creating healthcare for the world

Creating HEALTHCARE for the WORLD

Click icon to add picture

An- Najah National UniversityFaculty of Engineering

Industrial Engineering Department

Reem Asmr Nazmia Mana’a Ahmad ZaherShayma Smaaneh Sawsan Deek Rasha Abu-shanab

Developing Maintenance Management System in Al-Arabi Specialized Hospital

Eng . Tamer Haddad

Students

Supervisor

Sections :

5.Apply the 5S system to arrange the workshop and reduce the time taken in

maintenance.

Introduction

Maintenance management

Current Status for Maintenance System

Suggested Maintenance Management System

Conclusion and Recommendations.

Al-Arabi Specialized Hospital

History of Al-Arabi Specialized Hospital

Established in 2000 by a group of creative doctors

Located in Nablus ISO in 2001

ObjectivesThe main objectives of this project are :

1- Investigate implementing maintenance management systems in Healthcare Facilities. 2- Developing a new suggest maintenance system and compare it with the current used one. 3- Developing a new implementation framework for Healthcare Facilities. 4- Discussing the difficulties in the adoption of maintenance systems with proper solutions.

Maintenance Definition : to keep the equipment in

operational condition or repair it back into its‟ operational mode

Objective: increase availability of production systems, increase safety and optimized cost.

Preventive maintenan

ce Corrective

maintenance

Types of maintena

Maintenance in Healthcare Facilities The Hospital maintenance department is a crucial

element to a high quality healthcare facility. The excellent functioning or, by other words, the

maximum reliability of facilities and equipment is a main rule for this department.

The policy that permits such performance must always be based on planned maintenance including preventive maintenance.

To be in advance to failures The other goal persuaded, it is to maintain costs as lower as possible.

CURRENT SYSTEM

Current system include

The Organizational Structure

Flow charts

The used reports templates

Performance indicator

Analysis of available data

Problems related to the current system

The Organizational Structure

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

Medical maintenan

ce Engineer

Head if Maintenan

ce Departme

Maintenance

technician (1)

Maintenance

technician (2)

The Maintenance Activities Process

Flow chart :

Repairing the failure

The end

Inform the maintenance department for the

failure orally

Sending request for maintenance department

Inform the service technician internally or externa

lly for the failure orally

Is it possible to maintain the fault

internally?

Filling the request of the external

maintenance report

Sending the request to the competent

authorities

Sending the service technician to the site of failure

Failure

Filling the request of general maintenance report

Start Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

Report templates1- Devices and Machines List.

الصيانة قسم رئيس) والتاريخ) التوقيع :

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

Report templates2- Annual Preventive Maintenance Plan. اإلعداد / / :تاريخ

) والتاريخ ) التوقيع الصيانة قسم :رئيس

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

Report templates3- Summary of Preventive Maintenance Works.________: _________________ : _______________ السنة / الشهر الجهاز الماكنة /______ رقم الجهاز الماSكنة اسم : Organizatio

nal structure

Flow charts

Reports templates

Analysis of data

Problems

Report templates. 4- Request for General Maintenance report. Organizatio

nal structure

Flow charts

Reports templates

Analysis of data

Problems

Report templates5- Request for External Maintenance report.. Organizatio

nal structure

Flow charts

Reports templates

Analysis of data

Problems

Report templates6- Record of Maintenance Requests.

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

Report templates7- Machine/Device Record.

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

Report templates8- The “Under Maintenance” Card

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

الصيانة قسم" الصيانة "تحتUNDER MAINTENANCE

الجهاز / الماكنة هذه تستخدم الDo Not Use This Equipment / Device

Measurement of Maintenance Activities PerformanceThe Performance Indicator/ Maintenance Monthly report Organizatio

nal structure

Flow charts

Reports templates

Analysis of data

Problems

The Performance Indicator/ Maintenance Monthly report Organizatio

nal structure

Flow charts

Reports templates

Analysis of data

Problems

Measurement of Maintenance Activities Performance

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

Department malfunctions frequencies.

