Decision Support Procedure for Medical Equipment Maintenance Management

Purpose In today's competitive industries, the selection of best suitable maintenance strategy is dependent on large number of quantitative and qualitative factors, and it becomes an extensively difficult problem for maintenance engineers. Over the years, a diverse range of solution methodologies have been developed for solving this multi-criteria decision-making (MCDM) problem. In this paper, the authors have presented a comprehensive review of latest maintenance strategy paradigms and solution approaches proposed for the selection of an appropriate strategy in various industries. It would provide a systematic mapping of developments in this field and identify some research gaps to explore further studies. Design/methodology/approach A systematic state-of-the-art comprehensive literature review on maintenance strategy paradigms and selection approaches is presented in this study. In this study, 87 research articles published in peer-reviewed journals, since year 2012, are reviewed. Findings For the selection of a suitable maintenance strategy, a variety of criteria are considered to better evaluate the alternatives. In this study, contemporary strategies are discussed, and their applications in different industries are also depicted. Moreover, through the analysis of extant literature, critical criteria are selected and classified in six major categories (namely, economic, technical, safety, environmental, feasibility and social) and further sub-categorized in quantitative and qualitative classes. These clusters of criteria can be helpful as an initial set of criteria for survey and then case- or industry-specific criteria can be shortlisted for further alternative evaluation. Practical implications From the perspective of maintenance managers, maintenance management can be a very difficult task, considering the numerous factors affecting the decision-making process. In order to help in the decision-making process, this study presents the contemporary maintenance strategies in a systematic manner. In a previous study (Kothamasu et al ., 2006), these strategies were classified into repair and prevent classes only. With the developments of autonomous maintenance and design out maintenance (DOM), it was fair to include continuous improvement class. It will help managers and practitioners to identify, according to organization policy, appropriate maintenance strategy alternatives for the asset. A benchmark set of state-of-the-art maintenance strategies are laid out with their applications. The industrial case studies discussed in this study summarizes the optimal maintenance strategies for respective industries. Also, most critical criteria are identified from the existing studies for various industries that can help maintenance practitioners in acknowledging the critical factors and making appropriate decisions. Evaluation parameters for the maintenance strategy selection (MSS) generally conflict with each other, and considering the difficulty of quantifying the qualitative measures, it is a challenging task to determine the optimal trade-off. In order to overcome these challenges, popular MCDM approaches, demonstrating effective results across different industries are discussed with their limitations and applications. Decision-makers can refer this study to identify best suitable decision-making technique for the MSS problem in the industry of their choice. Maintenance managers and engineers can refer the case studies illustrated in Tables 1 and 2 to analyse the MSS techniques proposed by previous studies with industry-specific applications. Social implications This study is an attempt to provide a reference point for research scholars interested in the field of maintenance management and/or development of maintenance strategy framework. This study provides a critical state-of-the-art review of efforts made in the field of MSS. The prominent maintenance strategies being implemented in contemporary industries are discussed with respective case studies. Interested researchers and academicians can familiarize themselves with these strategies and their distinct features in this study. In order to guide future studies and provide a reference point for academicians, MSS critical criteria used in extant literature are identified and classified into a comprehensive benchmark framework. Moreover, the industrial case studies are discussed with the most critical criteria of MSS for different industries and which strategy is most suitable for the respective industries based on these criteria. Table 1 presents different MCDM techniques and their hybrid applications for solving MSS problem that can help researchers in identifying research gaps. Future research can be directed at addressing the limitation of MCDM approach employed in existing studies and comparing the differences in results obtained by the proposed approach. Different industrial case studies with considered maintenance strategy alternatives are presented in Table 2, which can help researchers in identifying the industries that have not been studied yet. Moreover, not all of the existing studies are carried out by considering all the presented benchmark strategies, which can be addressed in future studies by interested researchers. More detailed discussion on research gaps is presented in the following section. Originality/value From the analysis of the extant literature, the authors could observe that the decision-making process adopted in numerous studies was limited to the classical maintenance strategies and not inclusive of aggressive maintenance strategy alternatives. To overcome these limitations and help maintenance managers in the decision-making, this study depicts the contemporary maintenance strategies, critical evaluation criteria and MCDM frameworks (employed to solve the MSS problem with industrial case studies) in a structured manner.

