CHTM cheat sheet

PM completion rate = (PMs completed within the scheduled interval ÷ PMs due in that period) × 100.

Availability = MTBF ÷ (MTBF + MTTR), where MTBF = operating time ÷ failures and MTTR = repair time ÷ repairs.

The CMMS is the system of record for asset inventory, work orders, PM schedules, parts, and service history; if it is not in the CMMS, it did not happen.

The Joint Commission allows alternative equipment maintenance (AEM) intervals only when a documented, risk-based method covering equipment function, incident history, and manufacturer guidance is approved by leadership.

Work-order priority order: life-support failure > failure affecting active patient care > scheduled PM > cosmetic or non-clinical request.

Minimum inventory data set per asset: unique asset ID, manufacturer, model, serial number, acquisition date, warranty end date, physical location, and risk category.

Perform work in-house when annual repair and parts cost is below the service contract price and staff competency plus tools exist; contract when OEM proprietary software, calibration fixtures, or high complexity require it.

Recall and safety-alert workflow: log the alert, match affected assets by manufacturer, model, serial number or UDI, schedule remediation, and document closure.

When multiple PM interval sources apply (manufacturer, AEM, regulation, accreditation standard), the most stringent applicable requirement governs.

Straight-line depreciation = (acquisition cost − salvage value) ÷ useful life in years.

Book value = acquisition cost − accumulated depreciation.

Total cost of ownership = purchase + installation + maintenance contracts + consumables + training + utilities + disposal, discounted over the service life.

Payback period = initial investment ÷ annual net cash inflow; it ignores the time value of money.

ROI = (net benefit ÷ cost) × 100; NPV = present value of future cash flows − initial investment, and a positive NPV supports purchase.

The capital budget funds items above the capitalization threshold with a life exceeding one year; the operating budget funds consumables, repair parts, service contracts, and salaries.

Replacement is justified when cumulative maintenance cost exceeds a defined percentage of replacement cost, or when parts, software support, or clinical capability are no longer available.

A capital request package normally contains clinical justification, utilization data, total cost of ownership, alternatives considered, and projected financial impact.

Depreciation allocates cost for accounting; it is not a cash outflow and does not by itself indicate when to replace equipment.

NFPA 99 (Healthcare Facilities Code) assigns patient care spaces to Categories 1 through 4 by electrical system risk and specifies electrical, medical gas, vacuum, and essential electrical system requirements.

NFPA 101 (Life Safety Code) governs egress, fire protection features, and occupancy classification for healthcare occupancies.

CMS Conditions of Participation incorporate NFPA 99, NFPA 101, and NFPA 70 (National Electrical Code) as the technical baseline for hospital deemed status.

Safe Medical Devices Act: user facilities report device-related deaths to FDA and the manufacturer, and serious injuries or illnesses to the manufacturer and FDA.

IEC 60601-1 covers basic safety and essential performance of medical electrical equipment; IEC 60601-1-2 covers electromagnetic compatibility.

ANSI/AAMI EQ56 describes the recommended elements of a medical equipment management program, including inventory, risk-based maintenance, and monitoring.

AAMI ST79 addresses steam sterilization assurance; OSHA 29 CFR 1910.1030 requires an exposure control plan, hepatitis B vaccination offer, PPE, labeling, and training.

NFPA 70E requires an arc flash risk assessment, appropriate PPE, and an energized electrical work permit before justified live work.

The FDA regulates device manufacture and marketing; hospital compliance obligations flow mainly through CMS, accreditation organizations, OSHA, and NFPA standards.

FMEA risk priority number = severity × occurrence × detection; rankings direct corrective action to the highest-scoring failure modes.

FMEA is prospective and design-focused; root cause analysis is retrospective and systems-focused, and neither assigns individual blame as the corrective action.

ISO 14971 defines risk as the combination of the probability of occurrence of harm and the severity of that harm.

FDA recall classes: Class I = reasonable probability of serious adverse health consequences or death; Class II = temporary or reversible harm; Class III = unlikely to cause harm.

A sentinel event is an unexpected occurrence involving death, serious physical or psychological injury, or the risk thereof, and triggers a root cause analysis.

Leading indicators predict performance (PM completion, training compliance); lagging indicators report outcomes (failure rate, harm events, downtime).

PDSA (Plan-Do-Study-Act) uses small-scale tests of change before organization-wide implementation.

Equipment risk scoring for PM interval decisions typically combines physical risk to patient or operator, clinical function, incident history, and maintenance requirements.

An effective safety program closes the loop: event reported, cause analyzed, action assigned with an owner and due date, and effectiveness verified.

SBAR = Situation, Background, Assessment, Recommendation; a structured handoff and escalation format that reduces omitted information.

SMART goals are Specific, Measurable, Achievable, Relevant, and Time-bound.

Kotter's eight steps run from creating urgency and building a coalition through generating short-term wins to anchoring change in culture.

Competency requires documented verification by observation or testing; attendance at training alone does not establish competency.

Knowles' andragogy: adult learners need relevance to practice, problem-centered content, and self-direction.

The critical path is the longest sequence of dependent tasks in a project schedule and determines the minimum project duration.

Thomas-Kilmann conflict modes-competing, collaborating, compromising, avoiding, accommodating-are chosen by issue importance and relationship importance.

Herzberg: hygiene factors (pay, policy, working conditions) prevent dissatisfaction; motivators (achievement, recognition, growth) produce satisfaction.

HL7 version 2 messages exchange clinical and administrative data; FHIR provides RESTful APIs and discrete resources for modern integration.

DICOM defines the medical image file format and network transfer protocols used by modalities, archives, and viewers.

IEC 80001-1 addresses risk management when medical devices are connected to IT networks and assigns responsibilities across clinical, IT, and device organizations.

HIPAA Security Rule safeguards fall into three groups: administrative, physical, and technical.

NIST Cybersecurity Framework core functions: Identify, Protect, Detect, Respond, Recover; version 2.0 adds Govern.

Network segmentation places medical devices on dedicated VLANs or subnets with controlled routing to limit lateral movement after a compromise.

Device hardening: change default credentials, disable unused ports and services, apply risk-based patching, and maintain an accurate connected-device inventory.

FDA premarket cybersecurity expectations include a software bill of materials (SBOM), threat modeling, and a coordinated vulnerability disclosure process for cyber devices.

A business associate agreement is required before an external vendor creates, receives, maintains, or transmits electronic protected health information on the organization's behalf.