Hospital Equipment Planning &Selectionpmrpnt

8/6/2019 Hospital Equipment Planning &Selectionpmrpnt

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Hospital Equipment planningHospital Equipment planning

&selection&selection


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IntroductionIntroduction Medical equipment could be viewed as component ofMedical equipment could be viewed as component of

healthcare technologies, applied with the aim ofhealthcare technologies, applied with the aim ofachieving an effective and safe diagnosis or therapy.achieving an effective and safe diagnosis or therapy.

There are many obvious examples of healthcareThere are many obvious examples of healthcare

technologies and especially medical equipment hastechnologies and especially medical equipment hasoffered new opportunities in medical practice andoffered new opportunities in medical practice anddramatically contributed to improved health.dramatically contributed to improved health.

Hospital, a healthcare delivery agency is mostHospital, a healthcare delivery agency is most

affected by changing medical technology.affected by changing medical technology. Hospital equipment ,specially of new generation hasHospital equipment ,specially of new generation has

got immense role in advancement of modern medicalgot immense role in advancement of modern medicaltechnology.technology.


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There are many types of equipments used inThere are many types of equipments used in

the hospital nowadays. They can be classifiedthe hospital nowadays. They can be classifiedas therapeutic ,diagnostic, administrative,as therapeutic ,diagnostic, administrative,monitory and research purposes etc.monitory and research purposes etc.

Equipments being major resource of modernEquipments being major resource of moderntechnology based patient care and its hightechnology based patient care and its highcost (capital and maintenance) draws thecost (capital and maintenance) draws theattention for proper planning in future.attention for proper planning in future.


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Equipment planningEquipment planning Planning determine the objectives to bePlanning determine the objectives to be

achieved and future course of action to beachieved and future course of action to befollowed to achieve them.followed to achieve them.

It is a process which requires the use ofIt is a process which requires the use of

intellectual faculties, foresight and soundintellectual faculties, foresight and soundjudgment.judgment.

Planning is deciding the future course of actionPlanning is deciding the future course of action

by selecting best among available.by selecting best among available. Decision taking is the core of planning process.Decision taking is the core of planning process.

It involves deciding in advance what to do,It involves deciding in advance what to do,when to do ,where to do ,how to do and who iswhen to do ,where to do ,how to do and who is

to do.to do.


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Planning of the equipment is also based onPlanning of the equipment is also based onsame principle. Just acquiring an equipment issame principle. Just acquiring an equipment is

not a sound planning.not a sound planning. Modern treatment system is day by dayModern treatment system is day by day

becoming dependent on the equipments whichbecoming dependent on the equipments which

determine the quality and quantity of patientdetermine the quality and quantity of patientcare.care.

Therefore ,hospital managers should plan theTherefore ,hospital managers should plan theequipment from its acquisition to disposition.equipment from its acquisition to disposition.

There are many consideration involved in theThere are many consideration involved in theequipment .Therefore , the planning should beequipment .Therefore , the planning should bebased on these factors.based on these factors.


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Why planning of equipment isWhy planning of equipment is

important?important?Hospital equipments nowadays are very expensive.Hospital equipments nowadays are very expensive.

It is mentioned that in a modern hospital, equipmentIt is mentioned that in a modern hospital, equipmentand appliances makes up about a third to half of theand appliances makes up about a third to half of the

total project cost.total project cost.High tech equipment once introduced often remains idleHigh tech equipment once introduced often remains idledue to improper maintenance and lack of spare parts.due to improper maintenance and lack of spare parts.

In a recent estimation, it has been calculated that idle,In a recent estimation, it has been calculated that idle,

non installed or non functional equipments responsiblenon installed or non functional equipments responsiblefor wasteful expenditure of crores of rupees in hospitals.for wasteful expenditure of crores of rupees in hospitals.

