporting for the Office of Projects and Initiatives.

“But maintenance itself is split between two groups, the regulatory maintenance team and the operational maintenance team,” explains Stalker. “The person who oversees the regulatory maintenance group wants to separate their activities from operational ones, to make compliance reporting for required PM tasks easier. When the Joint Commission or CMS come to audit our facilities, they want to be able to see certain categories of information related to our meeting specific regulatory requirements.”

The ARCHIBUS Preventive Maintenance and On Demand Work applications handle 800 to 1000 preventive maintenance and operational work orders a month, which may consist of monthly, quarterly or yearly PM tasks as well as routine scheduled and unscheduled maintenance covering 18 problem types with 570 associated SLAs. Work requests are sent directly to the pagers of individuals or team leaders.

“The ARCHIBUS implementation is a big improvement over what preceded it. We had a time and material system that couldn’t track our compliance work and didn’t centralize worker activity reports. Those reports were kept in a worker’s own folder on the network with its own naming system and that made locating information and accessing it difficult,” explains Stalker. “Now ARCHIBUS gathers all that information together so it’s easier, for example, to pull reports on things like failure rates of certain types of equipment.”

In the past, TNMC also had to conduct extensive facilities surveys that would last six weeks but were paper-based and handwritten. It was a process that invited problems such as inputting the wrong room numbers, illegible handwriting, or taking sets of pictures that were incomplete and weren’t always attached to the report.

“With ARCHIBUS, data quality control is much better now,” notes Stalker. “Building floors and individual rooms are already in the database with the right location and room number information already assigned so workers don’t have the option of inputting an incorrect room number.”

The implementation of SLAs has also helped in improving craftsperson responsiveness and customer satisfaction by prioritizing work. Perhaps even more important has been the creation of a convenient, single-screen work order console.

The ARCHIBUS system has improved maintenance practices to such a degree that smaller, more rural hospitals have approached TNMC to outsource their regulatory preventive maintenance work and reporting.

“Smaller hospitals don’t have the funds to buy the technology needed for a PM program like that, which can cost $50,000,” says Stalker. “It’s better for them to piggy-back off our system, which our ARCHIBUS license allows. Outsourcing their PM work not only helps them meet compliance requirements, it also becomes a source of revenue for us.”