The Royal Melbourne Hospital (RMH) began in 1848 as Victoria, Australia’s first public hospital and is now one of the largest health providers in the state. RMH provides a comprehensive range of specialist medical, surgical and mental health services as well as rehabilitation, aged care, outpatient and community programs. A designated statewide provider for services such as trauma, RMH leads centers of excellence for tertiary services in several key specialties, including neurosciences, nephrology, oncology, cardiology and virtual health.
RMH serves a community of over 550,000 people based in the western and northern suburbs of Melbourne. In addition to its flagship facility, The Royal Melbourne Hospital, the health service includes two major campuses at City and Royal Park as well as an infectious disease laboratory and 12 satellite locations that provide mental health, residential care, rehabilitation and community-based services.
To maintain RMH’s extensive environment, over 600 Facilities Management (FM) employees work around the clock, providing a wide range of non-clinical services such as cleaning, waste management, ward support and patient transport, maintenance, engineering and biomedical engineering services, energy and utility management, switchboard, car parking, patient food services and hospitality catering.
Over the years, FM operated from a legacy system of pagers, messaging systems, phone calls, tickets and other paper-based tools to respond to service requests. Prior to its system transformation, there were eight different ways to call upon facilities services. However, with systems being managed from non-integrated silos, and with steadily growing workloads, RMH wanted to streamline and review its FM business processes before these systems were overwhelmed and to become more efficient and sustainable in their service delivery.
“The FM staff was increasingly presented with daily operational challenges in service delivery,” says Adriana Stormont, CAFM Project Director at RMH. “We also had a lack of qualitative data to better inform decisions. Asset data was not centralized or transparent so we couldn’t capture lifecycle costs, maintenance, warranties, contractor agreements and other important information we now needed to capture not just for best practice asset management but for also satisfying newly introduced regulatory compliances.”
To address these issues, RMH launched an independent service review, which recommended a digital task management system. “We then tested the market in an open public tender and followed a comprehensive evaluation and procurement process,” says Stormont. “Our evaluation journey included reference visits and meetings across healthcare and commercial entities locally and interstate.”
In November 2018, the RMH Board of Management approved business case funding for an integrated workplace management system (IWMS), including a mobility digital task management platform. In 2019, the organization also established a Computer Aided Facilities Management (CAFM) project team to oversee the digital implementation and change transformation. This major metropolitan health service selected the IBM® TRIRIGA® platform to become its IWMS. With a suite of analytics, critical alerts and automated process capabilities, TRIRIGA increases visibility, resource utilization, control and automation of FM needs.
For solution design and project implementation, IBM brought in IBM Business Partner TRIXi Building Insights because of its extensive experience with IBM Internet of Things (IoT) software.
The CAFM project included a review of over 100 business processes, design sessions for seven workstreams, data migration, change management, and user testing and training across multiple departments. But as the project continued—on time and on budget—into early 2020, an unexpected event would intervene and challenge RMH and FM in ways that nobody could have ever imagined.
As of mid-2023, the CAFM-TRIRIGA solution has processed more than 1.5 million tasks, including over more than half a million internal patient transfers throughout the hospital.
CAFM has replaced many paper-based processes with roughly 400 digitized tasks that employees receive via mobile devices.
In early 2020, just as RMH was getting close to launching the CAFM-TRIRIGA system, COVID-19 struck Australia, and hospitals began to prepare for a pandemic. In addition to the extraordinary demands placed on clinical staff to treat COVID-19 patients, monitor suspected COVID-19 (SCOVID) patients and maintain general acuity workload, FM staff saw its workload increase, with infectious cleaning and infectious waste alone trebling in demand compared to normal capacity.
The CAFM-TRIRIGA system was slated to become operational in late April, but the hospital decided to move up the go-live date for the Operations and Maintenance module to March 31, which would help prepare for the expected surge of COVID-19 patients. “This isn’t about waiting for the storm to pass, it’s about learning to dance in the rain,” says Stormont. “By launching CAFM as soon as we could, we would have the digital tools we needed to help meet this challenge and better support our clinical workforce.”
The CAFM-TRIRIGA system made an immediate impact in assisting with reporting on COVID-19 infectious cleaning and waste activity, including preparing the workforce to go into COVID and SCOVID wards. “When COVID-19 infection cases related to the Delta variant surged during the Australian winter of 2021, CAFM-TRIRIGA continued to be an important tool for RMH. In addition to supporting the clinical staff, CAFM-TRIRIGA enabled the tracing of facilities staff within the hospital when Tier 1 and Tier 2 exposures became identified across the health service outside of Covid wards,” says Michael McCambridge, Director of Facilities Management at RMH.
FM employees began using mobile smart devices to respond to service requests coming into TRIRIGA Request Central from clinical wards, the emergency department, allied health services and many other stakeholders. CAFM-TRIRIGA enables tasks and jobs to be viewed in real time via smart devices and dashboards used and actively monitored by each department.
Multiple areas of the health service have traditionally lacked transparency, visibility and accountability because of its multiple manual, labor-intensive or paper-based processes. The stakeholder base continues to grow across the health service as it digitizes task management with CAFM-TRIRIGA, including scheduled and reactive tasks that now encompass clinical areas. The responding workgroups now include such diverse stakeholders as cleaners, biomedical engineers, clinical assistants and radiographers.
