EBME Forums Forums Management Medical Equipment Management Failed/deferred PPM - what are the implications/s

Hello
How do you manage your planned preventative maintenance? Did the pandemic set you back months and you’re not caught up yet? Have you changed from interval-based to risk-based, or some other option? Do you want to, but don’t have the time to research or implement change?

I have a 3rd year Medical Engineering student (another one, if you read my other thread) doing a project on the implications of, and solutions to, failed or heavily deferred PPM. We would like to talk to anyone with a view on this. How big a problem is it? What solutions have been tried? Do clinical engineers have autonomy, or are ‘higher’ levels of management involved? How does PPM work (if at all) in low resource settings, such as low and middle income countries? Are we asking the right questions?

We’d like to talk to people with a range of views and experience in the next month or two, to help develop a survey to be sent out more widely.

I’ll duplicate this request on IPEM Clin Eng community and the IPEM CE community. Are there better ways to access the wider Clinical Engineering population? How could we disseminate the survey? (Particularly England, as the other nations have small enough numbers of organisations to email individually.)
Thanks in advance for your help.

Sue Peirce
CEDAR Research Fellow
Cardiff University

The questions are OK ... but the answers are surely self-evident.

Rather than launch into (yet another) essay on this topic - which has been batted about on this forum for at least the last twenty years - can I suggest that your student spends some time with the Search function on this website. There is a wealth of stuff available on line, too.

You see, we (at this end) don't yet know how much your student already knows about PM, Risk-Based PM, computer databases, assigning priorities ... and all the rest. Are we dealing with a novice, or someone already having some experience in such matters?

Perhaps I should also add (by way of enquiry), what is the purpose of projects of this type? Are they simply a requirement of the course (that is, that a "research" project be undertaken)? Are topics assigned, or does the student get to choose? What does the lecturer seek to establish from the work turned in? What use is actually made of the findings?

Sorry. I realise that I hadn't put my contact details in this post. If you have an opinon on this topic and can spare up to an hour to talk to a student (and me) please contact me at: peirces@cardiff.ac.uk

Geoff, my request was not intended to generate debate or reams of text on this forum, but to identify people with relevant experience who would be willing to tell us their thoughts as research participants. I.e. to have an online interview where we ask them questions, to learn what they know about the questions we want to answer.

The primary purpose of these projects is for undergraduates to get experience of research methods and to develop their autonomy, planning and problem-solving skills. But they should be working on things that aren't already well-established in the literature. They should be trying to generate new 'knowledge' or at least expand it a bit. By which i mean established in the academic literature or in common knowledge amongst the population, not common knowledge amongst those in the profession.
Students can come up with their own topics, but usually academic staff are asked to generate a number of potential topics every year and the students choose several from the list. This topic was actually suggested by an NHS colleague who has worked in ITU and has a keen interest in medical ethics, but little knowledge of equipment management. The student might have some leeway to direct the project in a particular direction that interests them. This student was familiar with the idea of PPM in their industrial year, but not on medical equipment.

As someone working in the overlap between academic research and NHS medical physics/clinical engineering departments I've realised that things that we taken as 'given' in real-world clinical engineering come as revelations to those outside. Yes, these published forum discussions are a data source, but it is broad rather than rich. There's little context or detail in most posts. By interviewing participants we can delve more deelpy into their experiences and ensure that we have all the relevant context to understand their evidence. This type of qualitative research is valuable in collating knowledge and experience that belongs to one group (clinical engineers, people caring for demntia sufferers, people living with bowel cancer, etc) and giving it an evidence-based spotlight.
However, I can't tell you that the results generated by a 3rd year student will be published in a peer-reviewed journal or change any policies. Mostly people participate in such research because they think it's a good thing overall rather than because it might produce benefit. Also, I find people generally like talking about their work to people who are really interested in it.
Sue

Thank you for that, Sue ... quite interesting. Context (or background) is always important.

Just a quick point (that you have already touched on, in fact); I would say that actual planned preventative maintenance only takes place in industry (aircraft maintenance being the obvious example, but also in factories, pumping stations et al). Routine PM of hospital equipment is really more like "keeping on top of things" (I call it just PM - planned maintenance, myself). In a word, it's all about the conditions and environment in which stuff is used.

From my own point of view, the only snag with the processes you describe is that we, on here, don't learn anything from it.

Anyway, good luck to your students. Maybe we'll see them making a contribution on here in the future.

Geoff
That's an interesting distinction that we hadn't noted previously in the information we've come across so far. Thank you for drawing it to our attention.
Sue

Hello Sue,
I am happy to speak to your students on a teams meeting if they want ask me questions. I have a couple of Masters students that I am currently supervising. One is doing his project on Maintenance, the other is looking at utilisation.
I was at a thought leadership meeting this with Mindray and a few senior managers from the NHS on Tuesday this week.
With regard to carrying out PM's the majority of us could see that probably >75% of devices that currently receive PM's don't need them under a risk based PM regime (mentioned by Geoff) The 2021 guidance allows for risk and audit types of maintenance systems.
Also, many manufacturers state their equipment is maintenance free, and yet hospitals still carry out unecessary calibration checks and electrical safety tests. I am all for not wasting time doing PM's Don't do them unless they are deemed a requirement by the OEM.

... or mandated by the Risk-Based PM system?

OEMs can (and do) claim many things ... but they have no control over how (where, how often, skilled or badly etc., etc.) "their" equipment is used.

And (unless the item is rented out, leased or whatever), equipment - once purchased - does not belong to the OEM. Surely the owner assumes what we could call "the right to maintain"?

Perhaps yet another research topic hoves into view ... the responsibilities of OEMs once they have sold their equipment. Don't lose sight of the fact that these days much equipment is manufactured in far away lands; regimes that may not subscribe to our way of thinking (or even produce half-decent service information).

Good points Geoff.
... or mandated by the Risk-Based PM system?
and
..... Perhaps yet another research topic hoves into view