Analysis Of Nature Of Complaints In Medical Equipment

Hospitals should always ensure to have lower downtime for all medical equipment without increase in maintenance cost index, suggests Deepak Agarkhed

Medical equipment is a vital part of any hospital. Maintaining them in such a manner that we can lower their maintenance cost should form an important part of hospital management. Here, we shall analyse the kind of problems faced with these assets and how to overcome those.

First, let's discuss about downtime in equipment. Downtime is the period of time during which equipment is not in a condition to perform the intended functions. It is a summation of problem realisation time by technician, diagnosis time by service engineer, spare procurement time by service agent, logistic time by service agent, and alignment time of spare parts in any equipment.

Now, we move on to the maintenance cost index. It is the ratio of total maintenance cost and equipment capital cost. The maintenance cost is the summation of cost incurred on equipment spares, repair, and annual maintenance cost.

There are certain blocks in medical equipment. Let us discuss some of them:

Stimulus: In many measurements, the response to some form of external stimulus is required. The stimulus may be visual (eg a flashlight), auditory (eg a tone) or direct electrical stimulation.

The Transducer: The transducer is a device capable of converting one form of energy to another. In medical equipment, the transducer measures temperature, pressure, flow, or any other variable that can be found in the body, but its output is always an electrical signal.

Signal-conditioning: The part of the instrumentation system that amplifies, modifies, or in any other way changes the electrical output of the transducer is called signal-conditioning equipment.

Display: Display equipment may include a monitor or chart recorder to view the desired signal.

Recording, Data Processing & Transmission: This is used to record the measured information (eg floppy disk, magnetic disk) for possible use later or to transmit it from one location to another in a hospital.

Control Devices: These usually consist of feedback loop, in which output from signal condition or display equipment is used to control operation of system in some way or other.

An analysis of complaints in medical equipment with respect to each block listed above was carried out. Data on spare parts, which are replaced in non-operational equipment, is the result of one-year research from an equipment maintenance tracker software of a multispecilality hospital. Data analysis is carried out to know percentage of complaints related to each block of medical equipment. Based on the analysis, a maintenance strategy was prepared by a team of biomedical engineers.

Following are the conclusions drawn from the above results:

(1) The equipment failure due to electronic part is double than due to mechanical parts failure.

(2) The mechanical parts failure (like compressor unit in ventilator, gear assembly in film processor, motor unit in saw) can be reduced by identifying major mechanical parts for each medical equipment and by preparing a check list of the same. Also, perform routine servicing and lubricate it on regular basis.

(3) In electronic parts of medical equipment, the transducers are highly susceptible to failure due to the fact that they do come in contact with patients and are handled by nursing staff and technicians.

Making nursing staff and technicians understand the do's and don'ts of equipment and routine calibration of transducers can reduce these failures. Training programmes should be introduced regulary, which must be co-ordinated and implemented by trained biomedical engineers.

(4) The electronic failures in other section can be reduced by regular routine preventive maintenance servicing of equipment as per the service manual of medical equipment. The few examples of failure of electronic parts are failure of preamplifier section in ECG machine, motherboard in syringe pump, pressure transducer in patient monitor, hardiest of computer section of MRI etc.

The author is Divisional Head-Biomedical Engineering Department, Artemis Healthcare, Apollo House.
Email: deepak.agarkhed@artemishealth.org