Medical equipment management strategies.

Clinical engineering professionals need to continually review and improve their management strategies in order to keep up with improvements in equipment technology, as well as with increasing expectations of health care organizations. In the last 20 years, management strategies have evolved from the initial obsession with electrical safety to flexible criteria that fit the individual institution's needs. Few hospitals, however, are taking full advantage of the paradigm shift offered by the evolution of joint Commission standards. The focus should be on risks caused by equipment failure, rather than on equipment with highest maintenance demands. Furthermore, it is not enough to consider risks posed by individual pieces of equipment to individual patients. It is critical to anticipate the impact of an equipment failure on larger groups of patients, especially when dealing with one of a kind, sophisticated pieces of equipment that are required to provide timely and accurate diagnoses for immediate therapeutic decisions or surgical interventions. A strategy for incorporating multiple criteria to formulate appropriate management strategies is provided in this article.

Analyzing planned maintenance (PM) inspection data by failure mode and effect analysis methodology.

There is no question that medical devices are becoming more reliable. However, we have had some difficulty finding a satisfactory method for providing persuasive documentary evidence that this improved reliability will allow us to relax our traditional planned maintenance (PM) practices without compromising patient safety. The acceptance and increasing use of Failure Mode and Effect Analysis (FMEA) by several of the oversight agencies, including the Joint Commission on Accreditation of Healthcare Organizations, provides us with an important opportunity to take another shot at this vexing problem. Using this proven FMEA methodology and some relatively simple rules to quantify the results of the routine PM inspections that all healthcare providers are still performing in considerable abundance, we have developed a method that allows us to reduce the test results to a simple, single measure (the Risk Score) that can be used to characterize the effectiveness and levels of safety of our current PM regimens. When tested on theoretical data and a sample of real PM inspection results, the method provides answers that seem reasonable. Although it will probably require some modification as we begin the standardized data gathering and gain working experience, it is our hope that this new approach will become generally accepted within the industry. This kind of positive response should enable us to persuade the various accrediting and licensing agencies to similarly accept the concept.