me mp 070812

8/20/2019 Me Mp 070812

1/27

MEDICAL EQUIPMENT

MAINTENANCE POLICY

(2012)

EMPLOYEES’ STATE INSURANCE CORPORATIONPanchdeep Bhawan, C. I .G. Road,

New Delhi-110 002

8/20/2019 Me Mp 070812

2/27

FOREWARD

The Medical Equipment Maintenance Policy 2012 is a self-

cont a ined guid elines documen t for MS s/SM Cs /S SM Cs of E SI C/E SI S

Hospitals, diagnostic centers, dispensaries & teaching institutions.

This Policy will strive for effective and efficient maintenance of

medical equipments used for diagnosis, treatment and prognosis of

IP s, beneficiar ies, sta ff & pensioners a nd a lso for educat iona l purposein ESI teaching inst i tut ions. This is for the f irst t ime that ESIC is

bringing out a comprehensive ma nua l for th e maint ena nce of medica l

equipments.

I congra tula te Dr. Surinder Kum a r, Medical C ommissioner a nd

the dedicated band of officers and staff involved in preparation of

this document. I believe this would go a long way in keeping the

medica l equipment s used in ES IC /E SI S H ospita ls in top w orking

condition for long time.

Dr. C.S. Kedar

Director General

Employees’ State Insurance Corporation Medical Equipment Maintenance Policy

(i)

8/20/2019 Me Mp 070812

3/27

PREFACE

The E SI Corpora tion ha s been providing comprehensive socia l securit y t o the w orkers

and their families in the contingencies of sickness, disablement and death for over six

decades. The Corporation has been continuously striving to improve and upgrade the

facilit ies for delivery of benefits as well as the quality of services. For providing the best

available healthcare to IPs, Beneficiar ies, Staff and Pensioners, cost ly equipments of

la test t echnology a re being used in E SI C/E SI S H ospita ls.

In order to maintain the cost ly medical equipments being used for the diagnosis,

prognosis a nd t reat ment of IP s, B eneficiar ies, Sta ff and P ensioners, the corpora t ion ha s

established its own Medical Equipment Maintenance Policy 2012. As the process of

Medical Equipment Maintenance involves various procedures, need was felt to have a

Medica l E quipment Ma intena nce Policy incorpora ting Life cycle of th e equipment , In ventory

& Document a tion, Commissioning & Accepta nce of equipment, B rea kdown ma intena nce,

Planned preventive maintenance, Equipment Audit to provide self-contained guidelines

for MSs/SMC s/SS MCs for effective a nd efficient ma int ena nce of Medica l E quipment s ina ll ES IC /E SI S hospita ls, diagn ostic cent ers, dispensa ries & tea ching instit utions.

I congra tula te th e team comprising of Dr. S.K . J a in (Dy. Medical Commissioner),

Dr. N.K. Arora (Dy. Medica l Commissioner), Dr. R.K. S ha rma (Dy. Medica l Commissioner),

Dr. A.K. Vaid (Medical Superintendent), Sh. Manish Agarwal (Assistant Director), Sh.

Nitin J uneja (B io-Medica l En gineer), Ms. Khush a bu P a liwa l (B io-Medica l En gineer) -

Hea dqua rters a nd a ll other MSs of various ES IC/ES IS Hospita ls an d SS MCs/SMCs for

bringing out this comprehensive Medical Equipment Maintenance Policy. I hope this

document will serve the purpose it is meant for.

Dr. Surinder Kumar

Medical Commissioner


(iii)

8/20/2019 Me Mp 070812

4/27

INDEX

1. Term i nol ogy 1

2. I n t r oduct i on 2

3. M i ssi on 2

4. Object i ve 2

5. L i fe Cycl e of the Equ ipment 3

6. Equi pment M aintenance Guidel i nes 3

I . At ESI S/ ESIC H ospi tal L evel 4

1. I nventor y & Documentat i on 4

2. Commissi oni ng & Acceptance of equi pment 6

3. M on i tor ing of use and per formance 6

4. M ain tenance of equ ipment 7

5. Equ i pment Audi t 16

6. Trai n ing & Development 17

I I . At ESIC H qr s. (Procur ement Cel l ) L evel 18

7. Or gani zat i onal Str uctur e 19

8. Summar y 21

Appendices:-

Annexure – I 22

Annexur e – I I 23


(v)

8/20/2019 Me Mp 070812

5/27


1

1. TERMINOLOGY

A. P ol icy : A document sys tem which provides a log ica l f ramework and ra t iona l ityof decision making for the achievement of intended objectives. It provides

guidelines to be followed in order to achieve our objectives. It has three parts:

objective, strategy and resource.

B . Equipment Ma intenance: A set o f ac t iv it ies conducted to keep an equipment

in optimum working condition and consists of periodic inspection, preventive

maintenance, and correct ive maintenance.

C. Medical E quipment : The complex equipment t hat is used for diagnosis, t reat ment

and monitoring purpose. The different uses can be classified as below:

I . D iagnos t ic – Used in est ima t ion o f body potent ia l s , blood va lues , imag ing

and laboratory equipment .

I I . Therapeut ic – Used wi th r a d ia t ion energy, pros the t ic and or thopedic

equipment used in resuscita t ion, special t reatment and surgical support

including the gas supply system.

II I . Moni tor ing of body para meters and a na lys is of hospita l environment .

