Healthcare Technology - Revision history

VSadiki at 10:22, 9 October 2020

2020-10-09T10:22:15Z

← Older revision		Revision as of 12:22, 9 October 2020
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	Equipment function has a direct impact on the risk associated with the equipment:		Equipment function has a direct impact on the risk associated with the equipment:

	'''Score Function'''		'''Score Function'''<blockquote>
			Therapeutic equipment
	'''5''' – Life-support.		</blockquote>'''5''' – Life-support.

	'''4.5 ''' - Surgical and intensive care.		'''4.5 ''' - Surgical and intensive care.

	'''4''' - Physical therapy and treatment.		'''4''' - Physical therapy and treatment.<blockquote>
			Diagnostic equipment
			</blockquote>'''3.5''' - Surgical and intensive care monitoring.

	~~'''3.5''' - Surgical and intensive care monitoring.~~		'''3''' - Additional physiological monitoring and diagnostic. <blockquote>
			Analytical equipment
	'''3''' - Additional physiological monitoring and diagnostic.		</blockquote>'''2.5 ''' - Analytical laboratory.

	'''2.5 ''' - Analytical laboratory.

	'''2 ''' - Laboratory accessories.		'''2 ''' - Laboratory accessories.

	'''1.5 ''' - Computer and related.		'''1.5 ''' - Computer and related.<blockquote>Miscellaneous equipment</blockquote>'''1 ''' - Patient Related Furniture and Other.

	'''1 ''' - Patient Related Furniture and Other.

	'''<u>Physical risk</u>'''		'''<u>Physical risk</u>'''
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	'''Score Intensity'''		'''Score Intensity'''

	'''5 - ''' Extensive and costly with highly skilled technical staff involved.		'''5 - ''' Extensive and costly with highly skilled technical staff involved.

	'''4''' - Moderate skilled technical resources required but still costly.		'''4''' - Moderate skilled technical resources required but still costly.
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	Available at <nowiki>http://www.who.int/medical_devices/management_use/en/</nowiki>		Available at <nowiki>http://www.who.int/medical_devices/management_use/en/</nowiki>



	{{Expand}}		{{Expand}}
	[[Category:Crosscutting Issues]]		[[Category:Crosscutting Issues]]

VSadiki at 09:52, 9 October 2020

2020-10-09T09:52:52Z

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VSadiki at 08:52, 9 October 2020

2020-10-09T08:52:55Z

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VSadiki at 08:40, 9 October 2020

2020-10-09T08:40:40Z

← Older revision		Revision as of 10:40, 9 October 2020
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	Flowchart 1: '''The basic equipment development planning process'''		Flowchart 1: '''The basic equipment development planning process'''
			[[File:Flowchart 1 - The basic equipment development planning process.PNG\|thumb\|none]]

	====Prioritising and appraisal of options====		====Prioritising and appraisal of options====
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	===Consumables===		===Consumables===
	Consumables are a major contributor to equipment-related cost of ownership, and form a significant portion of recurrent and operational expenditure. It is therefore important to establish the consumables needs so that adequate provision is made and service delivery is not interrupted. '''''Flowchart 2''''' below suggests a process to facilitate the needs assessment related to equipment-related consumables.		Consumables are a major contributor to equipment-related cost of ownership, and form a significant portion of recurrent and operational expenditure. It is therefore important to establish the consumables needs so that adequate provision is made and service delivery is not interrupted. '''''Flowchart 2''''' below suggests a process to facilitate the needs assessment related to equipment-related consumables.

			FLOWCHART 2: Establishing usage rates and requirements for equipment-related consumable items

			[[File:Flowchart 2 -Establishing usage rates and requirements for equipment-related consumable items.PNG\|thumb\|none]]

	==Asset management==		==Asset management==
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	====Asset management software====		====Asset management software====
	It is essential to adopt and standardise on an appropriate asset management information system. There are a number of such systems available; serious consideration should be given to open-source solutions and/or or solutions which are cost-effective and sustainable, requiring minimal support.		It is essential to adopt and standardise on an appropriate asset management information system. There are a number of such systems available; serious consideration should be given to open-source solutions and/or or solutions which are cost-effective and sustainable, requiring minimal support.
			[[File:Flowchart 3 - How to estimate total equipment stock values.PNG\|thumb\|none]]

	==Budgeting & financing==		==Budgeting & financing==
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	[See '''Section 10.2''' for further discussion on maintenance-related issues].		[See '''Section 10.2''' for further discussion on maintenance-related issues].
			[[File:Flowchart 4 - How to make rough estimates of maintenance costs for forward planning.PNG\|thumb\|none]]