Analysis of Malfunctions Data

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

Lab devices malfunctions frequencies.

Analysis of Malfunctions Data

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

A. Chemwell-Awarness

Malfunctions’ Causes Analysis

Failure of ChemwellAwarness device

Environment Poor Cleaning

Poor cleaning of lamp Poor

cleaning of filter

Excess loadUntrained

Dust in the surrounding

Bad preventive

maintenance

Cause-Effect diagram for Chemwell-Awarness device.

Chemwell-Awarness device has the highest number of failures

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

B. Blood Gas Analyzer

Cause-Effect diagram for Blood Gas Analyzer device

It’s the second highest device in number of failures

Failure of Blood Gas Analyzer Device

Poor Cleaning

Poor internalcleaning

Excess load

Untrained staff Bad

preventive maintenance

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

Cause-Effect diagram for Electrolyte device

It has the same number of failures as the Blood Gas Analyzer device

C. Electrolyte

Failure of Electrolyte device

Equipment Poor Cleaning

Poor cleaning

after using

Insufficient self washing

Calibration

Wrong calibration

process

Excess load

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

These problems can be summarized as:

Problems related to the existent system

1.The general and external reports are written by hand

2.The reports are stored in a non-professional and unsafe way

3.All maintenance reports related to all hospital departments are stored together in one record.4.Many simple malfunctions could be fixed at the instant of occurrence instead of taking a long time in performing the maintenance operation.

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

These problems can be summarized as:

5.When there is a need for external maintenance, then the request for external maintenance report must be documented and attached with the request for general maintenance report.

6.Record of Maintenance Request reports are not filled out.

7.The used performance indicator is not efficient and is not accurate.

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

•The following items are not documented in most request for general maintenance reports:1.The name of the department that submitted the request for maintenance report.

2.The name of the person who informed of the malfunction.

3.The date and time of malfunction occurrence.

Organizational

structure

Flow charts

Reports templates

Analysis of data

Problems

•The following items are not documented in most request for general maintenance reports:

4.The name of the technician who performed the maintenance.

5.Description of the malfunction and the reasons of its occurrence

6.Clarifying the need for local or external maintenance

SUGGESTED MAINTENANCE MANAGEMENT SYSTEM

Suggested Maintenance Management System

Include :

Job descriptionSuggested Organizational

StructureSuggested Flow charts

Suggested Tracking Serial Number

Suggested Report TemplatesSuggested Measurement of

Maintenance Activities Performance

5S ImplementationComputerized Maintenance

Management System (CMMS)

Job Description Job description

Organizational Structure

Flow charts

Serial Number

Report Templates

Activities Performance

a) The Head of the Maintenance Department•Job Title:Head of the Maintenance Department:

•The academic qualifications and experiences required:1. Bachelor degree in Medical, Mechanical,

Electrical or Electronic engineering.2. Six years of experience in maintenance work of which two years in experience as head of a department in a hospital.• Main tasks:1. Planning, organizing, directing and monitoring all maintenance activities in the hospital.2.Determining the departments annual needs of devices, equipment and spare parts.3.Supervision of preventive maintenance programs and Documentation and archiving the maintenance reports.4. Assess the level of performance of the department

(CMMS)

Job description

Flow charts

Serial Number

Report Templates

b) Medical Maintenance Engineer•Job Title:Medical Maintenance Engineer.

•The academic qualifications and experiences required:1. Bachelor degree in Medical or Electronic

devices engineering.2. Five years of experience in maintenance of medical devices.

• Main tasks:

(CMMS)

1. Developing a work program and distributing duties on medical devices technicians.2. Following-up on medical devices that are sent to outer repair shops.3. Provide the tools, inspection equipment and spare parts required for maintenance.4. Submitting the periodic reports to the head of maintenance department.5.Developing preventive maintenance programs associated with the medical maintenance department.