IV. G enera l – Eq uipment used in rout ine pa t ient care , CSS D e tc.

V. Medica l Equipment may be used for medica l research and educa t ion.

D. Types o f Equipments : Two Types a s g iven below

I . Major Eq uipments : - required to be Tendered/P ropr ie tary I t em

II . Minor Equipments/Instruments: - wh ich can be obtained by Local P urcha se

MEDICAL EQUIPMENT MAINTENANCE POLICY – will provide broad logicalfra mework of decision t o be ta ken for guiding certa in a ctions t ha t a re useful in prolonging

th e active life of equipment so tha t t he equipment provides accura te results in dia gnosing,

monitoring and treating our IPs, staff & beneficiaries. The equipment may be useful for

medical educat ion and research.

8/20/2019 Me Mp 070812

6/27


2

2. INTRODUCTION

E mployees’ St a te In sura nce Corpora tion ha s a num ber of hospita ls (149), dispensa ries(1402), few Medical/Dent a l/P ost G ra dua te hea lth inst itut es (P G IMS R) a nd s ome new

Medical Institutions are in pipeline too. There is a need of large number of medical

equipments for providing the best health care services to our IPs, staff & beneficiaries.

In addition, we need medical equipment for teaching as well as research purpose.

There is a necessity of certain guidelines to be followed by the users of medical

equipment so as to have maximum life of the equipment with minimum downtime and

let these equipments give the accurate results during their life.

This policy ha s been developed to ensure t ha t medica l equipment is st ored, deployed

and maintained in such a way that the r isks inherent in i ts use i .e . safety, radiat ion

effect etc. a re minimised a nd a ccura te & reliable results a re provided by th ese equipment s.

The Policy aims to ensure that whenever medical equipment is used, it is:

Suitable for its intended purpose

Properly understood by appropriately trained users

Maintained in a safe and reliable condit ion.

Keeping Medica l device sa fe an d effective will require plann ed prevent ive ma intena nce

and breakdown maintenance services carried out by competent people.

3. MISSION OF THE POLICY

To maint a in a l l medica l equipments to the a ppropriate st a nda rds a s prescribed by

equipment manufacturer , so as to ensure that a l l medical equipments to be used to

provide the best health care services to patients (IPs, staff , pensioners & beneficiaries)

should be safe, efficient, effective, reliable and long lasting.

4. OBJ ECTIVES OF THE POLICY

This Policy is intended for the maintenance of medical equipment that ensures:

a . M a xi mu m a v a il a bi li t y a n d rel ia b ili t y of eq u ipm en t s

b . M in im um dow n t im e a n d M a xim um U pt im e

8/20/2019 Me Mp 070812

7/27


3

c. Ma xim um ret ur n on in ves tm en t

d . P r e ven t ion of w a s t a g e of con s um a b les a n d s pa r es

e. E x t en d ed us ef ul l if e of eq u ipm en t s

f . Read iness of the equ ipment for emergency use whenever requ ired

5. LIFE CYCLE OF MEDICAL EQUIPMENT

The delivery of th e best hea lthca re services depends hea vily on medical equipment ,

whether for life support, for diagnosis, for patient monitoring, or for the delivery of

therapies or teaching and research purpose. The risks associated with the use of medical

equipment can only be controlled by managing the whole life-cycle of the equipment.

Life cycle of Medical Equipment

Th e bo ld ed ph ases o f th e l i f ecyc l e of t h e equ i pm en t h ave been cover ed i n

t h i s do cum en t .

6. STRATEGY: EQUIPMENT MAINTENANCE GUIDELINES to be followed at :

I. ESIS/ESIC Hospital Level

II. ESIC Hqrs. (Procurement Cell) Level

Details are given below:

8/20/2019 Me Mp 070812

8/27


4

6(I). GUIDELINES TO BE FOLLOWED AT ESI HOSPITAL LEVEL

The tasks to be performed at hospital level are related to:

(i ) i nv en t or y & d ocu men t a t i on

(i i) commissioning & accepta nce

(ii i) monitoring of use & performa nce

(iv) ma in tenance of the equ ipment .

6I(1). Inventory and Documentation

* It should be mentioned in the Tender Enquiry Document while floating

the tender that manufacturer/supplier has to provide CMC (for all the major

equipment(s)) for atleast three to five years after expiry of warranty period.

Inventory provides information to support different aspects of medical equipment

management .

The inventory of Medical Equipments should be maintained department wise a t

store level for the equipments:

P urcha sed a t MS/SMC /SS MC Level an d

Purchased through Procurement Agency (i f any)

The inventory record includes the following details:

1. Reference I D

2. E q uipment Na me

3. C om pa n y /M a ke (w i t h con t a ct d et a i ls )

4. S er ia l no.

5. D a te of I ndent

6. Ten d er N o. /L oca l P u r ch a s e

7. NOA n o. (Wit h d a t e)

8. C ost per unit

9 . Da t e of i ssue of C RC (C ons ignee receipt cer t i fi ca t e )

8/20/2019 Me Mp 070812

9/27


5

10. D a t e of I n st a l la t i on

11. Da te of issue of FAC (Fina l accepta nce cert i f ica te)12. Wa r r a n t y P e riod

13. M a in t en a n ce of E q u ipm en t

a . I n-H ouse

b . E x t er n a l Ag en cy /M a n uf a ct u r er L ev el

14. Af ter w a r r a n ty ma in tenance cont r ac t w i th per iod a nd cha rges*

15. Spare pa r t s/ consumab le inventory

16. Current st a tus of funct ioning of equipments

The record should be maintained in table form as given in Annexure-I

Th e i n ven t o r y mu st be up da t ed ( a t l east H a l f Yea r l y ) wh en : -

a) addi t iona l equipment ha s been procured or equipment is replaced by new one

b) equ ipment has been condemned and i s no longer in use

c) the equ ipment has been t r ans fer red to ano ther loca t ion

To ensur e th at al l m edi cal equi pment i s appr opr i ately mai nt ain ed, an in vent or y of

th is type of equi pment must al so be kept an d m ai nt ai ned u nd er th e cont r ol of h ead of

th e depar tm ent .

