Sask. health authority not efficiently maintaining Saskatoon-area facilities, says auditor's report
Health authority operates more than 50 facilities in Saskatoon area
The Saskatchewan Health Authority (SHA) is not properly maintaining many of its health care facilities, according to the latest report from the provincial auditor.
The report, released on Thursday, outlines concerns and recommendations around improving maintenance for more than 50 health care facilities in Saskatoon and the surrounding area.
That area received a "poor condition" rating in the report, which also notes the average age for health care facilities in Saskatchewan in 40 years.
A poor condition rating means:
- Facilities will look worn with apparent and increasing deterioration.
- Frequent component and equipment failure may occur.
- Facilities' staff time will likely be diverted from regular scheduled maintenance and forced to react.
- Resident/patient complaints will be high with an increasing level of frequency.
The facilities have an estimated $1.5 billion in deferred maintenance costs — almost half of the estimated $3.3 billion in deferred maintenance expenses for all of Saskatchewan's health care facilities.
Derek Miller, executive director of Infrastructure Management for SHA, said there are always challenges when dealing with aging infrastructure. He said other jurisdictions deal with the same problems.
"I don't think our situation in Saskatoon is unique. It's pretty common across the board," he said.
"Our focus is on managing and prioritizing the work to sustain the critical systems that really are essential for operating our facilities and making appropriate investment choices with the funding that we receive."
Work not done on time, not prioritized
The report says SHA is not always finishing preventative maintenance work on time and it's not mandatory for staff to document why.
Senior management also doesn't receive reports on maintenance status for the Saskatoon-area facilities or how maintenance will impact the facilities.
The report looked at 30 projects and found nearly half of them were finished late. It says the work was finished between 11 and 251 days after the scheduled maintenance date.
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A Code Blue system for nurses, which the report describes as "a critical asset," received maintenance 178 days later than expected. It's supposed to be maintained once a month, according to the report.
The auditor also found that four of six roof inspections were completed between 14 and 251 days after the scheduled inspection date. In one case, a roof was inspected once during a 12-month period when it was supposed to be inspected every six months.
The report found SHA has not set a minimum condition standard for maintaining critical equipment and areas. Maintenance work isn't always being done based on priority rating either.
Miller said SHA is already addressing some of these concerns.
"We're in the process now of developing standardized approaches to maintaining our facilities, performing maintenance operations and planning for capital projects, and so the audit is really good timing for us," he said.
The auditor says SHA, "has taken insufficient steps to keep information in its maintenance I.T. system accurate and reliable."
The system, known as Work Manager, is available to all 196 Saskatoon-area maintenance staff regardless of what facilities they are assigned to, which means they could change or delete existing data for a facility they aren't assigned to.
On top of that, the report says SHA does not have a way to track changes made to the data. It can identify that a change was made, but not what it was.
SHA also doesn't periodically review who has access to Work Manager. For example, someone who perviously worked for SHA may continue to have access to Work Manager.
The report says SHA doesn't have control around program changes to Work Manager either. The auditor found SHA didn't properly test a programming change before putting it into effect, which led to existing data being deleted.
Work Manager does not keep a complete listing of key facilities that need to be maintained, according to the report, and some critical equipment was missing from the system.
The auditor says the inefficiencies around Work Manager could result in the data being inaccurate or incomplete, which could affect maintenance decisions.
"We do acknowledge that we have improvements to make in terms of ensuring that we're doing the maintenance in an appropriate way and we're following up on it and documenting it so that we have evidence and can provide assurance to the people that are responsible that the work is being done," said Miller.
The auditor made seven recommendations to SHA, most of which address proper documentation and execution of maintenance work.
"The insight that was provided by the audit will help us in terms of approving services in Saskatoon facilities but also more broadly across the province," said Miller.