Job Description

Job description

Flow charts

Serial Number

Report Templates

c) Medical Devices Technician•Job Title:

•The academic qualifications and experiences required:

• Main tasks:

(CMMS)

Medical Devices Technician

1. A two years diploma in medical devices.2. Five years of experience in maintenance medical devices.

Job Description

1. Preparing tools and inspection equipment that are necessary to inspect and maintain the medical devices. 2. Dismantling and cleaning of medical devices for testing, calibration or maintenance and their re-installment according to the established maintenance procedures and manufacturer’s instructions. 3. Making sure that the backup parts of a device are available before starting to repair it.

Organizational StructureJob description

Flow charts

Serial Number

Report Templates

5S(CMMS)

Flow ChartsJob description

Flow charts

Serial Number

Report Templates

5S(CMMS)

1.Preventive Maintenance process

Flow charts

Serial Number

Report Templates

5S(CMMS)

Internal Maintenance Process2.Corrective Maintenance Process

Flow charts

Serial Number

Report Templates

5S(CMMS)

External Maintenance Process2.Corrective Maintenance Process

Suggested Tracking Serial Number

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

serial number is a unique number assigned to facilitate identification the devices locations.

( EM 04 11 1011)

emergency department,

fourth floor

room number

Machine code #

Suggested Report TemplatesJob description

Flow charts

Serial Number

Report Templates

5S(CMMS)

1. Device list.

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

2. Annual Preventive Maintenance Plan.

Suggested Report Templates

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

3. Preventive Maintenance card “PMC”.

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

4. Preventive Maintenance Checklist. Daily preventive maintenance checklist.

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

Suggested Report Templates5. Request for General Maintenance report.

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

6. Request for Outside Maintenance report..

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

7. Records of Maintenance RequestsSuggested Report Templates

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

8- Device Record

Suggested Measurement of Maintenance Activities Performance

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

• Data Sheets1- Preventive maintenance data sheet.

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

• Data Sheets2- Corrective maintenance data sheet for devices..

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

• Data Sheets2- Corrective maintenance data sheet for devices..

This chart helps in recognizing the most causes of failures and their frequencies. As shown it is obvious that the human causes have the highest frequency.

P .clea

fauiler casues-freq(for each device)

Failure causes

Frequency

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

• Data Sheets3- Corrective maintenance data sheet for departments.

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

• Data Sheets3- Corrective maintenance data sheet for departments.

The following chart represents the frequency of failures of the labs’ devices as an example.

Blood g

Chemwell

Electr

Micros

Hettic

trifug

Devices vs Failure freq

Device name

FailureFrequency

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

• Data Sheets4-Corrective maintenance data sheet for the maintenance department

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

• Data Sheets4-Corrective maintenance data sheet for the maintenance department

The following chart is used to facilitate identifying and the number of failures in each department in addition to notifying the maintenance type performed for each failure whether if it is internal or external.

ency Men

Cardiac

Matern

Nursin

Internal&External maintenance Vs failures frequency

InternalExternal

Departments

Failure frequency

5S ImplementationJob description

Flow charts

Serial Number

Report Templates

5S(CMMS)

Definition : It is an approach to keep the work place in the different departments and in the maintenance workshop in a suitable condition to perform the required work efficiently.

There are five primary phases of 5S: sorting, straightening, systematic cleaning, standardizing and sustaining.

Flow charts

Serial Number

Report Templates

5S(CMMS)

1. Sorting Eliminate all unnecessary tools, parts, and

instructions. Go through all tools, materials, and so forth in the plant and work area.

2. Straightening or Setting in order There should be a place for everything and everything should be in its place

3. Systematic cleaning or shining Clean the workspace and all equipment, and keep it clean, tidy and organized.

Flow charts

Serial Number

Report Templates

5S(CMMS)

4. Standardizing (Seiketsu) Work practices should be consistent and standardized. All work stations for a particular job should be identical.

5. Sustaining the discipline or self-discipline Maintain and review standards. Once the previous 4 S's have been established, they become the new way to operate.

Flow charts

Serial Number

Report Templates

5S(CMMS)

To assess the level of the maintenance workshop in the hospital based on the 5S modeling, the following checklist form should be followed.