Th e abo ve i n f or ma t i on i n t a bu l a t ed f o rm s ha l l b e k ep t a t H ead Qu a r t er

l evel a l so i f t h e cost o f t h e equ i pm en t i s above Rs. 10 L ack s pe r u n i t , So th e

i n f o rm a t i on m ay be sen t t o ES IC , H ead qua r t er s f o r t he sam e f o r t h e equ i p men t

o f sa i d cost .

Maintenance contract - the process for f r esh ma i n t ena n c e c on t r a c t (AMC/

CM C) of t he equi pment shoul d be i ni t i ated 3(thr ee) M ont hs before th e expir y of t he

war r ant y per iod/ AM C/ CM C. The necessar y concur r ence fr om t he fi nan ce depar tm ent

of th e I nsti t ut ion r equi r ed for r enewa l of cont r act/ fr esh cont r act shal l be tak en w ell

in advance so that equipm ent r emai ns funct ional and downt i me is min im ized. Al so,

th e ser vice pr ovid er shoul d be l ocated p r efer ably w it hi n t he cit y l i m it s.

8/20/2019 Me Mp 070812

10/27


6

Insurance - If t he Costly E quipment s a re not covered under AMC/CMC , then t hey

should be got insured so that if any breakdown occurs the expenditure incurred for

the same can be cla imed from the Insurance Provider .

6I(2). COMMISSIONING AND ACCEPTANCE OF THE EQUIPMENT :

The competent authority should ensure insta l la t ion and commissioning of the

equipment by m a nufa cturer/supplier. The process sh ould be monitored by in-house t echn ical

sta f f so that any technical matters can be noted and recorded in the Maintenance

Register (An nexur e- II ). This occasion also provides an excellent opportunity for in-

house technical sta f f to gain familiar i ty with the new item and i ts operat ion. Ideally,

in-house technical staff should also attend the operator’s training session.

I t i s par t icu lar ly impor tant to bear in mind tha t normal ly the manufac turer/

supplier ’s warranty star ts the day equipment is insta l led in the hospita l . I f equipment

is not going to be used for some time after delivery, special arrangements must be made

with the supplier to define the warranty period. Such an agreement should preferably

be made in the purchase order. Final Acceptance Certificate (FAC) to the supplier

should not be issued before the satisfactory performance has been confirmed by the in-

house technical staff .

Rega rding equipment w ith Turnkey project like CT/MRI Sca nner, CS SD etc., t he

deta ils will be ha nded over by th e agency to th e store ma na ger or Medica l Superintendent

or authorized person in the presence of Head of the Department and in-house staff .

6I(3). MONITORING OF USE AND PERFORMANCE:

I t i s impor tant tha t user should make a sa fe use o f the equipment and a lso

continuously monitor the performance of the equipment. User should also keep a direct

link w ith ma nuf a ctur e/supplier/service provider a nd observe a ny s upplier’s techn ical

services. Such services should be recorded in the Maintenance Register (An nexur e– I I ).This will also provide a good learning opportunity for the in-house user.

Ma ny equipment w il l require da ily/w eekly inspect ion a nd simple maint enan ce.

This t ype of ma int ena nce is vita l for t he cont inuous, safe, effective and reliable opera tion

of medical equipment so as to get accurate and reliable results.

8/20/2019 Me Mp 070812

11/27


7

D a ily/Weekly In spection a nd Ma int ena nce includes:

a . Visua l Inspect ion

b. P er form a nce Test s

c. C a libra t ion

d. C heckout et c.

These tasks can and must be carr ied out by the users as per the manufacturer ’s

instruct ions and suitable documentat ion should a lso be maintained for the same. Any

discrepancies if found, should be brought into the notice of the controlling authority for

necessary corrective action.

6I(4). MAINTENANCE OF THE EQUIPMENT :

P roper ma intena nce of medica l equipment is essent ia l to obtain susta ined benefits

a nd t o preserve ca pita l investment . Medica l equipment m ust be ma inta ined in working

order and periodically calibrated for effectiveness and accuracy of the results.

The Maintenance consists of:

a. Planned Preventive Maintenance

b. Breakdown Maintenance

a. Planned Preventive Maintenance (PPM)

Planned Preventive Maintenance involves maintenance performed to extend the

li fe of the equipment a nd prevent i ts fa i lure. P lann ed P revent ive Maint enan ce is usually

scheduled at specif ic intervals and includes specif ic maintenance act ivit ies such as

lubrication, calibration, cleaning (e.g. filters) or replacing parts that are expected to

w ear (e.g. bear ings) or w hich ha ve a finite life (e.g. tubing). The procedures a nd interva ls

are usually established by the manufacturer . In special cases the user may change the

frequency to accommodate local environmental conditions.

Planned Preventive maintenance wil l be a sta tutory requirement for most of the

medical equipments . It w ill enha nce the efficiency, effectiveness a nd reliability of medical

equipment and must be carr ied out a t appropr ia te f requency as suggested by the

ma nu fa ctur er/service provider.

8/20/2019 Me Mp 070812

12/27


8

Each equipment on the inventory wil l show whether i t is

a . ma int a in ed in -h ouse

b . m a i nt a i n ed by ext er n a l a g en cy or m a n uf a ct u r er.

The conditions for preventive maintenance required for medical equipment can

vary due to factor such as type of equipment, age of the equipment, frequency of use

of the equipment, etc.

