EBME Forums Forums Management Medical Equipment Management Planned preventive maintenance

Planned maintenance could be categorised in the following 3 areas:
1. High risk device
2. Medium risk devices
3. Low risk devices

Risk categorisation could be determined by:
 looking at clinical usage
 reliability
 dangers to patient on failure
 User training

A Risk centred common sense approach allows better use of resources.

High risk
These device are life saving / threatening. [e.g. Defibrillators, Infusion pumps]
All high risk devices will be checked regularly for safety and funtionality, technicians will receive technical training of a suitable standard.

Medium risk
These devices aid diagnosis and therapy [e.g. ECG, Physiotherapy]
Some medium risk devices may be maintained

Low risk
These devices aid diagnosis [e.g. Handheld Aurascope, Aneroid sphygmomanometer]

PPMs on high risk devices should be carried out more frequently than PPMs on Medium risk devices.
PPMs on Low risk devices may not carried out if the risk is deemed to be acceptably low.

We are already using this system to manage our ppm list. What is the concensus? (I know the MDA ONLY recommend following manufacturers advice) How do you manage your ppm's?

If PPMs cannot be carried out for any reason, should the EBME Manager use his experience and professionalism in deciding which PPMs are considered necessary?

John,
I have spent considerable time on this issue and have come up with a system which builds on the empirical work already in use in the UK and US. This has been ratified by my Risk committee as an appropriate means of quantifying risk, and optimising resource use. It has been peer reviewed by the NPAG southern benchmarking (EBME)club and has been proposed as 'best practice'

It basically derives a risk score in a similar way to you (High, Med,Low)which is used to prioritise/guide resource utilisation
Planned maintenance could be categorised in the

It considers several risk factors;

Functional, Physical, Location,
and overlays them with maintenance, utilisation, and mission scores (mission = degree of importance to Trust in providing a clinical service)

Obviously there is a lot more to it than assiging scores/weightings. The important thing is that is applies consistency of approach, optimises management of (device)risk, and provides a ready set of performance indicators, as well as the data needed to justify modification of some criteria (maintenance frequencies, relative change in importance to Trust in meeting clinical outputs).


'If PPMs cannot be carried out for any reason, should the EBME Manager use his experience and professionalism in deciding which PPMs are considered necessary?'

Yes, but it needs qualification in light of the risk factors outlined + justified from such evidence. Whilst extensive experience + gut feel are often good enough, trying to justify that to 'the one that got away' to a court will not cut any ice.

Morale = document, document, document.

If you want further info, I am happy to provide

Paul H

John, Paul, Louis employs a similar algorithm to the one's described. Louis's hospital FORMALLY classifies/grades equipment in a similar countenance which John describes. This classification is, Louis believes, an American system and it is quite often written in to the relevant specification i.e. (as Johns, and I believe he has worked where Louis is now)

Class
1. High risk device
2. Medium risk devices
3. Low risk devices

Louis's can then prioritize accordingly though Louis still likes to fulfill his PPM agenda as do we all, my friends, as do we all. If you can get your property managment etc. to formally grade equipment, you may find it easier to prioritize on a more qualitive podium than that of your personal “gut instinct”.

Louis III

Paul, Louis,
I'm pleased to see that we are thinking along the same lines.

I would like to carry out this function in the most professional way, and I would like to see your 'ratified' risk process, which is leap-years ahead of mine. Paul, Louis, if it is in a format which can be e-mailed could please you send me a copy to: john@ebme.co.uk , also would you like to put them up to share as downloads? If so, let me know when you send them.

John,
I have mailed you a couple of items which will help explain. I think that the presentation will need significant modification to make it self explanatory to a wider audience. Please give your views before consideration is given to doing this
PAul

Paul
Thank for the info.
I will have a read and get back to you.

John, its a public holiday where Louis dwells, Louis will e-mail you our full "equipment classification policy" when Louis's Gluteus is firmly back at his desk.

Meantime I believe it was tailoured around the The C.E. Medical Devices Directive guidelines:-

You could contact cemark@conformance.co.uk for an extensive listing or use the following:-


CE Conformance.
Great Hucklow
Buxton
Derbyshire
SK17 8RG
England
Tel: +44 (0)1298 873800

It works really well for Louis's institution and combined together with a risk assesment policy it is the "dogs b*lloc#s" in terms of "labour shortage" with regards to gluteus habiliment

Kind Regards

Louis III

Louis, I follow the device classification logic, + therefore the resource utilisation argument. But how do you factor in the maintenance and environment (things important/unique to your organisation) variables + how do you review/justify changes to PV/PM frequencies etc

I am observing + desperately hoping to learn !!

Paul

Paul, my coadjutor, if by environment you symbolize “location” then yes that has always and will continue to be a drawback, however, every clinical department in Louis's trust sits an entrusted person who is responsible for ensuring that items are available as and when they are due.(thanks KM) , Louis appreciates that a lot of trusts probably don't employ this type of system but it really does work. There are also added benefits of EBME-USER relations which Louis feels are strengthened by this arrangement. Our computer system is managed by our maintenance control room, this includes all PPM's and general maintenance, they distribute the work to their relevant departments i.e. electrical, mechanical, EBME etc. (Note EBME is totally independent of all other services) (Note EBME is totally independent of all other services) It is an excellent system but the initial cost is mega wonga, but it allows us to reschedule work if necessary. As there are in comparison only a small number of “in-accessible” pieces of equipment it hardly effects the annual distribution of work.

Hope this is informative my friend

Louis III

Louis, Paul,
Do you ever have problems trying to convince staff that their equipment no longer needs a PM check? (When classified as LOW RISK)
I currently have someone here trying to insist on their equipment having PM's.