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Hero
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Hero
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As equipment is becoming more reliable generally is it sensible to increase the service interval? The MHRA remain uncommitted. Manufacturers are also uncommitted (and may lose contract revenue by reducing service period). Evidence from our database and personal experience shows we are over-servicing some equipment and not looking closely enough at the NEED for service or the risks of not servicing or reducing service period. I am speaking on this subject at the PACE meeting on Tuesday 25th November 2003 at The Shropshire Education & Conference Centre, Royal Shrewsbury Hospital, Shrewsbury. Any ideas, suggestions for my presentation welcomed. smile

Do you look at reliability and risks assosiated with maintenance? (We have already changed our approach reducing the service intervals on some equipment groups, or waiting for failure on others.)


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John, we have just reviewed our annual PPM schedule and it was decided to follow the Service manuals "Done Thing" so to speak. The main reason for this is entirely from a legal point of view. I.e. in a court of law (incident leading to fatality:- medical equipment source of hazard etc.) you must be able to show you followed some form of recognized protocol and as 98% of our service manuals contained “service schedule information” it serves to keep my C.E happy as well as secure our jobs. smilewink

Kind Regards


A problem is a gift to be unwrapped :rolleyes:
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Hero
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Hero
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Seymour,
I understand your point of view, but it is not viable to keep increasing the resources for the department as the assset base grows. Our asset size has grown 80% in 6 years, the hospital has also grown. All NHS Hospital can expect their medical equipment asset size to increase by approx 100% in the next 10 - 15 years.

With standard Planned Preventive Maintenance some advantages are:
Increased component life-cycle. Reduced equipment or process failures, and some studies show a 12-18% savings over reactive maintenance methods (Fix it when its broke). frown
The Disadvantages are failures will still occur,
It is Labour intensive, and performance of unnecessary maintenance is carried out.
With Reliability Centered Maintenance a process is used to determine the maintenance requirements of any device based on its operating context.
cool
The maintenance plan is based upon reliability criteria with priority given to the most critical High risk devices. We determine what types of failures are likely to occur. Focus on preventing failures whose consequences are likely to be a serious risk. This emphasises the use of predictive maintenance practices and utilises previous aspects of reactive and preventive maintenance concepts, in concert with root cause analysis of component/device/system failure.

Careful analysis of failures and effects can identify effective maintenance tasks or alternative strategies. These changes can be integrated into the existing maintenance program.

This can be the most efficient maintenance program. (when done properly)
(With regard to resource and risk management) It lowers costs by eliminating unnecessary maintenance, and minimises frequency of maintenance. laugh There is still the reduced chance of sudden equipment failure. We are now able to focus maintenance activities on critical devices/components resulting in increased reliability.
It incorporates database analysis and can have significant startup cost, (training, equipment, etc). Unfortunately the savings potential is not readily seen by some senior management and some departments are unable to operate this type of system because their database is not up to the job, they do not have the manpower, training or test equipment. We are moving towards reliability centered maintenance because it is the most efficient way (in my opinion) to set up a maintenance program.

With regard to your point made about legal argument. As long as you are able to present a viable argument in court, you are on solid ground.
This is not about 'not doing maintenence', but 'improving maintenance' practice. smile


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Savant
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John

I suggest the introduction of equipment libraries, where the majority of the hospital's medical equipment is routinely visually inspected be skilled or semiskilled staff, would strengthen your case for rationalised maintenance schedules.

Bill smilewink


Bill
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Hero
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Bill,
We do have an equipment library, and the equipment receives a visual inspection, is switched on, reset to a standard config, and then placed on charge. We have reduced the maintenance period on some device groups already where we have carried out an appraisal based on reports produced from our database. This is on a concession note at the moment (until we have shown that the reduced period has not affected the reliability)


Be Proactive and reactive.
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Quote:
With regard to your point made about legal argument. As long as you are able to present a viable argument in court, you are on solid ground.
This is not about 'not doing maintenance', but 'improving maintenance' practice.
I cannot argue with you John, we can all only do a "days work" so to speak. But I personally would be very wary altering the said PPM interval when the manufacturer has already published their recommendations. If I where in the situation where I knew we couldn’t cover every “maintainable item”. I would certainly put pen to paper and as such draught up an official letter to my CE advising him/her of the shortfall.

Regards

Seymour wink

P.S. Huw, could you please please install a spell checker laugh


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KM Offline
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Have any changes in what the origional manufacturer has quoted as acceptable maintenance been ok,d at board level within your organisation and / or the origional manufacturer given their ok to the changing of stated service frequency.

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Hiya John

Ive no doubt that using a practical evaluation methodology to develop or optomise a maintenance program will realise a significant return on your project investment, protracted savings will be realised by the focusing of valuble resources.

There are so many different ways to approach reliablity centered maitenance, my experience and research indicates it is prudent to concentrate on the validation and optimization of existing PM tasks and rely predominently on existing sources of information and the expertise and experience of staff when performing failure evaluation etc.

Im sure youll find this process an eye opener, I know leading lights in ECRI have published papers which conclude the RCM process and implimentaion is often highly beneficial, Id be very interested to know how you get on.

We all strive to ensure that equipment is maintained with due reference to risk, importance, safety, reliability and availability, the writings on the wall, more to do with less to do it with, Im sure the optimization of the number and performance of PM tasks will become the norm rather than the exception.

Cheers

Darren

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Hero
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KM,
Not at board level. I made the decision.


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KM Offline
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John,
Are you sure your high enough up the tree to do this. I thought the only way to ensure full backing from the organisation was to have decisions like this ratified at top level. So ensuring legal eagles view and understand what they will be arguing in court, if they have worries about it at contemplation stage we wouldnt do it.

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