The record of Planned Preventive Maintenance should be maintained department

wise and must include following details :-

1. R efer en ce I D a s per in ven t or y

2. E q uipment Na me

3. C ompa ny/Ma ke

4. S er ia l No.

5. D a te of I nst a lla t ion

6. Wa rra nt y P er iod

7. U nder AMC /C MC

8. Frequency of P revent ive Ma in tenance/C a l ibra t ion

a . a s per m a nu fa ct ur er guid elin es

b . pr es en t ly bein g f ollow ed

9 . P revent ive Ma in tenance/C a l ibra t ion Done On

10. P revent ive Maintenance/Ca l ibra t ion Due On

11. Expenditu re w i th cos t and det a i l s

12. R em a r k s w i t h F u n ct i on a l S t a t u s

The record should be maintained in table form as given in Annexure-I I .

H er e i s g i v en t h e f r equ ency of P l an ned P r even t i v e Ma i n t ena nce (PPM) o f

some o f t he med i c a l equ i p men t a s a gu i d el i ne .

8/20/2019 Me Mp 070812

13/27


9

T a b l e sh o w i n g b r o a d b a s ed b a si c f r eq u en c y of P l a n n ed P r ev en t i v e

M a i n tena n ce o f some o f th e equ i pm en ts i s as g i ven bel ow :

S.No. Equipment Name Frequency*

1 X-Ra y (C omplet e S yst em) Qua r t er ly

2 C T S ca nner (C omplet e S yst em) Qua r t er ly

3 MRI S ca nner (C omplet e S yst em) Qua r t er ly

4 Ma mmogra phy (C omplet e S yst em) Qua r t er ly

5 C a t h La b S yst em Qua r t er ly

6 C -Arm Ma chine Qua r t er ly

7 H ea r t & Lung Ma chine Qua r t er ly

8 Art er ia l B lood G a s a na lyzer Qua r t er ly

9 E lect rosurgica l U nit Qua r t er ly

10 Aut ocla ve Qua r t er ly

11 U lt r a sonic Wa sher Qua r t er ly

12 D ent a l X-Ra y Ma chine Qua r t er ly

13 U lt ra sound Ma chine H a lf Yea r ly

14 I AB P (In t ra a or t ic ba lloon pump) H a lf Yea r ly

15 E choca rdiogra phy Ma chine H a lf Yea r ly

16 TMT Ma chine H a lf Yea r ly

17 P FT Ma chine H a lf Yea r ly

18 P a t ien t Monit or H a lf Yea r ly

19 C a rdia c Monit or H a lf Yea r ly

20 E C G Ma chine H a lf Yea r ly

21 D efibr illa t or H a lf Yea r ly

22 Anest hesia Ma chine H a lf Yea r ly

23 Vent ila t or H a lf Yea r ly

* T hese ar e br oad gu i del i nes. H owever, fr equency can be al t er ed depend i ng u pon

