A Multicriteria Model for Optimization of Maintenance in Thermal Energy Production Systems in Hospitals: A Case Study in a Spanish Hospital

Abstract

Health Care Organizations are large consumers of energy resources. This is due to the large number of services they must offer continuously, the strict requirements of temperature and humidity for patients and comfort for all visitors. Facilities for thermal energy production are critical as they guarantee the proper working of care services by producing primary air, eliminating legionella, and providing air conditioning to theatres, emergency areas, ICUs, neonatology departments, etc. Nonetheless, despite the importance of thermal energy production systems, there is no prior literature analysing the best maintenance to be applied to these systems. This study describes an innovative multicriteria model designed with the Measuring Attractiveness by a Categorical Based Evaluation Technique (MACBETH) approach and Markov chains, in choosing the best combination of maintenance policies to guarantee the best quality of care. The model was created with the co-operation of a decision group made up of those in charge of different areas of a Health Care Organization. This gives the current availability of the thermal energy production systems, and the availability that would be achieved by applying other alternatives. In the system that produces hot water for the air conditioning units, the best alternative is found to be corrective and preventive maintenance. In the cold-water production system for air conditioning, the model recommends the use of corrective, preventive and predictive maintenance, monitored by vibration analysis. For the systems producing hot domestic water and hot and cold water for other systems, corrective and preventive maintenance is recommended. In the legionella treatment system, it is best to apply corrective, preventive and periodic predictive maintenance (quarterly by combustion analysis). Finally, the implications for quality of care of changing the maintenance alternatives are considered. This research was carried out on thermal energy production systems currently operational in the University General Hospital of Ciudad Real (Spain). The methodology used in this study, together with the criteria, descriptors, weightings, etc., may serve as a standard for other Health Care Organizations, with the final goal of improving quality of care.

Multicriteria decision analysis (MCDA) in health care: a systematic review of the main characteristics and methodological steps

“…Decision makers - They presented the alternatives and parameters needed to structure the decision problem [ 21 , 28 ];…”

“…2 b , we have a small dominance, since we have Canada [ 25 , 29 , 38 – 41 ]. Turkey [ 8 , 31 , 42 – 45 ] and USA [ 33 , 46 – 50 ] with six publications each, followed by China [ 10 , 51 – 54 ] and the Netherlands [ 21 , 55 – 58 ] with five publications each, and Spain [ 28 , 30 , 59 , 60 ] with four publications, with six countries accounting for 48% (thirty-two studies) of all publications by all thirty-three study countries.…”

“…Eng. China Others Ranking Group discussion and decision-makers Literature and specialists IVIF-COPRAS Carnero and Gómez [ 28 ] Sustain. Spain Resources Choice Literature Group discussion MACBETH Hancerliogullari et al [ 86 ] BMC Med.…”

Asymmetries in the Maintenance Performance of Spanish Industries before and after the Recession

“…Table 2 shows the descriptors and measurement levels used in the criterion C 4 Characteristics of the head of maintenance and maintenance tasks carried out outside working hours. …”

“…Maintenance is attaining a more important role in organisations because it can affect productivity and profitability [1][2][3], the useful lifespan of the facilities, the quality of the processes [4] and the fulfilment of safety and environmental standards. This has brought about increasing concern over the performance maintenance measurement [5], as shown by the abundant literature that analyses the matter (see [6][7][8][9][10][11][12][13][14][15][16][17]).…”