Sommaire
In a healthcare facility, a ventilator, a defibrillator or an ultrasound machine do not expose operations to the same consequences if they fail. Assessing the criticality of assets helps prioritize risks and focus the maintenance interventions for biomedical devices where unavailability would have the greatest impact on care.
Key takeaways
- The criticality of a biomedical asset does not depend solely on its type or value: it should be assessed according to the consequences of its failure on the patient, on care delivery and on operational continuity.
- A criticality matrix must remain simple and adapted to the field: failure impact, possibility of substitution, level of use and observed reliability are four relevant criteria to rank assets.
- Criticality should not remain fixed: failure history, MTBF, MTTR and downtime durations help confront the theoretical ranking with the asset’s real behaviour.
- The CMMS provides the data needed to objectify and update this analysis: intervention history, recurring faults, downtime and reliability indicators support biomedical teams’ decisions.
1. How to assess the criticality of a biomedical asset?
Criticality should not be a simple “low, medium or high” label attached to an asset. Criticality analysis is part of a risk analysis process. Even before calculating a score, you must identify the possible consequences of a failure and their impact on operations.
Four dimensions can guide the assessment.
1. What would be the impact of an asset failure on the patient and on care?
Could the failure interrupt monitoring, delay a diagnosis or prevent a treatment? Could it affect patient safety or continuity of care? This involves assessing the clinical consequences of a failure.
2. Can operations continue?
Can another device immediately take over? Is there an alternative procedure? Can the activity be transferred or postponed without major consequences?
Redundancy in the asset pool strongly changes the analysis. An unavailability without a substitution option does not have the same impact as a failure that can be absorbed by multiple equivalent assets.
3. How heavily is the asset used?
A device used occasionally does not face the same exposure as one used daily by several departments.
4. What does its history tell us?
- How many failures has it had? Are they isolated or recurring?
- Are repairs becoming more frequent?
- Are downtime durations increasing?
Takeaway: criticality depends on the asset’s use, the consequences of its unavailability and its observed reliability.
2. Building a practical criticality matrix
An analysis can quickly become complex: clinical function, usage, safety, redundancy, history, age, cost, maintainability… Adding more criteria does not necessarily improve decision-making.
A matrix must above all remain understandable and usable by the professionals who know the asset base.
A first grid can, for example, rely on four dimensions:
|
Criterion |
Low |
Intermediate |
High |
|
Impact of a failure |
Limited effect |
Activity disrupted |
Patient risk or major impact on care |
|
Substitutability |
Immediate |
Limited |
None |
|
Usage |
Occasional |
Regular |
Intensive |
|
Observed reliability |
Stable |
Occasional incidents |
Recurring failures |
The criteria, thresholds and any weighting must be adapted to each facility’s assets, uses and organisation.
Beware the average-score trap! Suppose a device presents a significant risk to the patient but scores low on the other three criteria. A simple average could artificially lower its criticality.
Some situations may therefore require an escalation rule instead of a mathematical compensation between all criteria.
Before rolling out the method across the entire asset base, it is better to test it on a few different profiles: ventilator, defibrillator, syringe pump, ultrasound, analyser…
If the resulting ranking seems inconsistent to those who work daily with these assets, the criteria or their weighting probably need to be reviewed.
3. The CMMS to centralize, organize and manage maintenance
The criticality assessment must remain a living dataset, and the CMMS provides a factual basis for analysis: completed interventions, recurring failures, downtime or reliability indicators (MTTR, MTBF) can be compared with the level of criticality.
In healthcare facilities, the CMMS also centralizes the inventory of assets, tracks interventions and preventive maintenance of biomedical assets, preserves their history and organises the technical teams’ activities.
The importance given to history appears in several DimoMaint case studies.
At Cap Santé, the biomedical department started its project by compiling an inventory including location, interventions, dates, documents and costs. Étienne Drufin, then biomedical manager, emphasises the value of having information that allows one to react to recurring failures and to monitor their evolution.
At the Thiers-Ambert Hospital Centre, Christophe Crespo, technical director, describes the intervention history as a true “health record” for the asset. Information on failures and repairs thus remains accessible to the professionals who intervene later.
The tool supports decision-making; the expertise of biomedical teams remains crucial to interpret the data and adjust priorities
→ Discover DimoMaint CMMS software dedicated to healthcare facilities
When the same asset repeatedly returns to the top priorities despite repairs, other parameters can be examined: age, parts availability, maintenance costs, downtime or obsolescence. The question then becomes: should maintenance still be adapted or should replacement be considered?
The level assigned to an asset should not remain fixed throughout its lifecycle. A change in its use or operating conditions, the loss of a backup device or a deterioration in reliability can change the real risk.
A good criticality matrix must be understood by biomedical teams and confronted with their experience and field data.
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