Purpose– This paper aims to synthesize and categorize the published literatures related to maintenance strategies formulation, selection and implementation in various industries. The purpose of this paper is to develop a conceptual framework based on literature review for formulation of maintenance strategies, selection and the implementation of selected strategies. Further, to study on impact of maintenance strategies implementation in maintenance function.Design/methodology/approach– A literature review has been carried out to identify the existing frameworks related to maintenance strategies formulation, selection of maintenance strategy and implementation of maintenance strategy in the industry. Literature support for all the conceptual constructs referred in the framework has been discussed to establish a logical sequence.Findings– A conceptual framework for maintenance strategies formulation, selection and implementation and its impact in maintenance function has been developed. Further, constructs and sub-constructs which form the basis for maintenance strategies formulation, selection and implementation have been identified from the literatures. In addition, propositions have also been formulated to support the conceptual framework and these propositions provide the logical relationship among the maintenance strategies formulation, selection among the formulated strategies and the implementation of these strategies.Research limitations/implications– The conceptual framework developed in this paper for maintenance strategy formulation and selection is yet to be empirically tested. The proposed framework can be tested in various industries.Practical implications– Literature study on maintenance strategy formulation and selection has so far been very limited. Maintenance strategy selection is a critical decision-making problem for the maintenance managers working in the process plant, manufacturing companies, etc. The conceptual framework proposed in this paper will help maintenance managers to asses, formulate, select suitable maintenance strategy and implement for their organization.Originality/value– The paper provides comprehensive study on maintenance strategy problem which will be useful to researchers, maintenance managers and other professionals in various industries such as process industry, manufacturing industry, etc., to understand maintenance strategy selection problem and implementation of maintenance strategy.

Most things are driven by money. A constant and recurring theme in hospitals is how the monies for medical equipment maintenance should be budgeted and managed. There are two main schools of thought. Distributed model: All charges are paid by the department that uses the services. This means that surgery would budget and pay for all surgery expenses, parts, and contracts. Centralized model: All costs are centralized into a single medical equipment maintenance budget, controlled by biomedical engineering. This budget includes all in-house costs, external costs, contracts, and all overhead for biomedical engineering department operations. In the decentralized model, finance allocates all expenses as closely as possible to the departments that generate the revenue. However, in order for product managers to set rates and manage expenses, they need to have ALL of the expense data to analyze. Missing such a large part like equipment maintenance costs would skew the break-even point and lead to incorrect pricing. The benefits to the centralized system include: 1. The biomedical manager or director is a service management professional. His or her job, training, and professional life have been spent in the maintenance, repair, and support of patient care equipment. Who in the hospital can better oversee contracts, parts, and outside maintenance? A surgery manager whose main focus is patient care, not equipment costs and performance, is not the optimal person to manage equipment costs. 2. A central budget allows decisions to be made across departmental lines. The same type of equipment is owned and used by many different departments in the hospital. The decisions and choices made by a single department are often different than if the entire facility is considered. 3. Outside vendors will always be used to some extent. These vendors must be monitored and their work added to the comprehensive medical device record. Compliance and cooperation from the outside vendors cannot be attained except by the person responsible for paying for the service. 4. Unless the funds are in the biomedical department budget, they will not be closely watched and scrutinized. Clinical department managers do not focus on maintenance activities. But a biomedical manager who must meet budget and explain variances can more effectively manage a single cost center than try to manage the costs of 30 or 40 subaccounts scattered across the institution. 5. If hospitals are ever to consider less costly (and often more effective) service options than the original equipment manufacturer, the control and oversight must be given to the biomedical department. 6. As required by the Joint Commission, every biomedical department maintains a complete and upto-date medical equipment inventory. The software that keeps this inventory generally has the ability to track costs of every medical device and generate reports of labor and parts costs. These reports can be as granular as necessary, all the way to the device level, or summarized for each department. These reports can be the charge-back mechanism product line managers need to identify and manage their department costs. If a hospital is going to employ a professional manager of medical equipment service, that hospital must not tie his or her hands by removing the most powerful tool available—the money to negotiate and control costs and activities of outside companies and vendors. A centralized medical equipment maintenance budget in the hand of a professional biomedical manager is the best and cheapest way to care for your equipment. n