Flow charts

Serial Number

Report Templates

5S(CMMS)

The workshop table. The workshop shelves

As shown, the table is dirty and untidy.

As shown the shelves are in a

very bad

Computerized Maintenance Management System (CMMS)

Job description

Flow charts

Serial Number

Report Templates

5S(CMMS)

Definition(CMMS) is a type of management software that performs functions in support of management and tracking of maintenance activities.

A suggested CMMS interfaces has been developed for the maintenance department in the hospital to facilitate managing and documenting the operation since there are huge amounts of information should be extracted and documented.

Example:

Maintenance Department

ADD A NEW MAINTENANCE REQUEST

VIEW THE RECORD OF MAINTENANCE REQUESTS

EDIT REQUEST

PREVINTIVE MAINTENANCE CHECK LIST

DEVICE RECORD

RECORD OF MAINTENANCE REQUESTS

PERFORMANCE INDICATORS

MAINTENANCE DEPARTEMENTGENERAL MAINTENANCE REQUEST FORM

-INQUIRY FORM -

Date of reporting:Time :

Department:

Employee name:

Floor number :

Device number :

Device code :

Date of fauiler : Time :

Mechanical

medica electrical

clear proceedsave

Failure classification:Failure classification

Failed device informationDevice information

MEDICAL MAINTENANCE DEPARTEMENT -MEDICAL MAINTENANCE ENGINEER -

Failure description :

………………………………………………………………………………………………...

Failure causes:

Poor cleaning Human

Environment calibrration

Otherwise

Type of needed maintenance

Internal

External fill the external maintenance request form

nextNext back Exit

Fill the maintenance activity form

Request number :

MEDICAL MAINTENANCE DEPARTEMENTEXTERNAL MAINTENANCE REQUEST FORM

Request number : Date :

Device name :Device code :

supplier name:

Notifications:

…………………………………………………………………………………...

save back proceed

MEDICAL MAINTENANCE DEPARTEMENTEXTERNAL MAINTENANCE ACTIVITY FORM

The executed maintenance description : …………………………………………………………………...

The used parts -if exists

quantitytypenumber quantitytypenumber

Maintenance action date :

Delivered date :

Delivered to:

spent Time :

save next Back to menu

supplier name:

MEDICAL MAINTENANCE DEPARTEMENT PREVENTIVE MAINTENANCE CHECK LIST

Failure frequency VS minthType of maintenance check list

Department name

WeeklyMonthly AnnualSemi-annual

Back to menu Back to menu Proceed

MEDICAL MAINTENANCE DEPARTEMENT PREVENTIVE MAINTENANCE CHECK LIST

Failure frequency VS minthDaily preventive maintenance check list

PM code

Department name

Device name Maintenance status Result

NO . Of incomplete maintenance activity

Back to menu Back to menu Print

MEDICAL MAINTENANCE DEPARTEMENTRECORD OF MAINTENANCE REQUESTS

Choose a year :

Choose a month : Feb March April .….

20082009

20112010

Back to menu Back to menu Proceed

Frequency for internal maintenance request :

RECORD OF MAINTENANCE REQUESTS

Request number

Department name

Device name /Serial number

Maintenance type

(ext \ int)Executer name

Failure reporting Failure maintenance

Failure occurrence

Time Date Time Date TfTs Tspent

Data for department Select department:

Departments :emergency

Menoutoscope

Print Back to menu Back to menu

NO. of external maintenance requests in all departments t :

NO .of internal maintenance request in all departments t :

NO. of failures :

Number of failure :

Number of external maintenance request :

Number of internal maintenance request :

DEPARTEMNT MAINTAINANCE REQUESTS

Save Exit Back to menu

DEVICE RECORD

Choose a device : Chemwell- awarness Modonic Pressure device ECG Electrolyte …….