manu factur er ’s guid el i nes

8/20/2019 Me Mp 070812

14/27


10

S.No. Equipment Name Frequency

24 OT Ta ble H a lf Yea r ly25 OT Light H a lf Yea r ly

26 S uct ion Ma chine H a lf Yea r ly

27 I n suffla t ors H a lf Yea r ly

28 E ndoscope/La pa roscope H a lf Yea r ly

29 S yr inge & In fusion P ump H a lf Yea r ly

30 I nfa n t Wa rmer H a lf Yea r ly

31 P hot ot hera py U nit H a lf Yea r ly

32 F et a l D oppler H a lf Yea rly

33 P a t ien t B ed H a lf Yea r ly

34 P ulse Oximet er H a lf Yea r ly

35 AC T Ma chine H a lf Yea r ly

36 Tourniq uet S yst em H a lf Yea r ly

37 B lood a nd F luid Wa rmer H a lf Yea r ly

38 E lect romyogra m Ma chine H a lf Yea r ly

39 E lect roencepha logra m Ma chine H a lf Yea r ly

40 B i-P a p Ma chine H a lf Yea rly

41 H umidifier H a lf Yea r ly

42 H olt er S yst em H a lf Yea r ly

43 P a ce Ma ker H a lf Yea r ly

44 B u bble C P AP (C on t in uou s pos it iv e a i rw a y pr es su re) S y st em H a l f Yea r ly

45 I nfa n t Resuscit a t or H a lf Yea r ly

46 Microw a ve D ia t hermy H a lf Yea rly

47 H ot P a ck U nit H a lf Yea r ly

48 Tra ct ion U nit H a lf Yea r ly

49 C ont inuous P a ssive Mot ion S yst em H a lf Yea r ly

8/20/2019 Me Mp 070812

15/27


11


50 C old P a ck unit H a lf Yea r ly51 U lt ra sonic Tens S yst em H a lf Yea r ly

52 H emodia lysis Ma chine H a lf Yea r ly

53 C ont inuous rena l repla cement thera py (C RRT) Ma chine H a lf Yea rly

54 D onor C ouches H a lf Yea rly

55 Microscopes H a lf Yea r ly

56 C ent r ifuge/C ryofuge H a lf Yea r ly

57 H ot P la t e H a lf Yea r ly

58 C ell C ount er H a lf Yea r ly

59 C ell S epa ra t or H a lf Yea r ly

60 P H Met er H a lf Yea r ly

61 Refr igera t or H a lf Yea r ly

62 D eep Freezer H a lf Yea r ly

63 B io-sa fet y C a binet H a lf Yea r ly

64 Wa t er B a t h H a lf Yea r ly

65 La mina r F low H a lf Yea r ly

66 I ncuba t or H a lf Yea r ly

67 U rine Ana lyzer H a lf Yea r ly

68 Micropipet t es H a lf Yea r ly

69 Weighing B a la nce H a lf Yea r ly

70 P la sma Tha w ing B a t h H a lf Yea rly

71 P la t elet Agit a t or H a lf Yea r ly

72 Tube S ea ler H a lf Yea r ly

73 E LI S A Rea der H a lf Yea r ly

74 I mmuno Assa y S yst em H a lf Yea r ly

75 Microt ome H a lf Yea r ly

8/20/2019 Me Mp 070812

16/27


12


76 Refra ct omet er H a lf Yea r ly77 Opht ha lmoscope H a lf Yea r ly

78 S lit La mp H a lf Yea r ly

79 K era t omet er H a lf Yea r ly

80 Aut o P er imet er H a lf Yea r ly

81 I ma ge C a pt ur ing syst em H a lf Yea r ly

82 D ent a l C ha ir H a lf Yea r ly

83 D ent a l S t er ilizer H a lf Yea r ly

85 Lit hot r ipsy Ma chine H a lf Yea r ly

86 Lit hot r ipsy Ta ble H a lf Yea r ly

87 U roflow met er H a lf Yea r ly

88 E NT E xa mina t ion U nit H a lf Yea r ly

89 H a rmonic S ca lpel S yst em H a lf Yea rly

90 C hest Vibra tor H a lf Yea r ly

91 F ibr illa t or H a lf Yea r ly

92 VD RL Rot a t or H a lf Yea r ly

93 H ormone Ana lyzer H a lf Yea r ly

94 Air S a mpler H a lf Yea r ly

95 Wa x B a t h H a lf Yea rly

96 S urgica l/Opera t ing Microscope H a lf Yea r ly

97 P ha co-emulsifica t ion Ma chine H a lf Yea r ly

98 Tissue F lot a t ion B a t h H a lf Yea r ly

99 Vort ex Mixer H a lf Yea rly

100 Tra nspor t I ncuba t or H a lf Yea r ly

Th i s i s no t t he en d o f t h e l i st ; ot h er equ i p men t s may a l so be ad ded i n t he

l i st a s per t h e r equ i r emen t of t h e ES IC H ea l t h I n st i t u t i o n ( s) .

8/20/2019 Me Mp 070812

17/27


13

For a bove an d rest of the Medica l E quipment , a dvice of man ufa cturer/supplier/

service provider should also be taken into consideration.

N ote: - 1. Prevent ive M aintenance of a l l the equipments whether in use or not shal l

be done per iodi call y as advised by m anu factu r er / suppl ier, so that fun cti oni ng

stat us of th e equi pment coul d be kn own an d equi pment is readi ly avai labl e

whenever i ts u se i s needed .

2. In cr i t ical care areas l ik e Casual ty, ICU , OT etc., i f the num ber of equipments

ar e l ess (one or tw o), then aut hori ty m ay look i nt o that a stand by acti ve

un it shoul d be kept r eady so that pati ent does not suffer i n case th e

equ i pm en t i n use goes ou t of or der.

3 . L i fe of equipment and qual i ty of test ing : Ensur e usage of good qual i ty

consumables for prolongin g l i fe of equipm ent and main tai n i ng qual i t y of

testing.

* Ser vi ce r eport aft er ever y r epai r or schedul e ser vi ce (PPM ) shoul d be ta ken by th e user

i n w hi ch al l th e detai ls l i ke war r ant y on spare par ts need t o be add ed an d same shoul d

be upd ated i n t he invent ory r egister as wel l as in th e M ai nt enan ce Register. If any

deficiency i s obser ved, t he sam e may be comm un i cated t o ser vi ce pr ovid er and H ead of

th e i nsti t ut ion for n ecessar y acti on. (Per form ance Ban k Guar ant ee is m eant for such

problems)

b. Breakdown Maintenance

B reakdown Ma intena nce is a ta sk performed to ident ify, isolat e , and rect i fy a fault

so tha t the out of order equipment , m a chine, or sy stem can be restored t o an opera t ional

condition.

All medical equipment in use should be free from any fault or defect and all repairwork should be carried out to accepted standards by competent person(s).

Faulty or defective equipment shall not be used regardless of how minor is the

problem a nd must be report ed in t he first inst a nce to th e ma nufa cturer/supplier/a gency

hired for maintenance of the equipment as soon as possible.

8/20/2019 Me Mp 070812

18/27


14

User department should:

1. R ecor d d et a i ls of t h e d ef ect (s ).

2. At t a c h la b el t o t h e f a u lt y eq u ipm en t (s ).

3. Conta ct Service engineer of man ufacturer/supplier/hired agency by telephone

num ber/fa x/ema il supplied a nd keep a r ecord of th e sa me.

4 . Ensure tha t in forma t ion rega rd ing breakdown i s passed to a l l st a f f, includ ing

any shif t changes and head of the inst i tut ion.

All the breakdowns occurring in the department should be maintained on record

and must include following details:-

1. R efer en ce I D a s per in ven t or y

2. E quipment Na me

3. C ompa ny/Ma ke

4. S er ia l No.

5. D a te of I nst a lla t ion

6. Wa rra nt y per iod

7. U nder AMC /C MC

8. B r ea kdow n D a te a n d Tim e

9. B reakdown D et a i l s (Technica l f au lt or other reasons)

10. Da te and Time of Rect i f ica t ion

11. Tota l Time Ta ken (Rectificat ion Time – B reakd own Time)

12. Rect if ica t ion Deta ils wit h expenditure including cost (i f a ny)

13. R em a r k s w i t h fu n ct i on a l st a t u s

The record should be maintained in the table form as given in Annexure-II

Note: - Th e r ep l a cem en t o f t h e de f ec t i v e pa r t ( s) sh ou l d be don e a t t h e

ea r l i est f ea s i b l e a f t er t a k i n g t h e n ec essa r y c on c u r r en c e f r om t h e f i n a n c e

depa r tm en t a nd san c t i on f r om th e Comp et en t A u t ho r i t y. Th e r eason ( s) f or t h e

de l a y i f an y, sh ou l d be r ecor ded .