Medical devices are one of the most crucial segment of a country’s healthcare system. This paper reviews the demand and supply side factors, including socio-economic, market-enabling, technological and policy instruments, that could drive the growth of the medical device industry. It highlights some key issues and challenges the sector is grappling with. Despite there being several enabling factors for the sector’s growth, India primarily manufactures medical equipment within the low-tech segment, from consumable to implantable devices. This leaves domestic requirements unmet in other segments, pushing the country to import expensive equipment in the advanced technology segment. This drives up the cost of medical equipment, leading to higher diagnostic test fees for end-users, which in turn places a significant out-of-pocket financial payment burden on households for diagnostic services.

Introduction: Medical equipment is an indispensable part of hospitals. It is the basic condition and guarantee for the hospital to carry out medical services, scientific research, teaching, and other activities, and it plays an irreplaceable role in the entire medical process of the hospital. Therefore, the maintenance management of equipment is also the focus of our attention. In the past, traditional management methods such as paper were mainly used for equipment maintenance management, and it was difficult to share data.Methods: In today’s era of rapid development of information technology, we will use information technology to maintain and manage medical equipment. Through big data analysis and other technologies, the drawbacks of the existing traditional management methods are improved, so that medical equipment can be managed scientifically. By maximizing its functions, it can ensure the normal operation of medical facilities, improve the utilization rate and integrity rate of equipment, and reduce maintenance costs and unnecessary losses.Results: According to the research findings, based on the background of big data, a de-Bayesian network is used for data mining to build a medical equipment maintenance platform. Through the data in the platform, we can better discover the distribution and reasons of equipment maintenance, and at the same time conduct an analysis to provide reference for the formulation of preventive maintenance plans, reduce equipment failure rate and maintenance costs and improve equipment utilization. Through the survey of medical staff, we can also find that at least 40% of the people feel that the work distribution is more reasonable, and 45% of the people feel that the equipment failure rate and the time required for maintenance have been greatly reduced.Discussion: We can see that the network platform for medical equipment maintenance management built through big data is very feasible, which can help us work more effectively and improve work efficiency.

This paper deals with the development of standard In-service Training and Education of Users and Maintenance personnel on Medical Imaging Equipment in the health services of Bangladesh. Users and Maintenance personnel of equipment should be trained to do routine simple maintenance on equipment. This will increase user care of equipment and cooperation with maintenance technicians to reduce equipment breakdowns. At the same time, this will promote the culture of equipment care and maintenance to improve the quality of health care. Proper use and maintenance of medical equipment are essential to obtain sustained benefits and to preserve capital investment. In-service education and training have a direct impact on the quality of care. Various obstacles for expanding medical equipment use and maintenance capabilities in Bangladesh have been discussed. Proper operation and maintenance problems are complicated by the ever-increasing use of medical imaging equipment as health care is modernized. To date, the operation and maintenance situation in Bangladesh are getting worse and requires special attention. Use and maintenance capabilities are considered during the initial stage of making a decision to acquire equipment. Proper use and maintenance problems can be minimized through in-service training and education. The mission is to ensure that equipment used for patient care is safe, available, accurate, and affordable. In this paper, it has been described the problems and methodology to improve the existing in-service training and education of users and maintenance personnel on MIE. In this study, we designed a framework of in-service training and education of medical imaging equipment (MIE) uses and maintenance system used for in-house clinical engineering department.

