Provision for Maintenance

1.   The equipment management cycle

Maintenance of healthcare equipment is not just a question of repairing broken things. It is an integral part of managing the whole lifecycle of equipment. The following diagram illustrates this cycle:

 

 

 

It can be seen that maintenance and repair is just one element. To make the whole cycle work properly, a number of different inputs are required.

 

2.   Inputs for equipment management

 

Responsibilities need to be assigned to a number of different levels in the healthcare institution. A full description of such a system, and the steps needed to begin one, will be found in the How to Manage Series for Healthcare Technology listed in chapter 11. However, the diagram above offers a useful reference for the stages that should be covered in managing equipment.

 

All groups of staff will have a role at some point:

Management	Policy makers	Procurement
Stores	Portering	Finance
Clinical	Technical	Maintenance
Administration	Patients	Suppliers

 

The equipment user should be involved or consulted in each and every one of these stages.

 

3.   Recommended resources

The user should not be left on their own. Once a piece of equipment is installed, commissioned and accepted and once the user has been fully trained in operation, they will need these resources to carry out the use and maintenance of the equipment well:

 

Manuals in a fluent language

o    Operator manuals are essential and should be specified at time of purchase. It is often also possible to obtain service or technical manuals, which should be held by the maintenance department.

Scheduled Maintenance

o    A schedule of regular visits by qualified maintenance personnel will be needed. This might be managed by the maintenance department or senior hospital management. Whether the maintenance is in-house or outsourced, a system of reminders to prompt the work will be needed.

Repair Services

o    The user will need to be able to call on a repair team when things break. Smaller items of equipment will be serviceable by the hospital team, whereas large scanners etc will require specialist outside services.

Contract Management

o    The purchase contract should have details of what warranty services are available and contact details to call in these services. Either stores or administration should monitor performance against these contracts and plan for cover on expiry of any agreement.

Consumables supply

o    The needs for consumables should have been specified during the procurement process, so that necessary supplies are available from the start of equipment use. A schedule of restocking will need to be developed, so that there is never a gap in services.

Spares Supply

o    Technical advice will be required to decide which spares should be stocked on site and which should only be purchased when needed. As a general rule, it is recommended to keep spares likely to be needed for two years operation on site and to have these supplied with new equipment.

 

 

As a guide to technical personnel requirements, the How to Manage Guide 1 suggests the following number of posts:

 

	100 BED HOSPITAL	16    50 BED HOSPITAL	15 OR FEWER BED HOSPITAL
Biomedical Engineer	1	0	0
Biomedical Technician	2	1	0
Assistant Technician / Artisan	3	2	1