8/20/2019 Me Mp 070812

19/27


15

Informat ion regarding P lanned P reventive Maintenance an d B reakdown Maintenance

can be kept on a single sheet. The desired information recorded and analyzed are as

given below (also given in Annexure – II)

S.No. Information

1. Reference ID

2. E quipment Na me

3. C ompa ny/Ma ke

4. S er ia l No.

5. D a t e of Inst a lla t ion “In forma t ion a bout

6. Wa rra nt y P er iod t he eq uipment ”

7. U n der AM C/C MC (w it h cos t)

8. Av er a g e L ife (a s per m a n uf a ct u r er )

9. Conta ct deta i ls of the company (manufac turer/supplier)

10. L oca t ion of the equ ipment

11. Conta ct de ta i ls of Externa l contra ctor (i f any)

12. Frequency of P revent ive Maintenance/Cal ibra t ion

a . a s per m a nu fa ct ur er gu id elin es

b . pr esen t ly bein g follow ed

13. P revent ive Ma int ena nce/C a libra t ion D one On “Informa t ion a bout14. P revent ive Ma int ena nce/C a libra t ion D ue On P P M of t he

15. E xpendit ure w it h cost a nd det a ils eq uipment ”

16. Rema rks of Serv ice Engineer

17. Rema rks of H OD /Us er

18. B r ea k dow n D a t e a n d Tim e

19. Breakdown Deta i l s (Technica l f aul t or o ther reasons)

20. D a t e a nd Time of Rect ifica t ion “In forma t ion a bout

21. Tot a l Tim e Ta k en (R ect ifica t ion Tim e – B rea k dow n Tim e) B r ea k dow n of t he

22. R ect ifica t ion D et a ils w it h expen dit ur e in clu din g cost (if a ny ) eq uipm en t ”

23. Rema rks of Serv ice Engineer

24. Rema rks of H OD /Us er

Note: - Du e ca r e shou l d be g i v en f o r t h e sa f e t y and secu r i t y of t he equ i p men t

so as t o p r o l on g i t s ac t i v e l i f e.

8/20/2019 Me Mp 070812

20/27


16

6I(5). Equipment Audit

Eq uipment a udit is a periodic evalua tion system to measure th e qua lity of performan ceof th e medical equipments.

At a ny given point of t ime, a substa nt ia l number of equipment in the hospita l ma y

be non-functional. The reasons for the same could be:

1. Wa n t of Min or r epa ir s

2. L a ck of P r ev en t iv e M a in t en a n ce

3. L a ck of cor rect iv e M a in t en a n ce

4. L a ck of es sen tia l S pa r es

5. E lect rica l F ault s

6. U n f a v or a b le en v ir on m en t a l con d it i on s

7 . Mishandl ing of equ ipment by unt r a ined and unski lled manpower

8 . P urchase of equ ipment w i thou t jus t if iab le demand et c.

9 . Fa l se Repor t ing, Wi ll fu l Dama ge and Overuse than r a t ed

For this, there is a need for periodic evaluation of the quality of performance of the

equipment in a hospita l . I f such an audit is performed, i t wil l be an advantage to a l l

ESI Hospita ls so that not only bet ter ut i l izat ion of medical equipment is ensured butalso it contributes to the improvement in the quality of health care to beneficiaries and

judicious use of resources.

The E quipment Audit sh ould be done by a commit tee (E quipment Audit C ommitt ee)

at Hospita l Level on half yearly basis .

The Equipment Audit Committee should consist of:

1. The Medica l Superintendent/designa ted medical off icer of the hospita l

2. Th e h ea d of t h e con cer n ed d epa r t m en t

3. H ea d of m a in t en a n ce (I f P os t ed )

4. R epr es en t a t i ve f rom Ad m in is t r a t ion

5. R epr es en t a t i ve f rom F in a n ce D epa r t m en t

6. H os pit a l S t or e I n -ch a rge

7. Nur sin g S uper in ten den t

8/20/2019 Me Mp 070812

21/27


17

Focus of the Audit is to:

1. C heck the cur rent s t a tus of the medica l equ ipment2 . Ana lys is of the records such a s B reakdown Reg is t er, P revent ive ma in tenance

Register

3 . Ques t ion ing the user a bou t the usage and per formance of the equ ipment .

4 . Sugges t ing measures t o opt ima l ly u t i li ze the equ ipment for qua l i t y hea l th

services.

Advantages of the equipment audit are to:

Evaluate the performance and ut i l izat ion of the equipment

Provide an objective method for planning of equipment procurement in future

Analyze various inadequacies (including downtime) in the utilization of an

equipment and recommendation of remedial measures (including training to

th e users) so as t o maximize th e efficiency a nd effectiveness of the equipment .

6I(6). Training and Development

For the safety of the pat ient and the user , proper tra ining is cr i t ical for both the

user an d t he technical sta f f . Tra ining a nd educat ion is not a one-t ime a ct ivity but a

continuous process.

Tra ining ma y be:

1. I n-H ouse

2. At r ecog niz ed in st it u t ion s

1. In-House Training

a . For operat ing the equipment – to be given by Ma nufacturer/Supplier periodically

a nd prefera bly to be ment ioned in Tender E nq uiry D ocument .

b . To d ea l w i t h r ou t in e m a i n t en a n ce a n d repa i r s

Use of tool kit

Know ledge a bout common a nd recurrent ca uses of fa ilure of th e equipment

and how to rectify minor causes of failure

Calibrat ion of the equipment

8/20/2019 Me Mp 070812

22/27


18

2. Training outside at recognized institutions – workshops etc.

a . F or oper a t i n g t h e eq u ipm en t (if r eq u ir ed )b . To d ea l w it h r ou t in e m a in t en a n ce

6(II). GUIDELINES TO BE FOLLOWED AT ESIC HQRS.