	===Estimates of consumable operating costs for forward planning===		===Estimates of consumable operating costs for forward planning===
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	====Specific or annual estimates of consumable operating costs====		====Specific or annual estimates of consumable operating costs====
	It is equally important to make provision for consumables on an annual basis. '''''Flowchart 5''''' suggests how this could be done.		It is equally important to make provision for consumables on an annual basis. '''''Flowchart 5''''' suggests how this could be done.
			FLOWCHART 5: How to make specific or annual estimates of consumable operating costs
			[[File:Flowchart 5 - How to make specific or annual estimates of consumable operating costs.PNG\|thumb\|none]]

	===Estimates of equipment replacement costs===		===Estimates of equipment replacement costs===
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	iii. A starting point is to use 5% of the equipment stock value to cover equipment-related administrative costs.		iii. A starting point is to use 5% of the equipment stock value to cover equipment-related administrative costs.
			FLOWCHART 6: How to make rough estimates of replacement costs for forward planning
			[[File:Flowchart 6 - How to make rough estimates of replacement costs for forward planning.PNG\|thumb\|none]]

			As in the case of consumable-related costs, it is important to determine the annual equipment-related administrative costs (Flowchart 7).

			FLOWCHART 7: How to make specific estimates of assorted equipment-related administrative costs
			[[File:Flowchart 7 - How to make specific estimates of assorted equipment-related administrative costs.PNG\|thumb\|none]]
	==Requisitioning==		==Requisitioning==
	The following checklists cover three commonly encountered scenarios:		The following checklists cover three commonly encountered scenarios:
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	'''''Flowchart 8''''' below shows the common site preparation steps that may be required, depending on the type of equipment purchased. By the time the goods start to arrive, the site should be ready to receive them.		'''''Flowchart 8''''' below shows the common site preparation steps that may be required, depending on the type of equipment purchased. By the time the goods start to arrive, the site should be ready to receive them.

			FLOWCHART 8: Common site preparation steps
			[[File:Flowchart 8 - Common site preparation steps.PNG\|thumb\|none]]

	===An overview of the acceptance process===		===An overview of the acceptance process===
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	====Commissioning====		====Commissioning====
	Commissioning usually, but not always, takes place straight after installation. The technical and safety aspects of the equipment should already have been specified and considered during the selection process. However, it is also essential to carry out performance and safety tests on each piece of equipment. Such tests validate that each piece of equipment is safe and is capable of performing its intended function. Performance and safety tests should be carried out regardless of whether equipment is purchased, donated, leased or borrowed by the health facility. The commissioning team and any visiting installers are responsible for ensuring these tests take place. The steps in the commissioning process are shown in '''''Flowchart 9'''''.		Commissioning usually, but not always, takes place straight after installation. The technical and safety aspects of the equipment should already have been specified and considered during the selection process. However, it is also essential to carry out performance and safety tests on each piece of equipment. Such tests validate that each piece of equipment is safe and is capable of performing its intended function. Performance and safety tests should be carried out regardless of whether equipment is purchased, donated, leased or borrowed by the health facility. The commissioning team and any visiting installers are responsible for ensuring these tests take place. The steps in the commissioning process are shown in '''''Flowchart 9'''''.

			FLOWCHART 9: Key steps in the commissioning process[[File:Flowchart 9 - Key steps in the commissioning process.PNG\|thumb\|none]]

	Once the equipment has passed its safety, calibration, and function tests, the commissioning team is in a position to:		Once the equipment has passed its safety, calibration, and function tests, the commissioning team is in a position to:
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	Flowchart 10: '''Example of prompts showing that training is required'''		Flowchart 10: '''Example of prompts showing that training is required'''
			[[File:Flowchart 10 - Example of prompts showing that training is required.PNG\|thumb\|none]]

	When the device is removed from service, professional users should know how to clean it and to organise decontamination.		When the device is removed from service, professional users should know how to clean it and to organise decontamination.
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	Flowchart 11: '''Steps in a typical decommissioning process'''		Flowchart 11: '''Steps in a typical decommissioning process'''
			[[File:Flowchart 11 - Steps in a typical decommissioning process.PNG\|thumb\|none]]

	== Monitoring & evaluation of the HTM system==		== Monitoring & evaluation of the HTM system==

