“The patients have to be sent back to the ward as MRI is non-functional since yesterday.” “Ventilator is having major breakdown and cannot be used on patients.” These are some examples of medical equipment breakdown that occurs on an everyday basis in any hospital.
Equipment having breakdown and it being non-functional is inevitable, but the real challenge is how to minimise the equipment frequency of breakdown and reduce the equipment downtime.
Breakdown can be reduced by adopting Total Productive Maintenance (TPM), which will help in maximising equipment effectiveness throughout the lifecycle of the equipment. TPM also involves routine maintenance of system by the paramedical staff biomedical engineer, continual training to end user as per schedule and enhancing problem solving skills and activities to achieve zero breakdown.
The downtime of medical equipment is the period during which the equipment is not in a condition to perform the intended function. It is the summation of problem realisation time by the technician, diagnosis time by the engineer, logistic time, and alignment time of spare parts. Lately, with various hospitals’ emphasis on lesser duration of stay of patient, the equipment uptime is very critical. The downtime of two-five per cent based on criticality of the equipment is permissible. The downtime calculation in hours is based on application of the equipment. Typically, for most of the intensive care equipment like patient physiological monitors and ventilators, the calculation is based on 24 hours working per day. For most of the diagnostic equipment like CT scanner, colour doppler it is calculated considering 10 working hours per day and six working days per week. To illustrate further, considering 300 working days in year, 10 hours per day, two per cent downtime will be 60 hours.
The data on downtime pattern for three months for medical equipment for any multi-specialty hospital is collected from the medical equipment maintenance tracker and the compiled data is given in the form of Table-A and Table-B shown here.
The process map of downtime of medical equipment in a hospital is shown below. In this case, the hospital has adopted JIT (Just in Time) policy for spare inventories and does not keep any spare inventories in there stores department.
The indication of process centre is calculated from total mean value and the process range will provide total variability in a set of measured value. The average downtime of 4.3 days can be improved upon.