By July 2021, just over a year since system go-live, more than 500,000 service requests had been submitted through the CAFM-TRIRIGA information management system. Roughly two years later, the system has processed more than 1.5 million tasks, including over more than half a million internal patient transfers throughout the hospital. Today, the utilization of the IBM TRIRIGA solution continues to grow, with plans for Asset Management, Project Management, Space and Real Estate consolidation, Energy and Utility Management, and an IoT pilot project.
According to Stormont, the hospital’s FM area has now digitized over 600 service requests across the task management platform, ranging from ward cleans, patient transfers, delivery and collections for pathology and pharmaceuticals, reactive and scheduled maintenance, medical device repairs, and assistance with trauma and helipad retrieval, just to name a few. “The CAFM-TRIRIGA service request portal is accessible by all our 12,000 staff members across all our satellite locations,” she says.
Post-implementation, the FM staff has seen the following performance activity improvements:
- Reduction of duplication and waste. Relying on pagers for task dispatch has in the past not provided clear accountability of job ownership, and as a result, duplicate resources often responding to jobs. FM now has clear accountability of tasks and can better equip staff on procedures and requirements when attending jobs.
- Replacement of multiple paper-based processes. Multiple paper-based processes have been replaced with 100 business processes digitized to a system process. An example of this includes paper-based Cleaning Schedules and checklists, now accounted for with a system and devices. Engineering job tickets are no longer printed and physically collected by trades via the Engineering help desk. This contributed to 34% reduction in paper consumption, printing and paging costs.
- Enhanced workforce utilization through improved service response times. Activity data now demonstrates FM’s ability to shift resources and allocate based on customer demand and priority. An example of this was the heightened cleaning activity during the COVID-19 pandemic, where resources needed to be reallocated in response to demand. RMH’s service response to discharge cleans has witnessed an 85% improvement in response time. Service response times to facilitate patient transfers from wards to the Transit Lounge were also reduced by 84%.
- Visibility on outstanding work for next shift handover. Daily schedules can now inform staff in real time of the status and number of patient rooms and en-suite cleans completed. This transparency informs shift handover.
- Customer transparency on job status. Wards logging jobs can now see a dashboard of all FM jobs submitted regardless of type. Dashboards enable communication on job status and for the requester to communicate directly with the responding technician if required.
- Asset management. For the first time, RMH can now begin to develop the integrity of its asset data in CAFM-TRIRIGA. It will be better informed on asset locational information, maintenance activity and costs, asset risk profile, criticality, condition assessment and overall asset performance. Additional configuration and reporting developed by TRIXi will improve RMH decision-making processes on asset investment and asset replacement forecasting.
- Improved reporting capabilities. FM now has an e-tool to enable reporting on activity. TRIRIGA, as an integrated workplace management system, now drives many workflows and captures data, tasks, assets, CAD locations, aggregates and emerging trends. This reporting will better inform decision-making processes on resources, investment, procurement, customer demand and satisfaction
- Reduced carbon footprint. FM has identified that by optimizingFM’s paper-based processes, there has already been 110 kg of CO2 emissions eliminated from the hospital’s operations.
By using CAFM-TRIRGA, the FM team responds to service requests more efficiently because the system enables transparent communication through the task back to the requester, whether the status is “holding for parts” or, if a room is unavailable for medical reasons, “job on hold.” “We now have that transparency to quickly respond and reallocate our resources based on demand like never before,” says Stormont.
RMH will continue to grow and develop the CAFM-TRIRIGA roadmap with other key stakeholders and functionality modules to support clinical throughput, including energy management, asset and space management. The hospital will also maximize the IoT platform for connecting automation to deliver improved data and analytics on the performance of their assets with sensor technology. “The software replaced a number of siloed systems and it continues to be the catalyst for our business process reforms,” says Stormont. “Later this year in 2023 and currently in project development, we will see the CAFM-TRIRIGA integration with the hospital electronic medical record and inclusion in the new Hospital Command Centre, to gain even further process efficiencies specific to clinical throughput.
“We are very excited that this tool enables us to work smarter, become more innovative and sustainable, but more importantly, better support our clinical partners delivering on improved outcomes for our patient community.”
From the beginning, the IBM TRIRIGA solution was deployed as a managed service from an IBM data center. The IBM Cloud® Delivery Services team provides application support and actively monitors and manages the solution.
“The world is changing and the way people are working is changing. Managers need to be aware of how they drive that change within their organization,” says Mark Williams, Managing Director and Founder of TRIXi. “Having a solution like IBM TRIRIGA has obviously delivered great benefits for RMH. “By digitizing the way people work, we can really make some positive changes, even during challenging times.”
With its beginnings at RMH in 1848 as Victoria’s first public hospital, it is now one of Australia’s leading public healthcare providers. The organization delivers a comprehensive range of healthcare services, including specialist medical, surgical and mental health services as well as rehabilitation, aged care, outpatient and community programs. RMH has staff in excess of 12,000 employees and serves both a local community and broader statewide population for specialist services. Locally, the organization serves a community of over 550,000 based in the western and northern suburbs of Melbourne and this extends to patients residing in regional communities requiring specialist care. This community is diverse in terms of culture, language, age, ethnicity and socioeconomic status.
Based in St. Leonards, New South Wales, TRIXi (link resides outside of ibm.com) works with building managers, developers, designers and lease accountants to improve facilities management, achieve the most efficient utilization of building assets and to be more sustainable. The firm specializes in the design and integration of IoT systems to increase visibility, control and automation of real estate management.
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