Evidence-Based Maintenance

Abstract

In Brief During the early years of clinical engineering (CE), CE professionals in the United States devoted a significant portion of their resources to detect failures through inspections (incoming and scheduled) and prevent failures through periodic parts replacement, lubrication, and other tasks (preventive maintenance), with the goal of reducing patient risks. With the rapid evolution of technology in the last 3 decades that increased medical equipment reliability, it is unclear whether CE professionals should continue to focus their attention on equipment failure detection and prevention or broaden their scope to enhance further patient safety. Using scheduled and unscheduled maintenance data collected for almost 2 years from 8 hospitals and a standardized failure classification method, 22 equipment types were analyzed in terms of actions that CE can undertake to improve safety: directly, indirectly, or in the future. For each of these 3 CE action groups, the risk associated with the use of equipment was estimated from the respective failure probability and severity of harm. The results show that, for most equipment types, CE professionals have reached the saturation point of what they can do to reduce risks, although some redirection of their attention from certain equipment types to others would optimize the use of limited resources. On the other hand, plenty of opportunities exist in helping the users and other allied health professionals to reduce risks significantly through further training, better communication, and better selection in future acquisitions. During the early years of clinical engineering (CE), CE professionals in the United States devoted a significant portion of their resources to detect failures through inspections (incoming and scheduled) and prevent failures through periodic parts replacement, lubrication, and other tasks (preventive maintenance), with the goal of reducing patient risks. With the rapid evolution of technology in the last 3 decades that increased medical equipment reliability, it is unclear whether CE professionals should continue to focus their attention on equipment failure detection and prevention or broaden their scope to enhance further patient safety. Using scheduled and unscheduled maintenance data collected for almost 2 years from 8 hospitals and a standardized failure classification method, 22 equipment types were analyzed in terms of actions that CE can undertake to improve safety: directly, indirectly, or in the future. For each of these 3 CE action groups, the risk associated with the use of equipment was estimated from the respective failure probability and severity of harm. The results show that, for most equipment types, CE professionals have reached the saturation point of what they can do to reduce risks, although some redirection of their attention from certain equipment types to others would optimize the use of limited resources. On the other hand, plenty of opportunities exist in helping the users and other allied health professionals to reduce risks significantly through further training, better communication, and better selection in future acquisitions.