Technology based treatment system, high cost ofTechnology based treatment system, high cost ofequipment maintenance ,quality of patient care are theequipment maintenance ,quality of patient care are theburning aspects related to equipments which draw theburning aspects related to equipments which draw theimportance of planning of equipmentimportance of planning of equipment


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What to be planned? Considerations involved,What to be planned? Considerations involved,

which attracts the planning of an equipmentwhich attracts the planning of an equipment

1.1. Establishing the needEstablishing the need

2.2. SelectionSelection

3.3. Installation and runningInstallation and running

4.4. Equipment maintenance, spares and necessaryEquipment maintenance, spares and necessary

5.5. Training and DevelopmentTraining and Development

6.6. Utilization & cost effectivenessUtilization & cost effectiveness

7.7. Quality assuranceQuality assurance8.8. Equipment auditEquipment audit

9.9. Life of equipment &condemnationLife of equipment &condemnation

10.10. Equipment management information systemEquipment management information system


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Establishing the needEstablishing the need

The first step in equipment planning is toThe first step in equipment planning is toestablish the objectives and desired results fromestablish the objectives and desired results fromthe equipment.the equipment.

The need of the equipment should be fullyThe need of the equipment should be fullyjustified.justified.

The need should be supported by the internalThe need should be supported by the internaland external environment of the organizationand external environment of the organization

.SWOT analysis can be best applied while.SWOT analysis can be best applied whileplanning the equipment in support of need ofplanning the equipment in support of need ofthe equipment.the equipment.


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Strength : The hospital has enough workload andStrength : The hospital has enough workload andmoney for purchase of the equipment.money for purchase of the equipment.

weakness : can the hospital afford the capital andweakness : can the hospital afford the capital andrunning cost of the equipment though need is there?running cost of the equipment though need is there?Does the hospital have expertise to run theDoes the hospital have expertise to run themachine.machine.

Opportunity : How may machines are available inOpportunity : How may machines are available inthe hospitals located in vicinity. The utilization isthe hospitals located in vicinity. The utilization isensured.ensured.

Threat :Emerging hospitals in the vicinity may haveThreat :Emerging hospitals in the vicinity may have

the same equipment in future. Changing technologythe same equipment in future. Changing technologyin future may affect the use of the machine.in future may affect the use of the machine.

The decision of take or not to take shouldThe decision of take or not to take shouldbe based on abovebe based on above


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SelectionSelection

Once need is established, the great emphasis shouldOnce need is established, the great emphasis shouldgiven on the selection of the equipment.given on the selection of the equipment. Healthcare providers must be aware of the standardsHealthcare providers must be aware of the standards

and latest technology trend so as to make the rightand latest technology trend so as to make the rightchoice .choice .

Most of the time ,busy administration are misguidedMost of the time ,busy administration are misguidedby the rosy picture painted before them by theby the rosy picture painted before them by themanufacturer and or marketing agents. We must, atmanufacturer and or marketing agents. We must, atall costs, avoid playing puppets in the hands ofall costs, avoid playing puppets in the hands ofmanufacturers and vendors.manufacturers and vendors.

The specification should be prepared and select theThe specification should be prepared and select thebest among the available.best among the available.

The cost of the equipment is one of the majorThe cost of the equipment is one of the majorconsideration at the time of planning.consideration at the time of planning.


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The other criteria, which can be applied in theThe other criteria, which can be applied in theselection of an equipments VED & HML.selection of an equipments VED & HML.

