28 Comparative analysis of the medical equipment management process in Colombo Gampaha and Kaluthara districts in Sri Lanka

Introduction Bio Medical Equipment Management Team lead by Provincial Director of health services involved Department of Health Services Western Province Sri Lanka Issue/challenge: Timely management of Bio Medical equipment in the aspect of Preventive and corrective maintenance achieved with a minimum down time. Aims and objectives of the research project or activity Major challenge was timely supplement of spare parts, and availability of skilled man power. Quick purchasing methods such as shopping method was applied. Additional staff were trained to address the challenges. Method or approach Engineering (BME) professionals need to continuous review and improve their management strategies in order to keep up with enhancement in equipment technology, as well as with increasing expectations of health care organizations. In the last two decades, management strategies have evolved from the initial observation with electrical safety to flexible criteria that fit the individual institution's needs. 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 second improvement is the use of a grace period for determining when a piece of equipment should be considered overdue for a scheduled maintenance event. This flexibility provides some leeway when a scheduled maintenance activity cannot be performed at the appropriate time due to unavoidable factors, such as equipment that is in use on a patient or devices that cannot be located. In other words, a maintenance activity may be considered performed on time even if it takes place beyond the established inspection time, as long as it is consistent with the organization's Medical Equipment Management Plan (MEMP). For example, a quarterly in5. To compare the Preventive maintenance (PM)process in three districts. Aim: To compare the Corrective maintenance (CM ) process in three districts. To explore the equipment down time. To develop an innovative Medical Equipment Management Plan (MEMP). Combined, both actions above support the primary message that each organization should analyze its equipment inventory and find the most appropriate maintenance strategies in order to have 'effective, safe, and reliable operation.' In other words, Engineers can consider in their planning the experience acquired in their daily work, such as: Some critical-care monitoring equipment requires little maintenance, whereas some low-risk equipment such as. X-ray film processors needs frequent attention. Preventive maintenance ( PM ) often does not increase reliability and actually may introduce failures, in industrial maintenance. It is observed the difficulty in creating a single MEMP that fits all organizations. The MEMP that works well for an extremely busy, District General and Base hospitals are likely more comprehensive than what is required for a divisional level hospital. For this reason, the discussion has been more methodological than prescriptive. Readers must use their professional judgment and experience in establishing their own maintenance strategies. The primary goal here is to stimulate development of innovative management strategies that balance limited resources with the need to improve patient safety, clinical outcomes, patient throughput, and the organization's mission. Time gained from eliminating unproductive scheduled maintenance is better used to improve the value of the service. The staff can participate more effectively in equipment planning and acquisition projects to ensure selection of better engineered and more appropriate equipment, and potentially reduce medical errors. Staff can be more involved in the education and training of clinical staff, thus helping to decrease the number of equipment abuse. Finally, the BME staff may be able to increase repair capability, thus reducing equipment downtime and costs to the organization related to vendor service and required rental of supplemental equipment. Perhaps the most important benefit of this new approach is a shift from concentrating exclusively on medical equipment as the source of patient safety risk to a balanced evaluation of the contribution to risk by the equipment and by the user. BME professionals will be able to shift some of their attention from equipment itself to supporting the users. This shift in focus will help health care organizations meet their commitments to achieving the goals. Findings Conclusion and recommendations Lowest performance in preventive maintenance has been performed by Kaluthara district BME unit. But in the aspect of corrective maintenance they expressed the highest performance. Other two district evidence with average performance. It is recommended to instruct BME unit Kaluthara district to start preventive maintenance, ultimately, out come of the study was helpful in decision making on allocation of resources and addressing budget constrains. I kaluthara district team preventive maintenance has not done at all and it has been performed by service agent which was more costly. Healthcare leaders would have to correct this anomaly and instructed the team to start Preventive maintenance at their own. Lessons learnt Proper equipment management may lead to an effective health care service delivery and assure the patient safety. Measurement of improvement After the intervention and starting Preventive maintenance re assessment should be done comparatively after one year Strategy for improvement After one year re evaluation should be performed Key messages Preventive Maintenance is more helpful to make sure cost effectiveness and it should be done by our own Team rather than going towards the service agent.