Caregiving is an inherently difficult role, replete with the emotional strains of watching a loved one deteriorate physically or mentally while trying to balance work and home responsibilities, and finding needed services with little or no guidance. These challenges are compounded by extreme stress, emotional overload, and a sense of isolation. Family caregiving is a lifespan issue, encompassing those with chronic conditions, disabilities, disease or the frailties of old age. Caregiving embraces a wide spectrum, ranging from the families of children with special needs to adult children caring for parents with Alzheimer's disease. Many family caregivers interact with medical devices in home settings.Advances in medical technology have allowed care recipients to remain ambulatory and independent. Because care recipients expect to be able to stay independent, mobile or active, the term “home use” extends beyond the home to encompass all environments in which a person plans to use his or her medical device to continue or enhance the quality of daily life.1For medical equipment designed for longterm use in the home, labeling will often not be with the device. In such cases, the home healthcare provider must develop his or her own basic instructions for use, maintenance, and cleaning. Through the MedWatch adverse event reporting system, the Food and Drug Administration (FDA) receives medical device reports of problems that stem from missing, absent or inadequate labeling, or misinterpretations of the information in labeling and instructions for use (IFU).The FDA also receives anecdotal information from consumers, healthcare practitioners (HCPs), healthcare organizations and device manufacturers suggesting interest in enhancing medical device equipment labeling content and format. Consumers and HCPs are particularly interested in having a searchable website containing medical device labeling and instructions for products intended for home use.This study was conducted to help the FDA better understand device labeling-related challenges that family caregivers face when care is provided in the home environment. Study respondents are members of the Caregiver Action Network (CAN), formerly the National Family Caregivers Association (NFCA), which educates, supports, empowers, and advocates for the more than 65 million Americans who care for loved ones with a chronic illness or disability or the frailties of old age,2 advocating for the needs of family caregivers, including their desires and need for instruction in the safe and effective use of medical devices in the home. These findings will assist in guiding the FDA's future efforts to characterize information pertinent to medical device labeling and provide online access in order to facilitate safe medical device use at home.A web-based survey contained multiple choice questions with pre-coded responses offering CAN respondents the opportunity to provide free-text responses and comments. The questionnaires were developed collaboratively by CAN, FDA/CDRH, and contractor to the FDA Social and Scientific Systems (SSS). Questions for both methods were based around the following topics:The survey questionnaire was administered via e-mail to a random sample of CAN members who met selection criteria (n=557; See Appendix 1 in online version of this article). The email provided background information about the FDA and the purpose of the study.The web-based survey was conducted October 5, 2011 through January 6, 2012. Reminders were sent four times over the course of the study, in October, November, and two in December. After the survey closed, results were collated and de-identified to maintain respondent confidentiality and then analyzed by the authors.One hundred twenty-seven respondents completed the web-based survey, a 22% response rate. Ninety-five percent of all respondents care for adult family members (over 21 years old). Forty-nine percent and 45% of these respondents care for a family member 65 years or over (n=63) or a family member between the ages 21–64 years (n=58), respectively.Of these 127 respondents, 77% care for their family member in their own home (n=99) and 59% of all respondents have cared for their family member more than five years (n=76). Forty-four percent of all respondents care for their spouse/partner (n=56).The majority of respondents indicated that they have been using their medical equipment for two or more years for chronic conditions, including heart disease, lung disease, and diabetes, or conditions related to stroke and cancer. Free text responses also included conditions, such as dementia and