|
|
|
Anonymous
Unregistered
|
|
Anonymous
Unregistered
|
Management is the key, I think, with decent management everything else follows.
|
|
|
|
|
Joined: Feb 2004
Posts: 14,814 Likes: 72
Super Hero
|
Super Hero
Joined: Feb 2004
Posts: 14,814 Likes: 72 |
Now that John has had another go at his “Reliability-Centred Maintenance” piece (see top of the current front page), I make no apologies for getting this thread back into play, as it were (I’m still wading through your article, and mulling away, John. Light reading, it ain’t)! Let’s keep the debate alive … let’s have some comments, now that we are two years on since the last post on this topic. Any changes of heart, I wonder? Any more converts … ? 
If you don't inspect ... don't expect.
|
|
|
|
|
Joined: Feb 2004
Posts: 14,814 Likes: 72
Super Hero
|
|
Super Hero
Joined: Feb 2004
Posts: 14,814 Likes: 72 |
Having waded through, not only John’s piece on RCM, but this complete thread as well (yes, a bit of a marathon), I would suggest that three posts stand out as worthy of repeating once again:- Richard Ling on 02-Nov-03 The environment the kit is used in and how it is used, or abused, makes the difference. Ideas of reliability tend to fall apart when there are other influences. The other thing is the reluctance of users to report damage and other minor faults with equipment so it looks, on paper to be more robust and "reliable" than it actually is. Roy on 10-Nov-03 To sum up: -
If you've been trained by the manufacturer to service it, then service it - exactly as you've been shown.
If you've got to repair it, then carry out the tests in the manual before putting it back into service. If there isn't a manual (because the machine is too old) then write a test schedule / worksheet, verify it and then stick to it.
If you haven't been trained to service it and you don't have a manual, then don't service it. Get the Trust to pay for a service contract or accept the risk of not servicing it. Geoff Hannis on 24-Feb-04 My recommendation is to talk instead about *Risk* Centred Maintenance, whereby maintenance resources are targeted at equipment most likely to adversely affect "patient outcomes" if not properly supported (eg, defibrillators, ventilators, dialysis units, IV pumps ... and so on down the line). In essence, the way to start is to rank all equipment according to "patient-risk" and take it from there. Thinking about it, I realize that Risk-Centred Maintenance (of which I am a keen proponent) is really a sub-set of Reliability-Centred Maintenance (pity, then, that they both carry the same initials)! What’s in a name? RCM is just an evolution in the history of the maintenance of technical equipment. Many grand titles have been used before for the properly-conduction technical support of medical equipment. Remember Terotechnology (BS 3811) … whatever happened to that? And what I would say now, John, is what we need are simple steps to be taken (a check-list, even) in order to achieve (or at least aim in the right direction of) the lofty goals contained within RCM. My bet (and sincere hope) is that most well-organized techs are following the path already!
Last edited by Geoff Hannis; 03/04/07 11:35 AM. Reason: Minor tweaks
If you don't inspect ... don't expect.
|
|
|
|
|
Joined: May 2002
Posts: 137
Expert
|
|
Expert
Joined: May 2002
Posts: 137 |
There is another aspect to this that I don't think has been mentioned, the phenomena whereby frequent maintenance can lead to a reduction in reliability. I have seen this in complex electro-mechanical equipment with moving parts. I have actually reduced 'down time' by extending the PM period. ('down time' included all the time that the equipment was not available for production purposes, including PM's, upgrades, modifications etc. as well as break downs.) It may be argued of course that the phenomena was caused by service personel taking equipment apart and recommissioning it without adequate testing. However we are all human and with pressures of time etc. these things happen.
I am not sure that the argument can be applied to most of the medical equipment we are generally discussing, however I thought I would cast my stone in the pond and see where the ripples end up.
|
|
|
|
|
Joined: Feb 2004
Posts: 14,814 Likes: 72
Super Hero
|
|
Super Hero
Joined: Feb 2004
Posts: 14,814 Likes: 72 |
Actually, the possibility of maintenance work unintentionally contributing to failures does get a mention in John’s article, Rick. One question that I have is, in the “Run-to-Failure” (RTF) model (ie, where an equipment type is deemed not to be worth maintaining, economically speaking), once the inevitable failure occurs, does it get repaired or binned? Binned, I suppose. But then what? Does it get replaced? Will a like-for-like replacement be available? Won’t a replacement cost more than the original equipment (on which the “BER” calculation would have been based)? Let me suggest another maintenance model – inspect everything, and repair everything! We could even call this the “RAF Model”! 
If you don't inspect ... don't expect.
|
|
|
|
|
Joined: Feb 2004
Posts: 14,814 Likes: 72
Super Hero
|
|
Super Hero
Joined: Feb 2004
Posts: 14,814 Likes: 72 |
In the past I've seen syringe devices that have been literally split in half and still being used, taped-up, with no functioning occlusion alarms and ingress inside or others where the syringe actuator is broken and allows syringe-syphoning or where mains conductors are exposed that haven't been looked at for years and never been reported by users ignorant of the risks. Never really see this problem whenever I've worked on devices have been repaired or serviced within, say, a 12 month period (unless someones owned-up and sent it in for repair after it's been abused). Unfortunately it's the neglected items that slip through the net and aren't serviced at regular-enough intervals or not reported by operators as having damage (or inspecting the service-due labels) that are the biggest risk. ... something for Dave (in Oz) to take a look at the next time he comes on? By the way, this is an excellent thread (covering quite a few points that still get a frequent airing), which has also been quite well debated. So I urge everyone to find the time to go through it all (again) at some stage.
If you don't inspect ... don't expect.
|
|
|
|
|
Joined: Feb 2004
Posts: 14,814 Likes: 72
Super Hero
|
|
Super Hero
Joined: Feb 2004
Posts: 14,814 Likes: 72 |
Here's the other thread that was talking about the same sort of thing. Reliability-Centred Maintenance? Risk-Centred Maintenance? Let's compromise, and call it Risk-based PM (RPM) ... just as I do these days. Risk-based PM? Yes, PM carried out at intervals according to the perceived risk of equipment failure. With "perceived risk" primarily, but not exclusively, being addressed from the "risk to the patient" point of view.
If you don't inspect ... don't expect.
|
|
|
|
|
Joined: Feb 2004
Posts: 14,814 Likes: 72
Super Hero
|
|
Super Hero
Joined: Feb 2004
Posts: 14,814 Likes: 72 |
And so ... the debate continues! Whilst I'm at it, I may as well link to this one as well (even though it is a bit off-topic). As usual, Dave Harrington is spot-on, in my opinion (see the top section of the article).
If you don't inspect ... don't expect.
|
|
|
|
1 members (Huw),
7,737
guests, and
444
robots. |
|
Key:
Admin,
Global Mod,
Mod
|
|
|
Forums26
Topics11,274
Posts74,579
Members10,388
| |
Most Online69,877
Jul 17th, 2026
|
|
|
|