VSadiki: /* Centralised maintenance units */

2020-09-30T16:42:54Z

Centralised maintenance units

← Older revision		Revision as of 18:42, 30 September 2020
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	Figure 7: '''Typical structure for a central HT maintenance unit'''		Figure 7: '''Typical structure for a central HT maintenance unit'''
			[[File:Typical structure for a central HT maintenance unit.png\|thumb\|none]]

	'''Properties:'''		'''Properties:'''

VSadiki: /* Self-supporting (stand-alone) decentralised departments - tertiary hospitals */

2020-09-30T16:41:00Z

Self-supporting (stand-alone) decentralised departments - tertiary hospitals

← Older revision		Revision as of 18:41, 30 September 2020
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	\|'''20.79'''		\|'''20.79'''
	\|}		\|}
	Figure 6: '''Typical organisational structure for a self-supporting HT maintenance department'''		Figure 6: '''Typical organisational structure for a self-supporting HT maintenance department'''
			[[File:Typical organisational structure for a self-supporting HT maintenance department.png\|thumb\|none]]

	====Centralised maintenance units====		====Centralised maintenance units====

VSadiki: /* Human resources */

2020-09-30T16:38:13Z

Human resources

← Older revision		Revision as of 18:38, 30 September 2020
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	Figure 5: '''Idealised health technology department structure'''		Figure 5: '''Idealised health technology department structure'''
			[[File:Idealised health technology department structure.png\|thumb\|none]]

	====Self-supporting (stand-alone) decentralised departments - tertiary hospitals====		====Self-supporting (stand-alone) decentralised departments - tertiary hospitals====

VSadiki: /* CMMS implementation */

2020-09-30T16:30:52Z

CMMS implementation

← Older revision		Revision as of 18:30, 30 September 2020
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	Figure 4: '''CMMS planning & implementation process'''		Figure 4: '''CMMS planning & implementation process'''
			[[File:CMMS planning & implementation process.png\|thumb\|none]]


	'''Phase 1 - Evaluation'''		'''Phase 1 - Evaluation'''

VSadiki: /* Inspection and preventive maintenance planning */

2020-09-30T16:29:07Z

Inspection and preventive maintenance planning

← Older revision		Revision as of 18:29, 30 September 2020
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	====Inspection and preventive maintenance planning====		====Inspection and preventive maintenance planning====
	Maintenance planning should always start with a basic approach <s>were</s> <ins>where </ins>only staff and maintenance material are required, and further evolve to a more advanced approach where the specific asset and method required for the asset are addressed. This also forms the basis for the maintenance excellence hierarchy. The preventative maintenance planning is based on the following diagram:		Maintenance planning should always start with a basic approach <s>were</s> <ins>where </ins>only staff and maintenance material are required, and further evolve to a more advanced approach where the specific asset and method required for the asset are addressed. This also forms the basis for the maintenance excellence hierarchy. The preventative maintenance planning is based on the following diagram:
			FIGURE 3: The maintenance planning process
			[[File:The maintenance planning process.png\|thumb\|none]]



	<br />		<br />

VSadiki: /* Risk-based maintenance strategy */

2020-09-30T16:26:34Z

Risk-based maintenance strategy

← Older revision		Revision as of 18:26, 30 September 2020
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	Risk is adopted as an index for clarifying priority in risk maintenance[BvR1] technologies. That risk can be given as the product of the probability of failure occurring to the inspected area and the consequence of failure to the surroundings. In other words, risk is the expected value of the degree of impact. '''''Figure 1''''' shows the concept of distribution of risk held by devices in a system.		Risk is adopted as an index for clarifying priority in risk maintenance[BvR1] technologies. That risk can be given as the product of the probability of failure occurring to the inspected area and the consequence of failure to the surroundings. In other words, risk is the expected value of the degree of impact. '''''Figure 1''''' shows the concept of distribution of risk held by devices in a system.
			[[File:Distribution of risk for medical devices.png\|thumb\|none]]
			A to S on the horizontal axis are the devices in a system and the vertical axis is the relative risk each device holds. The graph shows that 80% of the total risk of the system is concentrated in just 20% of the devices. In that case, it would be irrational to inspect all devices with the same level of priority. It is thus important to identify the 20% of devices and raise their priority level in the inspection programme. That is the basic concept of risk maintenance technology.

			A framework for determining risk in the health industry should be implemented in the following manner:
			FIGURE 2: Risk-based maintenance framework

			[[File:Risk-based maintenance framework.png\|thumb\|none]]