Criticality Analysis Part 4: What Maintenance Teams Can Learn From Healthcare Triage
Quick Access
Criticality Analysis Part 1: Why Criticality Analysis Is the First Step Toward Maintenance Maturity
Criticality Analysis Part 2: The Criticality Dilemma – So Many Assets, So Little Time
Criticality Analysis Part 3: Beyond “Critical” – A Better Way to Classify Your Assets
Criticality Analysis Part 4: What Maintenance Teams Can Learn From Healthcare Triage
Criticality Analysis Part 5: Tiered Maintenance – Matching Tools and Talent to Asset Risk
Criticality Analysis Part 6 : From Screening to Correction – The Complete Predictive Maintenance Workflow
In Part 3, we introduced a more useful way to classify assets—one that accounts for how they impact business outcomes, not just whether they’re “critical.” But even with a smart classification system, maintenance teams still face a challenge: limited resources.
So how do you scale care across hundreds of assets without compromising reliability? It turns out, the healthcare industry has been solving this exact problem for decades—and maintenance can borrow a page from their playbook.
Handling the Criticality Dilemma: A Health-Care Example
Many assets may seem critical. Either you test only what you can or hire more people. Making a criticality list can be eye-opening, and it demonstrates how many of your assets are important. It often leads people to the following oversimplified solutions:
- You have limited resources, so you start at top of the list and maintain as much as you can — the most critical (binary, dynamic, thinned-out schedule). The downside is that you may still get overwhelmed because all the critical equipment that is not covered still fails and leads to downtime. It may feel like no return on investment for your effort, and you may return to firefighting mode.
- You scale up your resources, so you have full coverage on all your critical assets. You double your maintenance staff, send everyone to full training and certification, and buy all new tools (full coverage, all or nothing). The downside is that his is very expensive and attracts attention from management, which creates extreme pressure to deliver an immediate return on investment. Therefore, if any machines do go down, it is perceived as proof that the program isn’t solving the problem.
In the outside world, health-care workers face the same criticality dilemma. Everyone is equally important and resources are limited. Either create a cutoff and only serve the critical people, which is unacceptable, or build-up the vast resources needed to give everyone 100% care, which is unsustainable. What should teams do? They should implement a tiered approach.
Over decades of evolution, medical professionals have organized themselves into a tiered system that maximizes service levels, yet also optimizes the availability of the most specialized resources for the most specialized problems. For every specialist physician, there are many more generalist doctors. For every generalist doctor, there are many times more nurses.
Almost all patients who come into a medical facility needing “maintenance” first see a nurse. The nurse can perform a number of quick tests with basic medical tools to determine if everything is normal. If the nurse is able to diagnose and fix the problem, then the patient can receive care directly from the nurse and return home.
If the nurse finds a more severe problem or cannot diagnose the issue, then the patient is referred to a general practice doctor. The general practice doctor can perform more advanced troubleshooting with more advanced tools. If the general practice doctor is able to diagnose and fix the problem, then the patient can receive care directly from the general practice doctor and return home.
If the general practice doctor finds a more severe problem or cannot diagnose the issue, then the patient is referred to a specialist. The specialist has the most advanced knowledge and tools to diagnose and correct the patient’s problem.
This working structure ensures that scarce, specialized individuals only spend time working on the problems that require their specialized expertise. In theory, this allows every patient to receive adequate care, and it prevents the medical professionals from being overwhelmed. To accomplish this service model without unlimited resources, they have organized themselves into:
- Tiered levels of workers
- Tiered levels of training and certification
- Tiered volume of visits
Condition-based screening helps relieve the workload at each level of care.
So how can maintenance teams mirror this tiered approach? That’s exactly where we’re headed in Part 5.
Read Part 5 → Tiered Maintenance: Matching Tools and Talent to Asset Risk
Author Bio: John Bernet is a Mechanical Application and Product Specialist at Fluke Corporation. Using his 30-plus years of experience in maintenance and operation of nuclear power plants and machinery in commercial plants, John has worked with customers in all industries implementing reliability programs. He is a Certified Category II Vibration Analyst and a Certified Maintenance Reliability Professional (CMRP), with over 20 years of experience diagnosing machine faults.