Following things to be kept in mind while selecting theFollowing things to be kept in mind while selecting the

equipment.equipment.a)a) Hospital point of view:Hospital point of view:

--Cost of equipmentCost of equipment

--Profitability of the hospitalProfitability of the hospital

--Quality of patient careQuality of patient care

-- Use of the equipmentUse of the equipment

b) Patients point of view:b) Patients point of view:

-- Cost of the treatment/investigationCost of the treatment/investigation-- Safety of patientSafety of patient

-- Quality of treatment/investigationQuality of treatment/investigation

-- NonNon--invasiveness in treatment/investigationinvasiveness in treatment/investigation


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Final choice of equipment and facilitiesFinal choice of equipment and facilitiesto be depended uponto be depended upon

1.1. What is available or what can be madeWhat is available or what can be made;that is , the technological feasibility;that is , the technological feasibilityconstraints;constraints;

2.2. What is economically reasonable.What is economically reasonable.


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Bureau Of Indian Standards (1994) hasBureau Of Indian Standards (1994) hasrecommended that while planning for anrecommended that while planning for an

equipment the selection of the equipmentequipment the selection of the equipmentshould be based on following:should be based on following:

1.1. Need of the hospitalNeed of the hospital

2.2. Budget or available fundBudget or available fund3.3. Optimum utilizationOptimum utilization

4.4. Maintenance of the equipmentMaintenance of the equipment

5.5. Manpower development &training of the staff.Manpower development &training of the staff.6.6. Performance and utilization evaluationPerformance and utilization evaluation

7.7. INSTALLATION and runningINSTALLATION and running


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Consideration to be kept beforeConsideration to be kept before

installationinstallationa)a) Location /siteLocation /site

b)b) SpaceSpace

c)c) Availability of supportive services: civil, electricalAvailability of supportive services: civil, electrical

d)d) Auxiliary facilitiesAuxiliary facilitiesOperational requirementsOperational requirements::

1)Manpower1)Manpower

2) Material2) Material

3)Methodolgy3)Methodolgy

4)Environment4)Environment


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Equipment maintenanceEquipment maintenance

The equipment maintenance is one of theThe equipment maintenance is one of themost important components of themost important components of theequipment planning management.equipment planning management.

The main objective of equipmentThe main objective of equipmentmaintenance is uninterrupted operation ormaintenance is uninterrupted operation orservice in a hospital.service in a hospital.

The maintenance provides safety andThe maintenance provides safety andquality of work and life.quality of work and life.


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Maintenance policyMaintenance policy Each hospital should develop theEach hospital should develop the

maintenance policy.maintenance policy.

The basic concept of the maintenanceThe basic concept of the maintenance

policy is to support the life and health ofpolicy is to support the life and health ofpatient with keeping the reliability andpatient with keeping the reliability andsafety of the equipment operated daily.safety of the equipment operated daily.

To keep such a situation, overall factorsTo keep such a situation, overall factors

such as management ,finance, technicalsuch as management ,finance, technicalmatters and environment conditions basedmatters and environment conditions basedon the philosophy of medical serviceson the philosophy of medical servicesshould systematically be combined.should systematically be combined.


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General objectives of equipmentGeneral objectives of equipment

maintenancemaintenance1.1. To extend the useful life of assets.To extend the useful life of assets.

2.2. To ensure the optimum availability of installed plantTo ensure the optimum availability of installed plantand equipment for production and to obtain theand equipment for production and to obtain the

maximum possible return on investment in thesemaximum possible return on investment in theseitems.items.

3.3. To ensure the operational readiness of allTo ensure the operational readiness of all

equipments for emergency use at all times.equipments for emergency use at all times.4.4. To ensure the safety of patients, person using andTo ensure the safety of patients, person using and

operating the facility.operating the facility.

5.5. To provide a systematic approach to work of theTo provide a systematic approach to work of the

department.department.


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Types/systems of maintenanceTypes/systems of maintenance

Preventive maintenancePreventive maintenance: a systematic: a systematicmaintenance procedure wherein themaintenance procedure wherein theconditions of the equipment is constantlyconditions of the equipment is constantly

watched through a systematic inspectionwatched through a systematic inspectionprogramme and preventive action taken toprogramme and preventive action taken toreduce the incidence of breakreduce the incidence of break--down.down.