(PROCUREMENTCELL) LEVEL

The tasks to be performed at ESIC Hqrs. level:

1 . To a ssi st H ead o f the ESI Ins t itu t ions in planning , mana g ing and implement ing

th e ma intena nce of medica l equipment w ith th e help of Bio-Medica l E ngineer(s)

whenever request received.

2 . Ma in t a in ing in forma t ion ob t a ined f rom a l l ES I H ospi t a l s rega rd ing Inventory,

P lanned Prevent ive Maintenance (PPM) and Breakdown.

The informa tion received w ill be kept h ospita l-w ise as w ell as eq uipment-w ise

in the format given in Annexure-I & II.

3. Ana lyzing the above informat ion for Quali ty Mana gement of Medical equipments

being used at dif ferent ESI Health Inst i tut ions. This wil l be done through

assessment and ana lys is o f :

a . Downtime of Major Equipments such as in OT, ICU , Ima ging, Dialysisand Laboratory etc . I t needs to be compared quarterly.

Formula: -

Total Breakdown timeDowntime of equipment = ——————————————— X 100 Total Uptime

b. Maintenance Cost Index*

Maintenance CostFormula :- ————————————— X 100 Capital Cost

* To check th a t m a int ena nce cost should not in crease 80%of the capita l cost of equipment .

Th e above i n f o rm a t i on w i l l h el p i n i ssu i n g necessa r y gu i del i n es t o ESI H ea l t h

i n st i t u t i o n s (whenev er r equ i r ed ) i n r el a t i o n t o ma i n t ena n c e o f equ i pmen t .

8/20/2019 Me Mp 070812

23/27


19

7. ORGANIZATIONAL STRUCTURE: should be

I. At Hospital Level

Head of the Inst i tut ion

↓

Head of the Department

↓

S r. Techni cia n

↓

Techn icia n (s)

Duties Assigned should be:-

Head of the Institution: 1. G u i d i n g H ea d of t h e d epa r t m en t r eg a rd in g

maintenance of equipment and periodic checkup of

records.

2. In te r ference i f prob lem i s not solved a t t he Head of

the Department level .

Head of the Department: 1. S uper vis ion a nd m on it or in g t h e w or k of t ech nicia n s

2. G u i di ng Tech n icia n s r eg a r d in g u sa g e a n d

ma in tenance

3. F r eq u en t com m un ica t i on w i t h m ed ica l

superintendent r egard ing functioning of equipment.

Sr. Technician: 1. Superv is ion of Technicians for :

a . S a f e & s ou nd us e of t he eq uipm en t

b. P eriodic (Da ily/Weekly etc.) ma intenance of the

equipment .

c. F r eq u en t com m un ica t i on w it h H ea d of t h e

department and designated persons.

2. F r eq u en t com m un ica t i on w i t h H ea d of t h e

Department regarding funct ioning of equipment .

8/20/2019 Me Mp 070812

24/27


20

Technician: 1. S a fe & sound use of t he eq uipment

2. P er iod ic (Da i ly/Weekly e t c. ) ma in t enance of the

equipment .

3. Frequent communica t ion w i th S r. Technician and

designated persons.

II . At ESIC Hqrs. Level

Medical Commissioner

↓

Deputy Medical Commissioner

↓

Bio-Medical Engineer(s)

Medical Commissioner: 1. G uiding D eput y Medica l C ommissioner a bout

the a ctions to be ta ken in relation to equipment

maintenance at various hospita ls .

2 . In forming to D i rector Genera l abou t the act ions

taken in rela t ion to equipment maintenance

policy.

3 . In te r ference i f prob lem is not solved a t MS/

DMC level.

Deputy Medical Commissioner: 1. S u per vis ion a n d m on it or in g t h e w or k of B i o-

Medical Engineer(s)

2. G u i di ng B i o-M ed ica l E n g in eer in m a i nt a i n in g

records

3. I s su in g n eces sa r y in s t r uct i on s t o a l l E S I

Hospita ls whenever required.

4. I n for m in g Med ica l C om m is si on er a b ou t t h e

a c t i o n s t a k e n i n r e l a t i o n t o e q u i p m e n t

maintenance policy.

8/20/2019 Me Mp 070812

25/27


21

Bio-Medical Engineer: 1. G uiding H ea d of t he I nst it ut ion(s) rega rding

ma in tenance and prov id ing in fo rma t ion to

Deputy Medica l Commissioner a bout t he sta tus

of equipment a nd t heir funct ioning a t va rious

ESI Hospi ta ls .

2. M a i nt a i n in g t h e I n v en t or y /P P M /B r e a k dow n

record hospita l wise where the cost of the

equipment is more than 10 Lakh rupees per

unit a nd a na lyzing them. To suggest measur es

in appropriate si tuat ions.

3. C a l cu la t i ng D ow n t im e of t h e eq u ipm en t s &

ma int ena nce cost index periodically, compa rison

with other ESI Health Inst i tut ion(s) having

the sa me equipment a nd suggest ing measures.

Th er e w i l l b e a f r equen t c on t a c t between f u n c t i o n a r i es a t ES I h o sp i t a l s an d

ES IC H ead qua r t er s t h r ough cor r espond ence t el ephone/ema i l /f a x .