Alzheimer's disease.The survey determined that the home medical equipment respondents most commonly used in the care of family members included wheelchairs, specialty hospital beds, blood glucose monitors, patient lifts, nebulizers, and assistive equipment, such as canes, walkers, and bathroom handrails. Survey questions allowed respondents to share their experiences using the aforementioned medical products, specifically their experiences with the labeling and instructions that accompany the products they use.Respondents indicated that their medical equipment is most often delivered to their homes from the manufacturer or received from a pharmacy or drug store. From the free-text responses, respondents indicated that their equipment was handed down from friends or family after previous use. Respondents specified that it was ‘somewhat easy to very easy' to learn how to use their medical equipment, and most received training prior to use. Equipment use training was most often provided from the medical supply company representative.Other responses indicated that no training was received; or that training had been provided by the home health provider, rehabilitation staff, or hospital staff. Other methods besides training that helped respondents learn how to use their medical equipment included trial and error, following written (paper) instructions from the manufacturer, Internet instructions, verbal instruction, or observation and return demonstration.* Respondents noted that the best time to receive written instructions was upon delivery of equipment at home and the worst time was at the hospital.When manufacturer instructions came with their medical equipment, respondents indicated that it was ‘somewhat easy' to follow. Instructions were typically provided in a manual, booklet, or information sheet format. Respondents specify that the table of contents was most helpful in finding the information they need to use their equipment. When seeking information to troubleshoot their product, respondents believed they could ‘quickly and easily' find the information in the manufacturer's instructions.In free-text responses, respondents indicated that they would make use of the 1-800 helpline, or ask a nurse or company representative when they need information about using their product in general or for information about troubleshooting. Free-text comments indicated that a DVD would be helpful for these purposes.In addition to manufacturer's instructions, respondents indicated that they obtained information from medical supply companies, home health agencies, and hospitals, in the same format as the manufacturer's instructions. Interestingly, even when manufacturer's instructions are provided, information from additional sources is obtained in order to simplify and clarify the manufacturer's instructions.Respondents did not always use the instructions, because they felt the training they received was enough. The survey results indicated that most respondents commonly used their instructions when they were first learning to use their equipment; until they felt comfortable using it; and for information about cleaning.Respondents often referred back to their instructions when there was a problem, to find a phone number, or to refresh their memory and ensure they were using their equipment correctly. When respondents referred back to their instructions, they found what they needed to know. However, respondents specified that the information they needed was not always contained in the manufacturer's instructions. Instead, this information could come from other sources, such as from friends.Respondents who keep their instructions often file them with other medical information for as long as they own the equipment, which allows for easy access if needed. However, not all respondents have the instructions for their equipment. Whether this is because they never received it, or because they lost it requires further exploration.Most instructions include pictures and diagrams; however, whether respondents find them helpful is unclear. Interestingly, free-text responses indicated that pictures, diagrams, and other visuals are indeed useful and suggest that these be included in the instructions. Respondents report that the information they need to have to use their medical equipment, in the order of importance, includes the following:Respondents indicate that they most prefer to find information via paper instructions, such as a manual, brochure, or quick-start guide affixed to the equipment itself. In addition, respondents will also seek information online and find it helpful to obtain