Major and minor repairs are carried out onMajor and minor repairs are carried out onscheduled time in order to avoid machinescheduled time in order to avoid machinebreakdown.breakdown.


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Breakdown maintenanceBreakdown maintenance: of the equipment: of the equipmentis generally carried out when the equipmentis generally carried out when the equipmentbreaks down or gets out of order. Suchbreaks down or gets out of order. Suchbreakdown may occur to any machine anybreakdown may occur to any machine anytime.time.

It is carried out by inIt is carried out by in--house workshop orhouse workshop or

contractor.contractor. Corrective maintenance:Corrective maintenance: thethe use of

preventive maintenance techniques andcontrols will bring to light instances of repeated

failure of a plant or component of theequipment. where such repetitions areobserved corrective maintenance may benecessary to eliminate recurrence.


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Planning to be made to prevent thesePlanning to be made to prevent thesefollowings:followings:

1.1. Electrical safetyElectrical safety

2.2. Mechanical safetyMechanical safety

3.3. Chemical safetyChemical safety4.4. Thermal safetyThermal safety

5.5. Radiation safetyRadiation safety

6.6. Optical safetyOptical safety

7.7. Biological safetyBiological safety


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UtilizationUtilization

Essentially means the use of the equipment ofEssentially means the use of the equipment ofits full potential.its full potential.

It should be the Endeavour of the managementIt should be the Endeavour of the management

to optimize the equipment utilization to obtainto optimize the equipment utilization to obtainmaximum return for the capital invested.maximum return for the capital invested.

Proper utilization of the hospital equipment willProper utilization of the hospital equipment willlead to:lead to:

--optimal patient handling and rapid turnoveroptimal patient handling and rapid turnover--Minimum possible costMinimum possible cost

--Quality patient care and satisfaction.Quality patient care and satisfaction.


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Quality AssuranceQuality Assurance

Analysis and evaluation of functioning ofAnalysis and evaluation of functioning ofan equipment are essential to a sustainedan equipment are essential to a sustainedhigh quality of equipment.high quality of equipment.


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Equipment AuditEquipment Audit

Its a periodic evaluation of the quality ofIts a periodic evaluation of the quality ofperformance of equipment in a hospital.performance of equipment in a hospital.

It is hoped that if such an audit is performed, itIt is hoped that if such an audit is performed, it

will be an advantage to all concernedwill be an advantage to all concernedviz.Hospital ,professional, government and theviz.Hospital ,professional, government and themanagement so that not only better utilizationmanagement so that not only better utilizationof scarce resources ensured but also contributesof scarce resources ensured but also contributes

to the improvement of quality of hospital care.to the improvement of quality of hospital care.


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Advantages: BIS describedAdvantages: BIS described

1.1. To evaluate the concurrent performance andTo evaluate the concurrent performance andutilization.utilization.

2.2. It provides a satisfactory mechanism to assistIt provides a satisfactory mechanism to assist

the process of condemnation.the process of condemnation.3.3. The equipment audit reports provide anThe equipment audit reports provide an

objective method for procurement ofobjective method for procurement ofequipment in future.equipment in future.

4.4. To identify inadequacies and recommendTo identify inadequacies and recommendremedial measuresremedial measures

5.5. Cost effectiveness can be evaluated.Cost effectiveness can be evaluated.


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Training and developmentTraining and development

Training in hospital equipment can be broadlyTraining in hospital equipment can be broadlyclassified under the following categories:classified under the following categories:

Training by the supplier of the equipmentTraining by the supplier of the equipment

dealing with its operation.dealing with its operation.

Training within the hospital dealing with routineTraining within the hospital dealing with routinemaintenance/repairs.maintenance/repairs.

Training outside the hospital in a recognizedTraining outside the hospital in a recognizedinstitution dealing with maintenance /repairs forinstitution dealing with maintenance /repairs forelectronic equipments.electronic equipments.


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Hospital Equipment Planning &Selectionpmrpnt

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