Editor's note: This article is the sixth part of a 14-week series titled "Reliability Asset Management: Getting Started." The series explores the use of reliability-centered maintenance in health care facilities. One article will be published every other week. 

My colleagues and I have embarked on a journey that is taking us through multiple levels and perspectives around the concepts of reliability-centered maintenance (RCM). Our goal is all about bringing RCM to health care and making the case for implementing the process. My lens into RCM is from a system perspective. There is tremendous value in being able to deploy at scale. For my company, we have made great strides in being able to manage as a system. This includes deploying a systemwide computerized maintenance management system (CMMS) and a systemwide capital management platform. These two systems depend on each other for the accurate management of the capital assets, so it makes sense to leverage this symbiosis to benefit from the positive features of RCM.

Understanding the basics of RCM is important just to know where to start and that is where I find myself. If this can be implemented at scale within a large health care system, then the benefits of risk mitigation and cost reduction can create a positive impact to the bottom line especially in the nonprofit world. Additional benefits can include extending the life of equipment thus reducing the capital burden on already historical deferred capital needs.

When thinking about mitigating risk the focus rests on managing risks associated with patient care. There are many tethers here that connect directly with safety, reliability and environmental impacts that if managed through the RCM approach can be further reduced. The other thing that I am quickly realizing is that in our day-to-day operations we are already performing elements of RCM. For example, we are mitigating risk by using imaging devices to detect increased heat loads in energized equipment. In some instances we are using vibration analysis in our mechanical equipment to provide early warning of possible failures. All of these abilities come at a premium but gaining a solid foundation in the concepts of RCM can enable a successful business case to implement.

Reducing cost of managing equipment is another very important element of RCM. As I look further into this potential, I am quickly realizing how beneficial this can be to a system. Historically, capital investment in infrastructure has not been very consistent across the health care landscape. There are mounting needs for infrastructure upgrades and replacement, and every day, week, month and year that need continues to rise. RCM could potentially help that cause. If the life of equipment is extended by RCM, then the capital need can be managed based on capital availability. I understand that does not help the backlog, but, by extending the life of equipment the need does not grow as much.

Labor is quickly becoming a challenge in our industry. The Baby Boomers are setting their sights on retirement, and we are losing those critical skills in our operations. Trained backfills for these positions are not easily found so the prioritization of the existing labor effort must now be considered.

So, hear me out on this one: If you are now using elements of RCM such as vibration, pressure differentials and the like, you can now have a better predictive approach to maintaining equipment based on performance indicators and not on the calendar. This would allow the focus to shift to the greater needs and still plan for the RCM elements. 

It seems that the last hurdle to overcome is awareness, which must be addressed at all levels of your organization.

At the technician level, it now becomes a new way of approaching the maintenance tasks, and the “always done it that way” mindset must be adjusted by the principles of RCM. The facility directors and managers must now become experts in how to apply RCM. Remembering that your CMMS is the best place to start will help in understanding your assets since many of the assets’ requirements are set within that program.

“Selling” the concepts of this to senior leadership can be justified in the value of total cost and the ability to predict requirements. Taking that at scale can now provide for a more compelling reason to adopt the RCM approach. 

The RCM journey does have the potential to have a rough start if you are not prepared to take the first step. I can tell you that I am laser focused on understanding the critical elements so that I can have the insight to justify and deploy across a large enterprise. I am very thankful to be a part of this effort with the American Society for Health Care Engineering and excited to be able to develop tools and concepts that we can share with fellow members and facilities managers.