Development of a maintenance management framework to facilitate the delivery of healthcare provisions in the Kingdom of Saudia Arabia

The recent economic crisis has prompted many organizations to review their maintenance operations with the main objective of controlling costs while trying to maintain a similar level of services and quality. The healthcare industry in Saudi Arabia faced a similar set of problems as the main sponsor (i.e. the Government) received lower revenues from oil export. As intimated by Saudi government officials, the current growth rate in healthcare expenditure is unsustainable in the longer term and efforts are being made to manage resources more efficiently. One area under consideration is the maintenance functions of Saudi hospitals and clinics, as these operations accounted for the bulk of the maintenancerelated expenditure. As the largest strategic hospital in the Kingdom, the Riyadh Military Hospital (RMH) has a long term plan to improve the quality and reliability of its services, through better utilization of resources. The present project forms part of the on-going strategic review of the hospital’s current maintenance operations including outsourcing and subsequent management of contractors and suppliers. A key challenge is to understand how maintenance activities could be managed more successfully and implemented in a cost-effective way. Two sets of questionnaires were designed and distributed to the staff including contractors in the Maintenance Department. The questionnaire surveys were supplemented by interviews to assess the managers’ awareness/understanding of the importance of leadership, change management, transparency, documentation, communication and clarity of strategy. By means of statistical analysis, the data/information thus gathered was analyzed using a range of quality and reliability tools and techniques. A number of correlations have been identified which confirmed the observations of previous studies. For example, there appeared to be a significant correlation between "the clarity of strategy" and "consistency of maintenance performance", and between "a happy worker" and "the clarity of instructions" and "availability of appropriate tools". Five main parameters have been identified as critical to the success of the maintenance operations at RMH: clarity of policies and procedures; support of senior management; organizational structure; employee qualifications (i.e. technical knowledge and skills); and clarity of maintenance contracts (including communications with external contractors). Informed by the work of others for the engineering and related industries, a maintenance management framework has been proposed for the healthcare industry in Saudi Arabia. Part of the framework has been implemented at the case study hospital to facilitate validation. It was found that the framework provides a useful means for integrating various maintenance-related activities and to allow guidelines to be provided on the monitoring and control of the processes. This in turn enabled a substantial revision to be made to the current maintenance procedures at the hospital. The effectiveness of the revised maintenance procedures has been investigated using limited field studies. It is pleasing to note that encouraging results have been obtained. For example, the total number of dockets (i.e. maintenance work orders) issued for general maintenance over a 4-month period fell by 23% when compared with the figure for the previous year. The present study has made a significant contribution in the development of a maintenance management framework for the healthcare industry in the Kingdom of Saudi Arabia