Analyzing Past, Present, and Expected Operations: Trends, Forecasts, Development Opportunities
Unit 1: Financial Management. Lesson 6 of 60 in CHTM Academy.
Your director asks a question with no obvious answer: where is this department going, and what should we be doing differently next year? Nothing in the CMMS answers that directly. What answers it is an analysis you build yourself from the data you already own, and the manager who brings one has set the agenda before anyone else has spoken.
Three tenses, one method
Look at the past to find what actually happened, the present to find what is happening now, and the expected to state where today's trend lands. The raw material is already in your records: service history by asset and model, labor hours, parts and contract spend, work order volume, completion rates, downtime, and the inventory with its ages and support dates.
What the analysis is looking for
Two groups of findings come out of it. Development opportunities are the things worth doing: contracts to insource, devices to standardize, training that pays back. Areas needing improvement are the things going wrong, and the usual three are repeat repairs, overdue preventive maintenance, and overtime.
Signal in the data Development opportunity it points to
one vendor contract far above the insource the work, or renegotiate with the
department's cost of service ratio department's own cost data in hand
six models doing one clinical job standardize at the next replacement cycle
a model your staff cannot open negotiate training and manuals, or change
the service strategy on that model
Signal in the data Area needing improvement
the same asset repaired three times a bad device, a bad part, or a training gap
in thirty days in the shop
overdue scheduled maintenance rising workload, staffing, or a scheduling plan that
never matched the inventory
sustained overtime a staffing request waiting to be written
use error climbing on one unit operator training on every shift, not a repairTrend analysis and simple forecasting
A trend needs at least three comparable periods and a constant definition. Count the same thing the same way each month, or you will report a definition change as an improvement. To forecast, take the run rate from the periods you have, project it forward, then adjust for what you know: a contract escalation, a vacancy, equipment arriving, an irregular part due on its interval. Say which assumptions you used. A forecast whose assumptions are visible can be argued with, and that is what makes it useful.
Benchmarking, carefully
Comparing against similar departments is informative and easy to misuse. Cost of service ratio compares reasonably well because it is a ratio of two numbers both hospitals have. Devices per technician and labor hours per device compare badly, because every hospital counts its inventory differently, carries a different contract mix, and supports a different number of sites. Use an outside benchmark to raise a question, then answer the question with your own drill-down by department, modality, equipment type, and manufacturer. Your own history over three years is the most honest benchmark you have.
Presenting it to leadership
Leadership reads cost, risk, and capacity. One page: the number, the trend, the cause, the recommendation, and what you need from them. Put the ratio and the dollar figure in the first two lines, name the clinical consequence, and attach the detail behind the summary rather than in front of it. Bring the same metrics every time so the comparison is the message, and never present an analysis without a recommendation attached.
Analyzing Past, Present, and Expected Operations: Trends, Forecasts, Development Opportunities, explained slowly
Turning one year of CMMS data into three recommendations
A department pulls twelve months of its own records and lays them out by modality. Nothing here came from outside the hospital.
Modality Assets Orig cost Contract In-house Annual COSR Repeat
parts service repairs
Infusion pumps 410 1,640,000 0 38,000 38,000 2.3% 11
Physio monitors 260 2,080,000 0 61,000 61,000 2.9% 8
Ventilators 64 1,920,000 96,000 18,000 114,000 5.9% 3
Imaging, vendor A 9 3,400,000 310,000 12,000 322,000 9.5% 2
Imaging, vendor B 6 2,100,000 378,000 4,000 382,000 18.2% 1
Lab analyzers 22 1,480,000 214,000 9,000 223,000 15.1% 6
Sterilizers 14 560,000 61,000 26,000 87,000 15.5% 14What the table says
Observation Recommendation it supports
Vendor B imaging runs at 18.2% against review the contract at renewal with
vendor A's 9.5% on comparable equipment this comparison, or price a first-
look arrangement on the easy calls
Sterilizers carry 14 repeat repairs on investigate before spending: one
only 14 assets model, one technician, or a water
quality problem upstream
Pumps and monitors run near 2 to 3% leave them alone; this is what
in-house service at volume looks
like, and it is the benchmark you
use on everything elseNotice what the analysis did not do. It did not recommend insourcing vendor B's imaging, because the table does not say whether parts, training, or service software can be bought at all. The honest output of an analysis is sometimes a question with a date on it rather than a conclusion.
Trending the same number across three years
Metric Year 1 Year 2 Year 3 Reading Scheduled maintenance 94.1% 95.6% 96.2% holding, slight gain completion Open work orders at month end 112 141 188 deteriorating steadily Average total time to repair 2.8 d 3.4 d 4.6 d deteriorating Overtime hours 640 890 1,310 deteriorating Assets supported 1,480 1,660 1,910 up 29% in two years Technicians 6 6 6 flat Assets per technician 247 277 318 the cause
Three deteriorating metrics and one flat one make a single argument, and it is stronger than any one of them alone. Completion rate held only because overtime doubled, which means the department is buying its compliance at a premium rate. That is a staffing request that writes itself, and it is far more persuasive than a request that opens with "we are busy".
Forecasting with the assumptions visible
Assumption Effect on next year
Two imaging systems arrive in month 4 +180 scheduled hours, +1 contract
A contract renews with a 5% escalation +$18,900 purchased maintenance
One technician retires in month 7 -1,040 productive hours unless
backfilled
Pump fleet grows by 60 units +90 scheduled hours
No change to staffing assets per technician reaches 329Every line is a number somebody can argue with, which is exactly what makes the forecast credible. A forecast with hidden assumptions invites the reader to reject the whole thing.
Benchmarking: what compares and what does not
Measure Compares across hospitals Why
Cost of service ratio reasonably well both numbers exist
everywhere and the ratio
cancels hospital size
Repeat repair rate reasonably well a ratio of the department's
own work to itself
Assets per technician badly every hospital counts its
inventory differently
Labor hours per device badly contract mix and site count
change it completely
Your own three-year the most honest comparison the definitions are yours
trend you have and they did not changeWhat to memorize
Inputs service history, cost, workload, inventory age and support
Past what happened; Present: what is happening; Expected: where
the trend lands
Trend at least three comparable periods, one constant definition
Forecast run rate projected forward, then adjusted, assumptions named
Benchmark ratios compare; counts do not
Output one page: number, trend, cause, recommendation, the ask