EBME Forums Forums Management Modernisation (Formerly, Controls Assurance) Bio-medical Engineering Improvement Plan

Well, Delfin's original question has been qualified to a certain extent by his subsequent posts ... but sometimes we have to "read between the lines" a little, do we not?

But, unless I get a chance to visit his location (which is very unlikely to happen), and survey the hospital myself (and thereby establish the actual situation), it's difficult to offer definitive advice.

Failing that, I would need accurate data, plus an idea on what the "risks" associated with each equipment type are considered to be (leading to "how many PM's per year" ... and all the rest).

Meanwhile, as I say, I would have to stick to my guns (and "rules of thumb" that have worked well enough in the past) and continue to suggest four.

As a historical note, I hope my memory serves me well if I say that I recall we had three techs at the famous G-100 (general 100-bed hospitals) out in Saudi Arabia 20-25 years ago. A Senior Tech and two Techs ... plus a clerk (computer operator - storeman - general helper, whatever). And we certainly had more than five techs at certain well-known private hospitals (of 200 beds or so) "out there" that I could name. Similar situations (to Delfin's) I would have thought, except that in the case of "our" G-100's they also had "the company" (me and my gang) to back them up.

I continue to suggest two. If it wasn't for leave and possible sickness then based on the list of equipment given one man could easily cover it in my opinion.

My own feeling is that we don't yet know the full story, Paul.

There are two many unknowns.

For instance, what if (as I suspect), "4 autoclave machine" turn out to be full size steam autoclaves (with integral electrical steam generators, if I know anything about it)? Are you OK on kit like that?

Actually, it's a good thing there are four of them (whatever they are), as at least the "heat is off" (literally) when one, or even two, are down (out of order).

And - although we have heard about (as yet undefined) kit in the lab that's "outsourced", as well as the imaging kit - in theory at least that still has to be managed; as well as (I suspect) at least some sort of involvement at 1st.Line.

The trouble with having just the one biomed is (as we all must know) when the guy is busy - as he will always be - it doesn't take much for him to become swamped once the kit starts going wrong. Surely we've all "been there"?

And the novelty (privilege?) of being permanently on-call wears off after the first six-months or so, let me tell you.

No, the "jury's still out" on this one, as far as I'm concerned.

I'd be surprised if it was four "full sized" autoclaves for only a 100 bed hospital. I know autoclave validation can take days but if you're a one man operation or even a two man team you go of and do other things whilst waiting, a concept that some people don't understand.

Having looked at the equipment list provided I estimated no more than 20 man weeks to cover it all and that's being very generous but for the reasons I've explained you have to have two men.

I go off the information I'm given, if it's wrong then there's not a lot I can do about it!

For those that are suggesting two biomeds I would suggest that you do a complete time and motion study of your own facilities and reduce your staff to the bare minimum. You will never have any 'bored' biomeds to contend with. Can we assume that in your COSY "Geoff's words" WORLD only one equipment breaks down at any given time as it would be a nightmare if a few pieces of equipment broke down at the same time!

Ok, rather than go round and round in circles, can we have a look at a real world example and, those who are interested, let us know what level of resource you think would be needed for such a site.

Attached is the asset list from one of the sites that we look after. It is 130 beds, has five theatres, two day surg procedure rooms, a small ICU (fairly low level but they are licensed to ventilate), birthing suite with special care nursery and general medical, surgical and rehab wards. We provide a full biomed service (both PM and repair) for all the assets listed. We are not involved with the CSSD or imaging (except an EST on the listed II). We do the "area testing" for body and cardiac areas also the testing of "gas therapy" assets (not listed but I can provide if anyone is interested in the detail). Gas therapy includes regs, flow meteres, twin-o-vacs, blenders in maternity, wall outlet testing and of course the manifolds.

All assets are tested 12 monthly except defibs, vents, anaesthetic machines, SCN cots and manifolds which are tested 6 monthly. Where required (vents, anaesthetic machines and maniflods) kits are fitted 12 monthly.

So, what level of resource would you consider necessary to support this site? Once opinions are expressed I will reveal what the level is and I promise to be honest about it (in fact if anyone wants, I'll PM the "answer" to Huw now so that he can reveal all when the time comes, but really, I promise to be honest about it).

It may be of interest to know that I have just looked at the "compliance stats" for this site and we currently sit at 95% in date for PMs.

Ok, over to you guys

No doubt you will be expecting a reply from me (and as everyone knows, I hate to disappoint) ... but I just don't have the time to do a proper analysis right now, Dave. By "analysis" I mean breaking it down into man-hours.

However, straight off the top of my head, and using my usual "rule of thumb" (based simply on the number of maintainable items listed), I would go once again for four techs.

Specifically, a Senior Technician and three Technicians.

If that figure doesn't gel with the actual number of techs deployed, that will most likely be due to you not doing PM often enough (that is, my default PM interval is six months).

By the way, these days most of my time is spent fiddling about with data, so I am always on the look-out for "real world" inventories (of biomed maintainable assets) - parts stock lists as well. If anyone has some nice data that they don't mind sharing (.xls format preferred), please feel free to bung it together with an email. Confidentiality is always respected (and thanks again to those who have already sent some stuff).

Two.

Interesting setup, reminds me of somewhere. Two techs what do people think of that number?

There is another way of running delfin's department, guess how many techs a MES might put in and you might get a shock!

And Geoff one answer to the problem of on-call is just don't do it and buy extra equipment.

Still on 4, Dave, for your site who does the management of the site? As the overseeing company do you supply techs to cover leave, sickness etc. Do you pay overtime to complete tasks that require extra time (ppm on unavailable equipment)