Performance-Based Reliability-Centered Maintenance Planning for Hospital Facilities

The deteriorating state of the built environment has affected numerous sectors, and hospitals are no exception. Hospitals are relatively unique compared with other facilities because of the complexity of their systems and their criticality with respect to the communities they serve. Faced with limited budgets and pressures to comply with increasing performance requirements, hospital facility managers are required to strike a delicate balance between hospital maintenance costs and level of service requirements. Accordingly, this paper proposes a reliability-centered maintenance (RCM) approach that is combined with evolutionary optimization to develop optimal maintenance plans for hospital facilities. The scope of the developed model covers four mission-critical systems in hospitals, namely medical gases, primary HVAC, secondary HVAC, and elevators. Failure-mode effect analysis (FMEA) is used to determine the optimal maintenance strategy for various components within these systems. The model considers how each system contributes to the continuity of services in four areas within hospitals, namely intensive-care units, emergency rooms, operating rooms, and regular patient rooms. In order to demonstrate the capabilities of the developed model, a case study of a $\mathrm{5,200}\text{-}{\mathrm{m}}^2$ hospital is considered. Results demonstrate that by using the RCM and optimization approach, savings ranging from 6 to 16% in maintenance costs can be realized in comparison with traditional preventative maintenance approaches undertaken by existing maintenance contracts. The developed model is thus capable of providing hospital facility managers with an effective tool to better understand how their maintenance expenditures directly contribute to overall system availability and impact healthcare services delivered to patents.