Encompassing 40 acres and 55 buildings built from 1920 to 2006, the University of Kansas Medical Center in Kansas City, Kansas, devotes one-quarter of its 2.9 million sf to research space. The medical center’s Facilities Management Department employs 79 full-time maintenance workers, a staffing level equivalent to a domain of 36,000 sf per employee. Remodeling of existing buildings on campus is executed by a $2.5-million, fee-for-service construction company with 35 employees and managed by a 10-person design and planning office.

“There’s quite a bit to do,” says Don Rau, director of facilities management for the University of Kansas Medical Center (KUMC), “and we are always asked to do more for less. There’s never enough money, so you have to get creative.”

Complete dismantlement of the trades-based “stovepipe” management structure that had been in place at the University for more than four decades resulted in significant progress on serious problems the department faced in a number of areas—problems that are especially pressing in today’s research environments.

“Legacy facility operations and maintenance organizations are particularly badly suited for the sophisticated and new high-technology buildings that are being built today,” says Rau.

Budget Pressure

“We completed a new 200,000-sf research building in January 2007, and the maintenance budget for this building is 75 cents a square foot,” Rau says. “For the rest of the campus, the rate is $3.85 a square foot. Granted, it’s a new building, but you’re never going to stay ahead of the game if you start with a shortfall like that.”

According to a recent study of the Kansas Board of Regents’ university system conducted by the state of Kansas, such maintenance shortfalls over the years have resulted in a “deferred maintenance” figure for the KUMC campus of $72 million—which means there are $72 million worth of problems waiting to be dealt with.

“I have pipes that are held together not quite with duct tape, but almost,” says Rau.

One solution was energy performance contracting, for which the state legislature finally passed legislation. The medical center then funded a $12 million project in 2002.

“Ten million of those dollars went to energy upgrades,” says Rau. “We were also able to replace a 30-year-old, obsolete electrical entry switch to a state-of-the-art electronic switch and significantly increase the reliability of our campus electrical distribution system.”

Another solution has been to educate medical center leadership about the importance of funding maintenance.

“We were able to convince our campus leadership that significantly increasing our annual investment for infrastructure repairs could prevent catastrophic emergencies requiring significant repair costs,” he says. “For example, on Father’s Day weekend 2004, an abandoned water line burst at 3 a.m. on the top floor of the KUMC administration building. The entire 50,000-sf building required renovation at a cost of $750,000. Later that year the entire building was re-plumbed removing all of the 1920 vintage plumbing for $80,000.”

This educating of the medical center’s leadership has in turn facilitated a statewide effort to reduce deferred-maintenance levels. This past legislative year, the state provided the medical center $11 million to apply toward deferred maintenance.

Advancing Technology

Low-voltage direct digital controls are ubiquitous in modern building systems. When these controls needed repair, the medical center’s job classification system prevented KUMC maintenance workers from stepping out of their defined roles and fixing these systems—and there wasn’t enough money in the budget to pay system vendors to do the work.

“I created a new position through the IT department called network specialist, paid for six power plant employees to go through the vendor’s training, and promoted them when they passed,” says Rau. “In these new ‘unclassified’ positions, they received a 43 percent pay increase, and a lot more upward mobility than they would with the three percent yearly increase in a classified position. This improved morale significantly. This year, I’m going address a similar problem with my building automation technicians.”

Staffing

The maintenance workers are largely baby boomers, with an average age of 51, which means Rau is constantly on the lookout for new workers to replace those who are retiring. However, because the pay scale in place at state schools is lower than the going rate in urban markets such as Kansas City, hiring is difficult.

“I can’t pay them enough, and we can’t get the legislature to give us a market-based adjustment,” he says.

A creative solution allows Rau both to hire fewer new workers and to pay them more.

“I got the idea from listening to the guys talking in the hallway or the cafeteria about their plans for the weekend,” Rau says. “The plumber would be taking Friday off to go pour a driveway at someone’s house, or the building automation guy would be gutting and rebuilding an apartment and doing all the plumbing, electrical, and drywall himself.

“I realized that if I could find a way to let them be both a plumber and an electrician, for example, I might not have to hire more electricians.”

Rau worked with human resources to create a position called General Maintenance and Repair Technician III for workers who had a second license or a minimum of three years’ experience doing a different job.

The results have been great.

“In one year, 39 of the 81 maintenance employees went into this new classification, and I was able to double the amount of work they were able to do. I could send an electrician to go fix a leaking toilet, and I didn’t have to wait for the plumber to be free.”

The department’s stagnant organizational structure was also completely dismantled.

“The director of maintenance had 17 direct reports who had all been there for many, many years,” says Rau. “The supervisors’ friends would get the good jobs, and everyone else would get the dirty jobs. If the supervisor’s friend was assigned a dirty job, he might go in and patch it and not really fix it. Then it would break again and they’d give it to someone else. As a result, we had a lot of repeat maintenance issues and disgruntled employees”

Instead of having workers serve the entire campus from a single office space, Rau divided the campus into four zones, and put one maintenance office in each zone with two plumbers, two electricians, two HVAC techs, four general maintenance staff, a supervisor, and a manager. Each office had its own buildings to take care of.

The decentralization broke up long-standing cliques, increased accountability to customers, and created peer pressure to get jobs done right the first time.

“When an electrician goes out on a trouble call and he doesn’t fix it, either he’s going to get called back to fix it or his buddy’s going to—and his buddy’s going to say, why didn’t you fix it right the first time?”

Performance Metrics: Before and After

In addition to qualitative improvements in worker attitudes and accountability, productivity has improved markedly in the four years after the reorganization. Preventative maintenance work orders have increased 45 percent, and repair work orders have correspondingly declined.

“The cost of a preventative maintenance visit to a piece of equipment is about one-third of the cost of making a repair on a repair work order,” says Rau.

Repair work orders increased 59 percent over two years, and emergency work orders have decreased from 900 per year to around 625, a 27 percent decrease.

“I think as we continue to increase our preventative maintenance work orders, our emergency work orders will also go down,” he says.

Surveys have also revealed steady gains in customer satisfaction.

Current Challenges

The University will continue to push the legislature for increased maintenance funding. The ultimate goal is to achieve the funding level recommended by the NIH, which is currently $4.84 per sf. (KUMC currently receives $3.85 per sf for maintenance.)

The push for more money to attack the deferred-maintenance problem will also continue.

“Although the state has come up with $11 million to apply toward deferred maintenance in the past legislative year, by the time this money is spent, the $72-million deferred maintenance figure will rise to $77 million due to continuing budget shortfalls and inflation,” says Rau.

Other plans for improving productivity include the completion of bar-coding all equipment, and purchasing handheld wireless devices that will enable workers to download work orders and take them along to work sites, reducing the need to travel back to the office between jobs.

Elements of Future Success

Changing processes and purchasing new systems are very helpful, but their successful implementation requires excellent management and leadership skills from the team. Customer and employee focused managers and supervisors provide stability, efficiency, and effectiveness. They can listen to customer and employee issues and provide reasonable solutions. The higher-level leadership can focus on departmental improvements while managers focus on day-to-day operational issues.

“The most important part of my job is to make sure my employees are happy, that they’re productive, that they like their job, and desire to remain significant contributors to the success of the medical center,” says Rau. “If we can ensure employee satisfaction and implement needed changes, we’ll be able to meet the goals of the University and of our customers: the researchers, patients, faculty, and administration.”

By Deborah Kreuze

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