Start using date:

Serial number :

Back to menu Back to menu proceed

NO. of internal maintenance:

Request # Failure causes

Maintenance type

used parts Cost

Failure reporting Failure maintenance

Failure occurrence

Time Date Time Date TfTs Tspent

Print Print Back to menu Back to menu

Executer name

Device name:

DEVICE RECORD

Device number :

NO. of failure:

Mean Down Time

NO. of internal maintenance:

NO. of external maintenance:

Frequency of failure causes: causes frequency

.human

.Environment

. Cleaning…….

Mean spent time

Mean inactive time

Mean time between failures

Month :Year:

PERFORMANCE INDICATORS

Performance indicators :

Preventive Maintenance indicators.

Corrective Maintenance

indicators for departments

Corrective Maintenance indicators for devices.

Corrective Maintenance indicators of the Medical maintenance department.

Choose indicator :

Back to menu Back to menu proceed

Select department

Lab EmergencyMaternityNursingMen …..

MaternityNursingMen …..

Select department

Pressure device Outoscope …..

Select deviceEmergency

Show graph :

Starting date End date

Year : Month :

NO. of incomplete daily preventive maintenance:

NO. of incomplete weekly preventive maintenance:

NO. of incomplete monthly preventive maintenance:

NO. of incomplete semi-annual preventive maintenance:

-if exist in this month -

NO. of incomplete annual preventive maintenance:

-if exist in this month -

PERFORMANCE INDICATOR CORRECTIVE MAINTENANCE SHEET FOR DEPARTEMENT

Department name

No. of devices

Total No. of failuresFor the department

No . Of internal maintenance operation

No . Of external maintenance operation

proceed back

Device FrequencyOf failure

Frequency of failure for each device in the department

NO. External

NO. Internal

No . Of total maintenance operation

CORRICTIVE MAINTENANCE ACTIVITYPERFORMANCE INDICATOR FOR DEPARTMENT

Select indicator

Print Graph Back to menu

Department failure frequency VS month

operation frequency VS month

Devices in the dep VS failure frequency

Select type of operation

Internal maintenance operation

External maintenance operation

All maintenance operation

PERFORMANCE INDICATOR CORRICTIVE MAINTENANCE ACTIVITY

Month Frequency of failure

Failure frequency VS minthDepartment failure

frequency VS month

Print Print back End

jan feb march april may

month - frequency of failure for the departement

freq of fauilers

Department name

PERFORMANCE INDICATOR CORRICTIVE MAINTENANCE ACTIVITY

Failure frequency VS minth Devices Vs failure frequency in the department

Device name Frequency of failure

electrolyte1

Modonic

Microscope

Easylyte

Print Print back End

Department name

Table of values :

modonic microscope easylyte electrolyte

Frequency

device name

fauiler -freq(for each device)

RECOMMENDATIONS

Recommendation 1.Creating a computerized system to deal

with the data and to ensure the documentation of information to save time.

2.Review the approved coding system and replace it with a new system to facilitate

dealing with the hardware.

3.Hold training sessions for the maintenance crew every now and then.

4.Change the (organizational structure) used previously and apply the new

organizational structure which regulates and determines the crews’ responsibilities

5.Apply the 5S system to arrange the workshop and reduce the time taken in

maintenance.

creating healthcare for the world

external maintenance

general maintenance

maintenance definition

maintenance requests

planned maintenance

preventive maintenance

maintenance management

report templates8

Documents

creating new value in healthcare

october 2003 creating ge healthcare technologies

creating world-ready apps

intr odu ctio n slid - healthcareready.org...continuous...

creating a living world

operational integration: creating a high-performing...

creating value in healthcare

creating the sbc document for healthcare plan payers

creating an inclusive world

creating a world class holistic behavioral healthcare system...

creating value in healthcare

creating world-ready documentation

healthcare reform: improving the healthcare world in...

world of healthcare

creating value through technology in healthcare

world healthcare students’ symposium

creating differentiation in healthcare provision in a...

creating healthcare content marketing with built-in roi

healthcare bpm and creating process excellence for patients

creating an integrated healthcare delivery system through it