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

We're (well, we were) talking about a (private, charity, faith-based?) hospital in the Philippines, Chris. So somehow I doubt that simply throwing money around (in the NHS style?) is really an option.


... it's not enough. Unless we are now talking about some sort of "Boot Camp" situation; a place where we send fresh young techs to "test them out" - put them under a bit of pressure in order to "stress them out a bit" (towards a nervous breakdown, early grave ... or whatever). Sounds like fun!

Meanwhile, can you convince us with a clue about how you arrive at that figure?

In case anyone was wondering, my own first approximation (ancient yes, but I've yet to be convinced that it's not still valid) "rule of thumb" from Ye Olde Days is simply:-

2 Techs : AR of 600 entries : 100 beds

Where "AR" stands for the number of maintainable items on the Asset Register, and the beds figure is only used if no other information is available. In other words, it's the amount of kit that is given the most weight. I'm pretty sure I've used this on here before:- yes, here it is.

Notice that the AR figure doesn't simply include "everything", but just items for which planned maintenance is applicable or a foreseeable requirement.

I'd have to agree with you on that Geoff but if you don't include the team leader that's how many there are in my section. If anything if two does work as long as no one goes off sick.

I must admit when there was three people I did have to read a good book, but I personally would say you need techs working at 60% capacity but I do know other places where they either work at lower or higher.

Problem is some MES companies would actually say that the right number of techs in a small hospital like this would actually be Zero. Instead of actually having anybody on the ground you have one clerical person who just packs the faulty equipment into boxes and ships it either directly to the manufacturer or to their head office where a small number of techs work on multiple sites equipment.

There are many ways of supporting equipment, and (as I have said a few times before), in theory it doesn't matter how kit gets maintained just as long as it does (that is, everything is covered). But surely by now we all agree that there is more to in-house biomedical engineering than just repairing the kit once it breaks down (like getting off your idle butt and walking around the user departments, rather than sitting there reading a book, for instance)!

And anyway, that last "model" you mentioned is undoubtedly the worst of all the options. There are many reasons, but here are just three:-

1) Nurses et al don't get the direct support they need
2) Fixed equipment cannot be sent off (so will still need to be visited)
3) The dispatcher becomes a tyrant!

Yes Geoff I'm sure there is , but you'll probably find those departments have done all that and had to stop for fear of doing next years ppms before that happens.

I'd still say three or four was the right numbers even if the department has spare capacity for sickness and emergencies.

Where do you get the idea that Delfin's hospital is a private, charity or faith based hospital Geoff? I can see nothing in the posts that says it is. I do hope that you are not making unwarranted assumptions again

Delfin, could you please clarify if this is this the case (not that it makes that much difference)?

Thanks.

It makes no difference at all to the "calculations" ... but whatever the foundation of Delfin's situation is, I doubt that it's awash with funds.

That comment was made in response to Chris suggesting that "one answer to the problem of on-call is just don't do it and buy extra equipment"!

Once again it has been demonstrated that my own experiences as a hospital biomed and those of many of our fellow correspondents on the forum must have been during a different era, at different places (if not on different planets).

Poor Delfin must be totally bemused at this point.

Then again how do we not know that Delfin's hospital doesn't have the spare capacity already? I notice five anaesthesia machines and imaging equipment is covered by a third party, how many of those is going to fail out of hours? It depends on what type of work the hospital does, if it's a small community hospital it might not need on call. (also note distinction between private clinics and the hospital, so it doesn't seem to be a private hospital)

Also how do we know that a UK hospital is awash with money? Apparently there's more hospitals in worse conditions.

Yes, Neil. I agree.

I noticed that Delfin looked in at the forum a few hours ago, yet hesitated to make a reply ...

However, I think that his original question has been answered:- he shall need a total of between two to four in-house techs; so he can take his pick. Three?

@Delfin: if you have an equipment list already prepared on your computer (in whatever format - but .xls is easiest) I would be happy to take a look at it. And even load it up into the latest - and soon to be issued [I hope] - version of the TaskMaster equipment maintenance management database program, then email it all back to you. That's the best I can do.

@Chris: do any of the guys at Weston ever get on here? No doubt we could offer them a few tips as well. But somehow I doubt that "biomed" is the root of the problem there (or at any other of the disgraceful situations we hear about so often these days).

Yes, I agree with Neil here as well.

@ Delfin, in concert with Geoff, if you want an alternative view you are also welcome to send me (PM me) a copy of the asset list and I will have a look. An alternative view might be useful.

For those of you who had a look at the asset list I uploaded, the answer is ................ 0.6FTE.

Yep, that's correct, one person, 3 days per week.

Well ok, that's not the entire story, as well as the 3 days a week of one person, we also provide specialist support for anaesthetics machines and manifolds from our gas specialist and management support from yours truly.

Gas support probably amounts to a week or two per year (in total) and management support to perhaps one day per month (reports, meetings, answering questions etc etc etc).

Now, in fairness, this is not a "stand alone" hospital but part of group that is serviced by us. As such we can provide holiday cover etc. But, to think that a hospital the size of the one Delfin is talking about would need 4 people is, frankly, ludicrous. As I said in an earlier post, even with this level of support we run at 95% PM compliance.

Before anyone says "but you don't do XYZ" pls check my earlier post. This is a full service biomed support arrangement (within certain limits).

Honestly, 4 people?, you jest me thinks (except I know you don't). Two would be quite sufficient to cover all the work and, with a little cooperation, provide leave cover etc, etc for a hospital the size of the one being asked about by Delfin.