Whittington hospital occupies a site on the lower slopes of London's Highgate Hill. It's a large site, there are 2000 people occupying a half million plus square feet of working space distributed among 30 buildings. The Whittington's facilities directorate decided on ARCHIBUS to manage its facilities.
The decision to deploy ARCHIBUS, says Jerry, goes back two or three years to when the National Health Service had stripped out a layer of management. That had been advantageous in terms of saving salary costs but it meant that there was a pressing need for an information system to fill the gap, especially when, with the reorganisation, came a requirement for better information on NHS assets and a whole range of reports on the current state of things. As it was, Jerry was unable to make a proper estimate of the Trust's assets because there was no standardisation of information and no help desk for the users of the hospital's assets. The hospital had used the NHS system WIMS, which some hospitals are still using. But it was quite old, slow, not very responsive and monitored only a limited number of elements. What Jerry wanted, in addition to his immediate needs, was the ability to carry out space allocation and planning as well as to establish and monitor occupancy levels. Space data would be shared with occupants and the help desk would operate across the hospital.
The only system
There, waiting in the wings, was the answer, ARCHIBUS. It was not only the leading system, it was, Jerry says, just about the only working system available at the time. It provided an integrated environment where database information, CAD plans, photographs, documents, images and other information were all used together and it had plug-in modules, which tailored the system to user's specific needs.
In setting up ARCHIBUS, one of the first things Jerry had to do was an estate survey and audit. Luckily, the hospital had started on a £25 million redevelopment programme which also involved reducing the floor area. An essential preliminary for this was a major detailed survey of the hospital trust's buildings and its site. This was exactly what Jerry also needed to do in order to establish the basic database. There would be no point in counting rubber band boxes if there were no way of telling where they were stored - although ARCHIBUS can start its information management from any direction. Jerry was able to piggyback his survey on the Trust's redevelopment survey but he really recommends that other users find the budget for a measured survey before they start. As systems administrator, Ray Lincoln, says 'The whole point is that if you are using the Space Management application in ARCHIBUS you have to have the physical data and it's essential if you are charging for space.' Although they didn't use it, ARCHIBUS offers a cabling audit module, Telecommunications & Cable Management. As Jerry points out, setting up such information is a horrendous task. He says, 'It's OK for a new building because you have the mechanical and electrical engineers' CAD drawings. In fact at the Whittington, although we haven't done it for existing buildings, we have done a pipes and cables audit for the whole site because we needed to know what was under the ground for the redevelopment programme.' In addition Ray already had the hospital's asset register on a big Excel spreadsheet which Excitech helped import directly into ARCHIBUS.
ARCHIBUS's modular approach allowed users to select the elements they need. Jerry and Ray chose Space Management, Building Operations Management, Real Property & Lease Management and Help Desk & More(an ARCHIBUS Developer Network product). He says 18 months later, his most pleasant surprises have been about ARCHIBUS's flexibility and the rich variety of standard reports.'
This is an ARCHIBUS application which monitors the floor space of users' estates, the way it's used, the cost of using it, who should be charged for it and how. Facilities data, business graphics, images and CAD drawings are all integrated. Its bias is to commercial property management but the NHS is looking more and more to a business model in which assets have to be managed, if not profitably then at least economically and efficiently. Such business-style reporting as space utilisation costs and efficiency, tenant and employee occupancy plans and the like are directly relevant to the Whittington or indeed any large institution. As Jerry explains, 'We now have to deal with budgetary hierarchies, setting up notional recharging components and backcharging activities.' The facilities manager of a single-building company might use this module to re-allocate finite space or work out the pros and cons of letting some of the building's space. With such an extensive operation as the Whittington's 30 buildings and the extra complications of imminent refurbishment and rebuilding it is a matter of maximising resources and, should an ARCHIBUS analysis turn out that way, of maybe spending budget on re-organising existing space instead of new building. Space Management is not simply a cost analysis application because its inventory can easily track employees by building, by physical location in a room and as individuals with details of such things as organisational functions, personal profiles, employment contracts and the like. Jerry and Ray reckon that they had mastered the Space Management application within six months, Building Operations Management has taken twice that time and Help Desk & More is still unfolding its riches.
