EBME Forums Forums Management Medical Equipment Management Risk-Centred Maintenance

We aren't allowed to carry out Post Mortems.

They won't even let us provide the Breast Screening Service, which we offered to do for free.

There's just no fun any more.

They asked us to do specimen collection for Urology but we said that was taking the p**s.

As well as helping out in Gynaecology but we haven't practised wallpapering the hall through the letterbox!!

Before this thread degenerated into 'mirth', it was quite interesting (I thought so, anyway). Can anyone add to it again now, I wonder? Meanwhile, to see how seriously others take this topic, check-out the titles of some of the award-winning papers at the AAMI website.

Geoff,
As you know I am a keen advocate of risk centred maintenance. The rest of the ebgineering world has accepted this is the way to go - even NASA. I know some EBME depts have been forced down this route, but even if they weren't its the way to go.

But doesn't risk centred maintenance take us back to the old chestnut:-

Do you test and maintain equipment in line with measured/perceived risk or in line with the manufacturer's recommendations?

The first is typically argued around money and time.

The second is generally backed up with 'what happens when you stand up in front of the judge?'

Lee

No, it has nothing to do with time and money. The first is argued around the perceived risk (ie, to the patient) if the equipment fails. I don't believe that manufacturers' manuals look at things in that way at all (do they)? Surely any judge can understand that?

And (as John has alluded to), how come NASA, mining companies etc. 'get away' with this approach?

I might add that, having been in this game for more than thirty years, I have yet to stand before a court of law and explain why or why not I was carrying out maintenance. Perhaps I've just been lucky?

Nor me but I've only been "at it" for twenty.

Lee

Geoff
I'm an old stager like yourself of 35 years in. We probably have been fortunate not to stand up in court and explain our actions. I remember attending a course many moons ago before risk management was even thought of, where the chair was a barrister. I recall, that the prosecution is going to argue that the equipment failed due to lack of maintenence and will have a copy of the recommended interval and procedure at his disposal, along with an "independent" technical expert. The judge will only deal with fact and unless you can prove that you have performed an extensive foolproof risk analysis, taking into account manufacturer's recommendations, I don't think you'd stand a chance. NASA etc may get away with it, but if you remember the steelworks in South Wales a couple of years ago, and other large industries, have been heavily fined by the HSE for not having adequate maintenance schedules. The HSE has made massive inroads in the NHS over the last few years, coupled with the American style of litigation that has also appeared, I personnaly, would not like to put my neck out so close to retirement.
Graham

Nicely put, Graham. My only rebuttal would be:- define “adequate maintenance schedules”. Can the H&SE help us there, or are they only in existence to react to our failings? What we need is guidance, leadership even … where is it? Or put another way, if “Nanny” really does know best, where is Nanny to be found?