It’s 10 years since a vast maintenance project was started at
the Hospices Civils de Lyon (HCL). More recently, the project
involved installation of a CARL Master CMMS (computerised
maintenance management system).Val Kealey visited the
hospital to find out more

The HCL East Hospitals group includes
the hospitals Pierre Wertheimer,
Louis Pradel and the Femme Mere
Enfant on a site that comprises buildings and
technical facilities built between 1963 and
2007. At the end of the 1990s several
incidents, including electricity outages, led
HCL management and technical services
division to give serious consideration to the
maintenance of the building and facilities of
the Hospices Civils de Lyon.

The conclusion was that the buildings and
facilities, which cover 850,000m2 of
developed site, consisted of mixed and
ageing facilities that had not been subject to
effective preventive maintenance. The
maintenance function was fragmented; there
was no dedicated technical management and
those carrying out the work had no clearly
defined goals.

The decision was taken to reorganise and
modernise maintenace procedures and the
‘Maintenance Project’ was started. A new
Maintenance and Operations department
was set up comprising 325 technical staff.

The department has an annual budget of
€31.5m.

A technical strategy was developed with
the aim of establishing a uniform and
satisfactory level of service to ensure
continuity of patient care. This included:
Creation of four specific disciplines (high
current, low current, water & air, and
energy) with a lead engineer for each
discipline.

An inventory of technical facilities
Improving knowledge of the facilities
Defining the role and scope of the
maintenance department.

A recruitment campaign for maintenance
engineers and lead engineers was launched
in 2003 and the Maintenance and
Operations Department was set up in
January 2004. The department then
identified critical areas under the four key
disciplines, establishing a hierarchy of
criticality of facilities within each discipline.

A division into geographical sectors was
carried out to optimise management of those
areas. The HCL is divided into four hospital
zones of about 200,000m2 floor area, each
with specialised workshops, staff and one
lead engineer per sector.Maintenance staff
were reorganised to strengthen technical
know-how and knowledge of the equipment
inventory, with the aim of improving the
image of the technical services department.

CMMS project The size and complexity of the inventory to
be managed, prompted the management
team to opt for a CMMS. It chose CARL
Software’s CARL Master. The objective was
to prioritise prevention of problems and
ensure the security of the facilities. The
CMMS project enables the HCL’s 17
establishments to:
Have a shared, easily accessed database
Optimise, unify and rationalise
monitoring of maintenance work
Monitor the progress of work with work
orders
Trace and manage requests for work
Improve the service provided to other
hospital departments by technicians, for
example, through information on the
status of requests (pending / in progress/
completed.

The project was organised institutionally,
with collaboration between DAT (Technical
service Division) and the DSI (Information
Systems Division). DAT took the lead in
terms of the project’s functions, the
inventory of facilities and premises, software
configuration and the adoption of the system
by the maintenance teams. The DSI was
responsible for integration with the HCL
information system and for the supply of the
computing infrastructure.

The deployment phase was the most
onerous and involved: Installation of the
computer equipment; inventory of
premises/facilities with updating and
labelling of maps; training of workshop staff;
training of senior managers (users of Quick
DI, the interface for requesting work); data
entry; and commissioning.

This phase required major on-site support
with the regular presence of a member of the
project team, especially when the preventive
workload was rising, to help avoid any
problems.

The success of the deployment was
deemed to depend on maintenance staff
using the software in their day-to-day
activities. About 120 staff were trained in the
required computing skills and the entire
maintenance team (350 people) was trained
in the software (one to two days training
according to their role).

Site workshops provided direct training
for ‘customers’, ie those making work
requests – ward managers, senior
administrators and so on. This means that in
excess of 1000 people underwent training
and, although this involved considerable
time, the project management team believed
it to be necessary in order to establish a
connection with ‘customers’, convincing
them of the benefits of making a
computerised work request.

The CMMS is centralised on a single
database to ensure uniformity of
maintenance functions. Apart from the
geographical scale of the project, the main
problems were the volume and organisation
of data.

Database details (August 2011) Geographical points: 46,972
Installation families: 38; sub-families: 309
Installation points: 24,169 with 121,508
defined characteristics
Work requests per month: about 6300 .

Work requests dealt with in less that 48h:
about 70%.

Work requests dealt with in less than 72h:
about 80%
Work requests dealt with since
commissioning: 247,792
Work tickets per month: about 9500. In
2010, 100,470 work orders were generated,
with more than 30,000 orders generated
by the technical service (generally
preventive) and not by the ‘customer’
Active preventive triggers: 8764
Active preventive plans: 446
Contracts managed: 1016
CMMS users: in excess of 450.

The technical remit covers all of the
hospital’s fixed facilities:
Electricity: A power station with five
generators, transformers, low-voltage
distribution panels, electrical cabinets,
emergency lighting, and PABXs.

HVAC/plumbing: Boiler room with three
combined gas/fuel boilers and 21 heating
and hot water production substations
(with associated sensors and pumps),
refrigeration units, air treatment units, fan
convectors, and softeners.

General maintenance: Lifts, automatic
doors, pneumatic conveying lines, main
vacuum pumps, networks of medical
gases, and compressors.

Quick Di Quick Di is implemented on each of the
sites. It simplifies work requests and permits
tracking of progress by the person making
the request. The user connects to Quick Di
using his/her usual Windows password for
starting the PC and accessing the network.

On connection, the person making the
request can see the status of requests made
over the past 30 days for his/her functional
unit (this corresponds to the department to
which the user belongs). This filter avoids
having the same request several times as the
user is able to see the requests made by his
department over the previous 30 days.

The person making the request is also able
to check on the progress made in processing
the request, a factor that the maintenance
team believes to be important in achieving
customer satisfaction.

Ongoing The CMMS is an evolving software package
and enlargement of the database at HCL is
considered essential.Work will also continue
on further ramping-up preventive
maintenance tasks, integrating maintenance
providers and establishing a stock
management module.

Results The CMMS project is considered a success at
HCL. It has played its part in the overall
reorganisation of the maintenance function
at the hospitals. Its implementation at all of
the HCL sites was carried out progressively
and had the support of the staff, who were
kept well informed about the project. Staff
involvement and the close support of the
various teams involved stemmed from a
strong desire to have in place a professional
and down-to-earth tool.

Cost savings are difficult to identify,
although there have been savings on staff
costs. The true benefit, however, comes from
the security the system provides. Since its
installation there have been no major
maintenance incidents, an enormous benefit
to the hospital and one that it is difficult to
put a price on.