Date of Conferral

9-25-2026

Date of Award

September 2026

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Sciences

Advisor

Miriam Ross

Abstract

Despite advances in healthcare delivery, acute care hospitals often lack standardized strategic planned preventive maintenance (SPPM) protocols, resulting in equipment failures, higher costs, and disruptions to patient care. The purpose of this integrative review was to identify evidence-based best practices for implementing SPPM programs in acute care hospitals. The review question concerned the organizational practices and strategic approaches most effective for implementing an SPPM program. The Donabedian structure–process–outcome model represented the foundational framework for this review. The initial literature search yielded 110 articles. After further assessment, 27 studies were appraised using the Johns Hopkins Nursing evidence-based practice tools. Three low-quality articles were excluded, leaving 24 articles for theme and subtheme analysis. Four main themes and nine subthemes emerged from the analysis. The main themes were strengthening leadership SPPM knowledge, implementing digital transformation, improving reliability and patient safety, and enhancing sustainable healthcare technology management. Key subthemes were to encourage predictive maintenance and establish leadership accountability. The findings were the basis for four recommendations: (a) governance oversight to enhance maintenance accountability, (b) digital intelligence to support maintenance systems, (c) organizational leadership to foster ongoing improvement, and (d) principles of sustainability for workforce development. This review may advance positive social change by emphasizing a strong maintenance system that extends beyond equipment oversight and serves as a long-term investment in patient safety, organizational excellence, and sustainable care delivery.

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