Building Operations Management
This application is a computerised maintenance management system (CMMS) for managing planned preventative maintenance (PPM). Hitherto conventional wisdom has claimed virtue for this kind of planned proactive maintenance, getting in first before things break down even if the outlay is high. It makes sense in nuclear power stations but not necessarily economic sense in all facilities management. Ray says 'We use both the PPM and on-demand approaches. You would use PPM for routine maintenance tasks like cutting the grass every fortnight and clearing the drains more regularly in autumn but equipment is more reliable these days. You wouldn't strip down a motor and renew the bearings just because it was on the PPM action sheet. You would do it because it needed to be done. We have a programme of fitting operational monitors on all our equipment, there's around 3000 installed at the moment, reporting every 15 seconds and although they are not yet integrated with ARCHIBUS they almost certainly will be.' Because of this Jerry and Ray have started moving over to an on-demand (and eventually monitor-called) maintenance approach. This change has been the result of analysing equipment performance reports and taking into account the effect of new health and safety legislation. With ARCHIBUS, Jerry says, 'We now have the possibility of monitoring the performance of all our equipment.'
Help Desk and More
This is a special module for ARCHIBUS from iiS Ltd. which uses all the same data and allows Jerry to generate work orders, room bookings, visitor bookings, warnings about overdue jobs and resource recording. Work orders could be generated as the result of the Building Operation Management system but Way uses Help Desk & More as the conduit for trouble calls. The caller uses drop-down menus to enter such details as location and the nature of the problem. Once the work needed has been set, Help Desk emails the appropriate work team with the details. The work is monitored and user satisfaction may be recorded. There are audit trails for internal records and to ensure that the work has actually been carried out but Help Desk and More is more than operating maintenance and trouble calls. It can be used for such complex purchase procedures as ones involving calling tenders and it has modules for booking rooms and managing visitors including producing instantly printed passes. Where these things can take hours and days to process manually, Help Desk & More uses email to transfer requests, orders and responses instantly.
ARCHIBUS is an immensely powerful program. Its asset management and bar coding facility allows users to list every single thing they own or manage, from buildings all the way down to boxes of rubber bands, that also includes people. You can digitally photograph and bar code them (or not), put them in the database and periodically run audits to find out whether they are still there, if they have moved location or have been used up or been lost and in the case of buildings, been demolished and replaced. In reality you would probably not have to wait for an audit to have noted that something quite as obvious as demolition had happened.
There are of course limits. As Jerry Way points out reasonably, there is a cut-off point where it becomes cost ineffective to list every single thing and at the Whittington, he says, 'We had a lot of debate about how far we went. You have to balance costs of keeping the information up with the value of the information. We decided to go down to the scale of rooms and non-clinical appliances.' That's the current position but it may well be that in the future the use of bar code reading by hand-held devices may make it economically feasible to go down to a finer grain of detail. ARCHIBUS can do it, no sweat. The issue is whether the Whittington decides it really needs that degree of control.
Getting new kinds of reports from ARCHIBUS doesn't necessarily sound exciting but Jerry says that some very interesting figures have been coming out. For example there are those to do with relative functions in the hospital. 'When you look at the space ratios of administration, patients, storage and empty space, even without much analysis you see that a large proportion is taken up by storage space. Looking at primary circulation spaces which include waiting areas, if we could improve the efficiency of appointment-keeping we could reduce the size of waiting areas.' In all the well-founded complaints about NHS waiting lists, it's rarely reported that throughout the NHS patients themselves are quite bad at keeping appointments. ARCHIBUS could cope with appointment management but there are political demarcations in clinical and non-clinical areas of responsibility and although visitor management is part of Jerry's responsibility, which is managed by Help Desk & More, patient management is not.
ARCHIBUS is capable of opening up management procedures to everybody. Says Jerry, 'We encourage managers to produce statistics and we expect people to integrate with the system themselves. I believe we should make all information available to everybody so that people can even make their own room bookings and do their own planning. At the moment this kind of activity resides with the facilities directorate but we feel it really should be available to everyone.' He also points out that with ARCHIBUS and the currently developing wireless technology the facilities manager should be able to manage the whole hospital from his home or his car.
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