Bertus Janse van Rensburg bertus.jvr@mediclinic.co.za

1. Bertus Janse van Rensburg bertus.jvr@mediclinic.co.za Equipment Stability and the Effect Thereof on Service Delivery: Case Study - Medi-Clinic

2. and here and here MCC is here

4. Medi-Clinic Southern Africa Overview 53 Hospitals in South-Africa and Namibia Over 7000 Licensed beds 258 Theatres Over 600 ICU and High Care beds Replacement Value of Physical Assets:R 3.446 Billion Replacement Value of Buildings:R 9.305 Billion Total Staff of 13 300 Projected Revenue of over R 8 Billion

5. On Key Overview before Project Introduced in 1998 at Panorama (version 1.4) Re-installed three times at Panorama due to development work Installed at 28 hospitals with access by regional and head office Covers ± 80% of beds in group On Key Version 3 Individual databases at each site

6. EAMS Project Overview Version upgrade to On Key 4 – Central Database Assets identification and verification 3 Teams deployed consisting of 5 members each Each team is allocated a hospital Estimated average duration perhospital of 6 weeks 26 Hospitals and 5 Office complexescompleted 59 % of Operational beds installed

7. Equipment Stability – Categorise Assets CATEGORY # 1 – LIFE SUPPORT All equipment where a failure would create a risk to the patients’ life whether directly or indirectly. Maintained according to the manufacturers instruction by the agent or an authorised representative or a person appointed by Medi-Clinic Medi-Clinic Policy

8. Equipment Stability – Categorise Assets CATEGORY # 2 – STRATEGIC All equipment where a failure would cause gross inconvenience to our clients, large negative financial impact or significant effect on the service we provide. Maintained according to Medi-Clinic policy in-house by our staff, the agent or a contractor appointed byMedi-Clinic Medi-Clinic Policy

9. Equipment Stability – Categorise Assets CATEGORY # 3 – GENERAL All equipment not falling in the preceding categories.Failure of this equipment still has an overall effect on the service we provide and will be maintained according to Medi-Clinic policy in-house by our staff, the agent or a contractor appointed by Medi-Clinic Medi-Clinic Policy

10. Equipment Stability – Asset Classification Operational requirements Civil projects – New hospitals or upgrades ICT Requirements – Bulk purchasing and technology change Insurance Claims Third party equipment: • Placement / Hired / Loan • Externally Owned Serviced for a fee • Service Exchanges • Evaluation Equipment

11. Equipment Stability – Asset Classification cont. “Virtual Assets” • Facilities – Detailed Attributes • Number of Theatres • Square meters of buildings or land • Number of parking bays • Floor coverings / Wall coverings • Clinical power tools • Instrument sets Resource Assets • Electricity • Water • Medical Gas

13. Equipment Stability – Using an EAMS (On Key) Asset Register – Details of the assets you have and where these assets are in order to maintain it • Capture all assets > R1000 (Comprehensive baseline) • Financial details for depreciation and value • Warranty dates for work order control Asset Care Plan Developer • Single view of scheduling • Management of risk by using profiles such as: • Schedules with a blank due date – Per category • Unconfirmed schedules

15. Life Cycle Costing Report Links to Asset Register Need to know what must be replaced and when

16. Equipment Stability – Using an EAMS (On Key) Maintenance Manager • Work history • Work in progress reports • Closed work analysis • Productivity • Staff utilisation • Facility Red Flag – Reported incidents by: • PatientRed • Nursing Green • Management Blue

17. Technical Service Level Feedback and Average Age in Days

18. Effective Closed Work Analysis Select period Select number Run report to identify problem children (Excludes planned maintenance)

19. Staff Utilisation & Productivity Measurement

21. Equipment Stability – Using an EAMS (On Key) Maintenance Manager • Condition based monitoring usingthe following methods: • Manual – Hardcopy capture • Electronic monitoring of: • Generators • Uninterruptable power supplies • Air handling units • Total hospital electricity usage

23. Electrical Reticulation Power Failure Essential Load Generator Failure ! Lock-Out ! Open Closed Open Closed Closed Open Closed Open Do Manual Bus Coupling UPS Essential ICU Theatre Neonatal Cath-lab Kitchen Laundry Hot Water Air-con Doctors UPS Do Load Shedding

24. Equipment Stability – Using an EAMS (On Key) Identification and Assessment • Calculate expected replacement date based on: • Commissioned date • Expected life per asset type • Assess assets “due” for replacement • Generate provisionalreplacement budget • Confirm assessment • Agree replacement budget

26. EAMS Data - Asset Master Database Management • Single version of the truth • Align other systems • Standard configuration – Asset description • Ward allocation stickers – Recognise your assets Define Business Processes and Documents • Review documentation Standard reporting – SSRS conversion Analyse the data – Does it make sense

28. MediCode is based on a universally accepted coding structure. This is important to enable all the software applications currently in use and any future applications to be able to interface successfully and ensure accuracy of data in the database. MediCode Manual MediCode News Available MediCode Datasets MediCode Dataset Owner MediCode Tips Items - Capital and Direct Purchases including printed stationery Business Unit Division Company General Ledger 3 Letter Code Items - Nico Venter Business Unit - Karen Barkhuizen Neetling Division - Lourens Botes Company - Lourens Botes General Ledger -Marie-Elise Stofberg 3 Letter Code- Eugene Manoek Use for your 2010 Capital Budget Follow MediCode Tips How to create your Capital Budget How to........ Search Copy Paste Export Use Descriptions © 2008 Medi-Clinic

29. Ward Allocation Stickers

30. INFORMATION SSRS Reports Analyser Tool Profiles DATA ON KEY ON KEY WISDOM KNOWLEDGE Apply

31. Blender 2 Yearly Service Changed interval to 3 yearly Saving: R135,000 per year

32. EAMS Future Integration with other systems • Central procurement SSRS Reporting Development • Availability of information to different management levels Grow data maturity in order to createmore focus on equipment Expanding scope of electronic conditioned based monitoring - Energy initiatives Installation of On Key 5

33. Closing Thoughts Aspects that would differentiate a company from the norm will be one that will have: • Quality data • Available to the end user • In the correct Format for the end user for Immediate use Do you spend 80 % of your time extracting or compiling information and 20 % analysing?

34. Thank You • Bertus Janse van Rensburg • bertus.jvr@mediclinic.co.za