N o t e: - Once I T Ro l l ou t i s f u l l y oper a t i ona l , t he da t a f ed can be u t i l i z ed a t

H ead Qua r t er s an d p er i p h er y a t t h e sam e t i me.

7. SUMMARY:

To provide the best hea lthca re services, there is a need of th e best q ua lity m edica l

equipment which helps in diagnosis, t reatment , monitoring of pat ients (IPS, Staff &

beneficiaries). Some of the equipments are also to be used for teaching and research

purpose. These guidelines have been framed to keep these equipments well maintained

so as to get the accurate results in order to provide the best healthcare services to IPs,

staff & beneficiaries. It is expected that these guidelines shall be followed by all in true

spirit so to achieve our (ESIC) objectives and mission.

8/20/2019 Me Mp 070812

26/27


22

A N N E X U

R E - I

I N V E N T O R Y

R E G I S T E R

S . N o .

R e f e r e n c e

I D

E q u i p m e n t

N a m e

Q t y .

C o m p a n y /

M a k e

( w i t h

C o n t a c t

D e t a i l s )

S e r i a l

N o .

D a t e

o f

I n d e n t

T e n d e r

N o . / L o c a

l

P u r c h a s e

N O A N o .

( w i t h

d a t e )

C o s t

p e r

u n i t

D a t e o f

i s s u e o f

C R C

D a t e o f

I n s t a l l a t i o n

D a

t e o f

i s s

u e o f

F

A C

W a r r a n t y

P e r i o d

( w i t h

E x p i r y

D a t e )

A f t e r

w a r r a n t y

m a i n t e n a n c e

c o n t r a c t

w i t h p e r i o d

a n d c h a r g e s

S p a r e p a r t s /

C o n s u m a b l e

i n v e n t o r y

C u r r e n t

s t a t u s o f

f u

n c t i o n i n g

o f

e

q u i p m e n t

w i t h

R e m a r k s

N o t e : - I n v e n t o r y r e g

i s t e r s h o u l d b e u p d a t e d h a l f y e a r l y

f o r c u r r e n t s t a t u s o f f u n c t i o n i n g o

f t h e e q u i p m e n t , w i t h n a m e a n d s i g n a t u r e

o f t h e c o n c e r n e d p e r s o n b y w h o m e q u i p m e n t h

a s b e e n c h e c k e d .

N e c e s s a r y a c t

i o n s h o u l d b e t a k e n i f r e q u i r e d s o t h a t e q u i p m e n t i s n e a r l y a l w a y s

a v a i l a b l e f o r t h e r i g h t u s e .

8/20/2019 Me Mp 070812

27/27


23

A N N E X U R E - I I

M A I N T

E N A N C E

R E G I S T E R

E q u

i p m e n

t N

a m e w

i t h R

e f e

r e n c e

I D :

C o m p a n y

/ M a

k e :

S e r

i a l N

o . :

D a

t e o

f I n

s t a

l l a

t i o n :

W a r r a n

t y P

e r

i o d ( D

a t e

o f E

x p

i r y

) :

U n

d e r

A M C / C M C

( w i t h

c o s t

) :

A v e r a g e

L i f

e ( a

s p e r

m a n u

f a c

t u r e r

) :

F r e q u e n c y o

f P l a

n n e d

P r e v e n

t i v e

M a

i n t e

n a n c e

( a s p e r

m a n u

f a c

t u r e r )

:

C o n

t a c

t d

e t a i l

s o

f t

h e c o m p a n y

( m a n u

f a c

t u r e r

/ s u p p

l i e r

) :

L o c a

t i o n :

C o n

t a c

t d

e t a i l

s o

f E

x t e

r n a

l C

o n

t r a c

t o r

( i f

a n y

) :

N o t e

: -

1 .

P l a n n e d P r e v e n t i v e

M a i n t e n a n c e

c o l u m n

s h o u l d

b e

f i l l e d

w i t h

G R E E N

P E N

i n

R e g i s t e r a n d

w i t h

G R E E N

C O L O R

i n

c o m

p u t e r .

2 .

B r e a k d o w n

c o l u m n

s h o u l d

b e f i l l e d

w i t h

R E D P E N

i n

R e g i s t e r a n d

w i t h

R E D

C O L O

R

i n

c o m p u t e r .

S . N o .

( 1 )

P r e v e n t i v e

M a i n t e n a n c e /

C a l i b r a t i o n

( 2 )

E x p e n d i t u r e

w i t h c o s t

( I f a n y )

( 3 )

R e m a r k s o f

t h e S e r v i c e

E n g i n e e r w i t h

f u l l n a m e

s i g n a t u r e

( 4 )

R e m a r k s o f

H O D / U s e r

w i t h f u l l

n a m e

s i g n a t u r e

( 5 )

B r e a k d o w n

D a t e a n d

T i m e

( 6 )

R e m a r k s o f

H

O D / U s e r

w

i t h f u l l

n a m e

s i g n a t u r e

( 1 2 )

R e m a r k s o f

t h e S e r v i c e

E n g i n e e r

w i t h f u l l

n a m e

s i g n a t u r e

( 1 1 )

R e c t i f i c a t i o n

D e t a i l s

w i t h

E x p e n d i t u r e

( I f a n y )

( 1 0 )

T o t a l

T i m e

T a k e n

( 9 ) = ( 8 - 6 )

D a t e a n d

T i m e o f

R e c t i f i c a t i o n

( 8 )

B r e a k d o w n

D e t a i l s

( T e c h n i c a l f a u l t

o r a n y o t h e r

r e a s o n s ) a s

e x a m i n e d b y u s e r

( 7 )

D o n e

o n

N e x t

D u e O n

me mp 070812

Documents