instructional information by phone with a company representative or home health nurse. To that end, respondents commonly turn to these sources, in addition to seeking advice from friends or others with the same condition or equipment.Respondents specify that a short version or quick-start guide would be helpful, especially if it includes the following:Sixty-five percent of all respondents are very comfortable with using computers (n=83), and 70% of respondents indicate they would welcome and make use of an FDA ‘searchable website that contained instructions for medical equipment used in the home' (n=90). Respondents noted that if the FDA created a searchable website, it should include videos to supplement the written instructions, diagrams, and pictures, all of which should be easy to print, and parallel the instruction preferences discussed above.Individuals likely to use medical products in the home setting may be elderly, chronically ill patients of any age, pregnant women, high-risk infants, and rehabilitation patients. These individuals vary significantly in their ability to operate and maintain devices. Complex instructions with multiple steps could confuse the user's ability to understand or adequately operate the device. To that end, instructions and information written in simple language should accompany any home use device product. Photographs, diagrams or other graphical representations may be used to provide clarity, as evidenced by respondent preferences.Survey results about medical equipment training portray an interesting situation: More complex devices used in the home environment are designed to be used by trained healthcare professionals in an acute care facility, rather than in a nonclinical setting. Furthermore, care recipients may not be able to choose the devices that they will ultimately use, as the device may be pre-selected by their insurance, for example.For these reasons, care recipients may not receive devices that are optimal for their comprehension level or that of a family caregiver. Therefore, it is imperative that home care recipients are properly trained on how to use their device as well as provided with instructional information that is readily accessible, easily understood and in a format that meets the users' needs.While this study generated important feedback on medical device labeling and use instructions, not all respondents (n=127) answered every question. Toward the end of the survey, there was attrition, evidenced by the dwindling number of responses to all remaining questions. This is likely due to the fact that respondents were requested to answer questions related to three pieces of medical equipment, which, in hindsight, is a large time commitment. While the free-text responses presented respondents with an opportunity to elaborate on their responses, many free-text reactions include ‘gripes' about the specific equipment(s) they use. Future studies like this one should consider responses of this nature during survey question development.Social desirability respondent bias was also present in this study. When comparing responses to questions with pre-coded selections with responses to questions that offered free text, there was a tendency for respondents to select favorable pre-coded responses to downplay the difficulties they experience, especially with regard to learning, following instructions, and using medical equipment.The pre-coded responses do not always match free-text feedback, which many times express frustration and confusion with regard to following medical device labeling and instructions. Furthermore, many free-text responses indicate that respondents do not recall receiving or did not receive instructions upon receipt of their medical equipment, which may also skew the results.Many study respondents are comfortable using computers, and often refer to information sources online and using a website that contains instructions for medical equipment used in the home. This finding, however, cannot be generalized to the entire population. Clearly there is selection bias at play: Respondents taking a web-based survey are likely to be more comfortable with computers, which could impact their ability to accurately respond to these questions.Another limitation to this study is that CAN respondent educational levels were not captured, nor were they included as part of the selection criteria eligibility. Authors suggest that in future studies of this nature, a question to obtain respondents' educational levels be included to determine whether there are relationships between education and labeling comprehension ease.

