Maintenance of Medical EquipmentDr A PrakashSr Professor, Health ManagementNational Academy of Indian ail!ays"al#aug$adodara %&'E()I$ESHighest le*el of a*aila#ility of medical equipment to the clinical users+uality impro*ement , cost reductionApplica#le regulations , standardseduce the need of premature replacement of the equipment DE-INI)I%NS-.N()I%N!hat the equipment is designed to doPE-%MAN(E S)ANDADSlimits !ithin !hich a function is considered accepta#le to the user#ut esta#lished #y %EM !hen designing the equipment-.N()I%NA" -AI".Eina#ility to fulfill a function to a performance standard accepta#le to the useror to perform according to the original technical specification -AI".E )/PESE$IDEN) -AI".Ethat on its o!n e*entually , ine*ita#ly #ecomes e*ident to the user under normal circumstancesHIDDEN -AI".Ethat !ill N%) #ecome e*ident to the user under normal circumstances if it occurs on its o!nSE+.EN)IA" -AI".E!hen a protected function fails after the failure of a 0not fail1safe0 protecti*e de*ice goes undetected -AI".E PA))ENS2ear1out -ailure Pattern 3 Normal distri#ution of failure frequency after M)&-4 Age related failure traditionally addressed #y pre*enti*e maintenance , scheduled replacement of parts4 Steady Increasing -ailure Pattern 3 )he pro#a#ility of failure increases steadily !ith age4 (ommon for mechanical de*ices that !ear out !ith time4 -AI".E PA))ENSandom -ailure Pattern 3 )he pro#a#ility of failure does not change !ith age #ut is constant through out the life of the equipment4 )ypical of electronic equipment4"o! Initial -ailures Pattern 3 )he pro#a#ility of failures increase rapidly initially #ut #ecomes constant after a short period of time4 &ad quality machines4 -AI".E PA))ENSInfant Mortality -ailure Pattern 3 High pro#a#ility of failure initially #ut #ecomes constant after!ard4 &ad +(40&athtu#0 -ailure Pattern 3 (om#ination of Infant Mortality -ailure Pattern , 2ear1out -ailure Pattern MAIN)ENAN(E (A)E5%IESProacti*e Maintenanceeacti*e Maintenance MAIN)ENAN(E (A)E5%IESP%A()I$EPre*enti*e MaintenanceScheduled replacement of parts for age6usage related deteriorationPredicti*e Maintenance)o check for potential failure , action taken to pre*ent functional failureEA()I$E-ailure1finding )askPeriodic inspection to detect Hidden -ailures , -ailure of non1fail1safe protecti*e de*icesA"" MAIN)ENAN(E M.S) &E )E(HNI(A""/ -EASI&"E , 2%)H D%IN5 7 MAIN)ENAN(E SE$I(E )/PESEquipment Acceptance%perational (heck%( frequency 3 High isk1Each .se6Medium1Daily6"o!12eeklySafety , Performance Inspection)o detect potential6hidden failures , includes Electrical Safety )estPre*enti*e Maintenance(orrecti*e Maintenanceeplacement MAIN)ENAN(E S)A)E5IESeplacement onlyepair or eplaceScheduled InspectionsNon1sampled InspectionsSampled Inspections-ull Ser*ice 8 Scheduled PM9 MAIN)ENAN(E S)A)E5IES *s SE$I(E )/PES Equipment Maintenance Management Plan2HA) )% IN(".DE : E(I Method 8;9IS? "E$E"-unction 1 therapy6diagnosis6monitoringApplication isk 3 in@ury6dangerous energyEAperience , 5eneralSPE(IA" E+.IEMEN)S"ife (ycle (ost%perational DifficultiesStandards , egulations E(I isk "e*elsHI5H IS?"ife Support, esuscitation, (ritical Monitoring , other de*ices !hose failure or misuse is likely to seriously in@ure the patient or staffMEDI.M IS?De*ices including many diagnostic equipment !hose failure, misuse or a#sence !ould ha*e significant impact on patient care #ut is not likely to cause serious direct in@ury"%2 IS?De*ices !hose failure or misuse is not likely to cause serious consequences E(I Method Implementation.se isk "e*els , Special equirementsInclude all High , Medium and some "o! isk de*ices in Maintenance PlanInspection -requency 3 High isk 3 )!ice a yearMedium isk 3 Annually"o! isk 3 Eliminate unnecessary inspections #ased on eAperience -ennigkoh , Smith MethodAlso kno!n as isk &ased (riteriaEquipment gi*en a *alue 3 Equipment Management Num#er 8EM9EM B -unction C Physical isk C Maintenance equirements -unction)herapeutic"ife Support 1111111111111111111111111111111111111111111111111111 ;DSurgical , Intensi*e (are 11111111111111111111111111111111111(omputer , elated 1111111111111111111111111111111111111111111 HMiscellaneous 3 Patient related , %thers 1111111111 I Physical iskPatient Death GPatient or %perator In@ury >Inappropriate )herapy or Misdiagnosis HNo significant in@ury ; Maintenance equirementsEAtensi*e GA*erage HMinimal ; -ennigkoh , Smith Method ImplementationEM 3 min B > , maA B IDIf EM J ;I, the equipment is included in the Maintenance Management Plan%ther!ise EK(".DEDEAcluded equipment is repaired as neededIncluded equipment goes for pre*enti*e maintenance 3 monthly6quarterly6half yearly6yearly as per EM *alue Su#sets of EquipmentsPM.se , )hro!epairPM AN%)HE 2A/ 1 ("ASSI-I(A)I%NPatient iskHigh Medium "o!Mission(ritical)ier ; )ier ; )ier ;(riticalityImportant)ier ; )ier I )ier INecessary)ier I )ier H )ier H EKAMP"ES %- )IE S/S)EMPA)IEN) IS?HI5HMEDI.M "%2MISSI%N(I)I(A"Anaesth4 Machine, $entilatorAuto (hem Analyser, (), MI, (ath "a#Electron Microscope(I)I(A"I)/IMP%)AN)P(A Pump, Defi#rillator, Incu#atorInfusion Pump, ES., A&5, MonitorsSpecial Procedure )a#leNE(ESSA/Patient "ifter, "aminar Air -lo!E(5, Pulse %Aymeter, -eeding PumpPatient Scale, EAamination "ight IMP"EMEN)A)I%N)ier ; 3 Definitely SPI, Some for PMPSI for need , frequency, PM for need)ier I 3 May require SPI or PM for operational efficiency or quality of careSPI for need , frequency analysis, PM cost effecti*eness:)ier H 3 ecord maintained for asset control or replacement planningeplace only for lo! cost, epair or eplace the rest MAIN)ENAN(E S(HED."IN5)HE%A)I(A" APP%A(HPM Period L M)&-SPI Period B I K 8; 3 a*aila#ility9 K M)&-PA()I(A" APP%A(H%EM ecommendationPast EAperienceEApert %penion MAIN)ENAN(E M%NI)%IN5)otal Maintenance EApense as M of )otal In*entory Acquisition (ost)otal Maintenance EApense 6 Pt4 discharge or Pt4 Day)otal Maintenance EApense 6 &ed or )otal %perating EApenses)otal .ptime a*aila#le S.MME/ %&SE"EN(E , EP"A(EMEN)eplacement is not needed for a !ell !orking old machine4(hanged safety standards(hanged !ork needs%ther machines of different designs"ack of ser*ice from *ender 8eAplore %EM9"ack of accessoriesPost ser*icing certification6cali#ration not possi#le Thank you+uestions :emailN prakash4nrchOgmail4com