Hospital Equipment planning &selection

Introduction


Medical equipment could be viewed as component of healthcare technologies, applied with the aim of achieving an effective and safe diagnosis or therapy. There are many obvious examples of healthcare technologies and especially medical equipment has offered new opportunities in medical practice and dramatically contributed to improved health. Hospital, a healthcare delivery agency is most affected by changing medical technology. Hospital equipment ,specially of new generation has got immense role in advancement of modern medical technology.

There are many types of equipments used in the hospital nowadays. They can be classified as therapeutic ,diagnostic, administrative, monitory and research purposes etc. Equipments being major resource of modern technology based patient care and its high cost (capital and maintenance) draws the attention for proper planning in future.

Equipment planning


Planning determine the objectives to be achieved and future course of action to be followed to achieve them. It is a process which requires the use of intellectual faculties, foresight and sound judgment. Planning is deciding the future course of action by selecting best among available. Decision taking is the core of planning process. It involves deciding in advance what to do, when to do ,where to do ,how to do and who is to do.

Planning of the equipment is also based on same principle. Just acquiring an equipment is not a sound planning. Modern treatment system is day by day becoming dependent on the equipments which determine the quality and quantity of patient care. Therefore ,hospital managers should plan the equipment from its acquisition to disposition. There are many consideration involved in the equipment .Therefore , the planning should be based on these factors.

Why planning of equipment is important?

Hospital equipments nowadays are very expensive. It is mentioned that in a modern hospital, equipment and appliances makes up about a third to half of the total project cost. High tech equipment once introduced often remains idle due to improper maintenance and lack of spare parts. In a recent estimation, it has been calculated that idle, non installed or non functional equipments responsible for wasteful expenditure of crores of rupees in hospitals. Technology based treatment system, high cost of equipment maintenance ,quality of patient care are the burning aspects related to equipments which draw the importance of planning of equipment

What to be planned? Considerations involved, which attracts the planning of an equipment

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Establishing the need Selection Installation and running Equipment maintenance, spares and necessary Training and Development Utilization & cost effectiveness Quality assurance Equipment audit Life of equipment &condemnation Equipment management information system

Establishing the need



The first step in equipment planning is to establish the objectives and desired results from the equipment. The need of the equipment should be fully justified. The need should be supported by the internal and external environment of the organization .SWOT analysis can be best applied while planning the equipment in support of need of the equipment.

Strength : The hospital has enough workload and money for purchase of the equipment. weakness : can the hospital afford the capital and running cost of the equipment though need is there? Does the hospital have expertise to run the machine. Opportunity : How may machines are available in the hospitals located in vicinity. The utilization is ensured. Threat :Emerging hospitals in the vicinity may have the same equipment in future. Changing technology in future may affect the use of the machine. The decision of take or not to take should be based on above

Selection
 

 

Once need is established, the great emphasis should given on the selection of the equipment. Healthcare providers must be aware of the standards and latest technology trend so as to make the right choice . Most of the time ,busy administration are misguided by the rosy picture painted before them by the manufacturer and or marketing agents. We must, at all costs, avoid playing puppets in the hands of manufacturers and vendors. The specification should be prepared and select the best among the available. The cost of the equipment is one of the major consideration at the time of planning.

The other criteria, which can be applied in the selection of an equipments VED & HML. Following things to be kept in mind while selecting the equipment. a) Hospital point of view: -Cost of equipment -Profitability of the hospital -Quality of patient care - Use of the equipment b) Patient s point of view: - Cost of the treatment/investigation - Safety of patient - Quality of treatment/investigation - Non-invasiveness in treatment/investigation Non

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Final choice of equipment and facilities to be depended upon What is available or what can be made ;that is , the technological feasibility constraints; What is economically reasonable.

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Bureau Of Indian Standards (1994) has recommended that while planning for an equipment the selection of the equipment should be based on following: Need of the hospital Budget or available fund Optimum utilization Maintenance of the equipment Manpower development &training of the staff. Performance and utilization evaluation INSTALLATION and running

Consideration to be kept before installation

Location /site b) Space c) Availability of supportive services: civil, electrical d) Auxiliary facilities Operational requirements: requirements: 1)Manpower 2) Material 3)Methodolgy 4)Environment
a)

Equipment maintenance


The equipment maintenance is one of the most important components of the equipment planning management. The main objective of equipment maintenance is uninterrupted operation or service in a hospital. The maintenance provides safety and quality of work and life.

Maintenance policy
 

Each hospital should develop the maintenance policy. The basic concept of the maintenance policy is to support the life and health of patient with keeping the reliability and safety of the equipment operated daily. To keep such a situation, overall factors such as management ,finance, technical matters and environment conditions based on the philosophy of medical services should systematically be combined.

General objectives of equipment maintenance

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To extend the useful life of assets. To ensure the optimum availability of installed plant and equipment for production and to obtain the maximum possible return on investment in these items. To ensure the operational readiness of all equipments for emergency use at all times. To ensure the safety of patients, person using and operating the facility. To provide a systematic approach to work of the department.

Types/systems of maintenance


Preventive maintenance: a systematic maintenance: maintenance procedure wherein the conditions of the equipment is constantly watched through a systematic inspection programme and preventive action taken to reduce the incidence of break-down. breakMajor and minor repairs are carried out on scheduled time in order to avoid machine breakdown.

Breakdown maintenance: of the equipment maintenance: is generally carried out when the equipment breaks down or gets out of order. Such breakdown may occur to any machine any time. It is carried out by in-house workshop or incontractor. Corrective maintenance: the use of preventive maintenance techniques and controls will bring to light instances of repeated failure of a plant or component of the equipment. where such repetitions are observed corrective maintenance may be necessary to eliminate recurrence.

Planning to be made to prevent these followings: Electrical safety Mechanical safety Chemical safety Thermal safety Radiation safety Optical safety Biological safety

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Utilization


Essentially means the use of the equipment of its full potential. It should be the Endeavour of the management to optimize the equipment utilization to obtain maximum return for the capital invested. Proper utilization of the hospital equipment will lead to: -optimal patient handling and rapid turnover -Minimum possible cost -Quality patient care and satisfaction.

Quality Assurance


Analysis and evaluation of functioning of an equipment are essential to a sustained high quality of equipment.

Equipment Audit


It s a periodic evaluation of the quality of performance of equipment in a hospital. It is hoped that if such an audit is performed, it will be an advantage to all concerned viz.Hospital ,professional, government and the management so that not only better utilization of scarce resources ensured but also contributes to the improvement of quality of hospital care.

Advantages: BIS described

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To evaluate the concurrent performance and utilization. It provides a satisfactory mechanism to assist the process of condemnation. The equipment audit reports provide an objective method for procurement of equipment in future. To identify inadequacies and recommend remedial measures Cost effectiveness can be evaluated.

Training and development

Training in hospital equipment can be broadly classified under the following categories:  Training by the supplier of the equipment dealing with its operation.  Training within the hospital dealing with routine maintenance/repairs.  Training outside the hospital in a recognized institution dealing with maintenance /repairs for electronic equipments.

Thank you