Medical equipment maintenance management information system is a web-based information system designed and developed to facilitate hospital management in monitoring and supervising the maintenance and calibration activities of medical equipment. The aim of study is to make system design and development analysis are based on the Systems Development Life Cycle with the waterfall method. System design analysis is intended to obtain information according to the needs and desires of users and the criteria limits of the system to be developed. The system can meet the needs of users with system operational functions by identifying the needs and functional identification of the system. Analysis and design of management information system for medical equipment maintenance can fulfill system requirement needed by hospital management. With medical equipment maintenance management information, hospital management can obtain reports of maintenance and calibration activities quickly and accurately.

Clinical engineering departments in hospitals are responsible for establishing and regulating a Medical Equipment Management Program to ensure that medical equipment are safe and reliable. This paper describes an application of the Analytic Hierarchy Process (AHP) for selecting the appropriate maintenance strategy for radiology medical equipment as maintenance plays a key role in reliability, availability, increasing efficiency, and equipment safety. Three most common strategies are considered: corrective, time-based and condition-based maintenance.

PurposeEffective maintenance management of medical equipment is one of the major issues for quality of care and cost-effectiveness especially in modern hospitals. An effective medical equipment maintenance management (MEMM) consists of adequate planning, management and implementation. This is essential for providing good health services and saving scarce resources. Considering the importance of the subject, the purpose of this paper is to extract the influential factors on MEMM using a qualitative approach.Design/methodology/approachDocuments review and interviews were main methods for data collection. Semi structured interviews were conducted with a purposive sample of 14 clinical engineers with different degree of education and job levels. Interviews were voice recorded and transcribed verbatim. Qualitative data were analyzed using a content analysis approach (inductive and deductive) to identify the underlying themes and sub-themes.FindingsFactors influencing an effective and efficient MEMM system categorized in seven themes and 19 sub-themes emerged. The themes included: “resources,” “quality control,” “information bank,” “education,” “service,” “inspection and preventive maintenance” and “design and implementation.”Originality/valueThe proposed framework provides a basis for a comprehensive and accurate assessment of medical equipment maintenance. The findings of this study could be used to improve the profitability of healthcare facilities and the reliability of medical equipment.

Modern medical equipment and devices have become very sophisticated and complex. These assets are expected to operate under rigorous environments. Hospitals need to confirm that their critical assets particularly medical equipment are reliable, safe, accurate and operating with high level of performance. However, activities of maintenance, condition monitoring, inspection and maintenance optimization models are fairly new to medical devices. Current maintenance strategies in health sector have difficulty in applying the optimal maintenance strategy. This paper addresses clear gap based on literature review for medical equipment maintenance and condition monitoring. Implementing right maintenance strategy can lead to detect faults before they occur, so that preventive maintenance can be optimized through predication and analysing failure patterns. This paper aims to critically identify the predicting Remaining useful life (RUL) for hospital’s Gas-Pipe based on degradation analysis. According to previous studies, there is almost no research has been tackled this method of analysis in the medical device, especially in the gas pipeline system. The present research described the use of degradation data to estimate failure time in terms of P-F interval, which it was 8 years. Results of this paper show that the majority of gas-pipes reached the critical point less in than 15 years. While the manufacture specify the life-time between 15–20 years. In addition, this research contributed to the knowledge through recommended a developed framework in order to improving the facilities and assets management by increase the life time of medical devices, reduced the failure of critical devices, reduced the maintenance costs, and predict the critical failures before occurring.

In order for the Health Technology Management Policy at the state level to be successfully implemented, first of all, adequate personnel are necessary, and among these, biomedical engineers play an important role. Biomedical engineers (clinical engineers) work in a wide range of settings and disciplines in the health sector and play a key role in: innovation, design and development of new technologies in health care; testing, implementation and development of new diagnostic tools and medical equipment; defining safety standards for medical equipment; maintenance of (complex) medical equipment. The Ministry of Health of the Republic of Serbia labeled the biomedical engineering workforce as a "critical workforce". This critical workforce is defined as "a workforce that contributes to critical and essential elements of health technology management, especially in the domain of maintenance and replacement of (complex) medical equipment, now and in the future".

The first article of this series demonstrated that some medical equipment exhibits clear, progressive deterioration with age, whereas some others do not. The second article showed that although most equipment remains safely and reliably deployed well over its respective depreciation period and the end-of-life or end-of-support dates declared by the respective manufacturers, some equipment needs to be replaced sooner. Because it is not practical to wait for the collection and analysis of large amounts of data to better plan for maintenance and replacement, a simple, quantitative model for equipment aging is introduced in this article to help improve both types of planning. The model was tested on professionals not directly involved in its formulation and applied to 34 equipment types. The results show this aging model can be used by professionals experienced in medical equipment maintenance and management, with only some basic instructions. Furthermore, it can be used to update the traditional “risk-based criteria” for planned maintenance and turning it into a risk management method fully compliant with the ISO 14971 standard.

Medical technology is by now an integral part of health care according to consisting general accepted standards. The Medical Equipment Management Plan defines the mechanisms for interaction and oversight of the medical equipment used in the diagnosis, treatment, and monitoring of patients. The related policies and procedures govern activities from selection and acquisition to incoming inspection and maintenance of medical equipment. The mission is to ensure that equipment used in patient care is safe, available, accurate, and affordable.

Resource Depletion Risk for Medical Equipment: Embracing the Circular Economy.