Q: Due to constraints in our biomed budget, I was wondering: Is there anyway to reduce the rotations for sterilizers in our preventive maintenance (PM) program?A: Sure. In fact, several years ago, we reduced the rotation and the items we change on sterilizers. Our facility has 11 operating rooms (OR) and two labor-and-delivery rooms. Our sterilizers get fairly heavy use between 6 a.m. and 11 p.m. But we're definitely not as busy as facilities that run 24 hours a day, 365 days a year. So we reduced the PM schedule for some of them to a semiannual basis. This process has worked very well. We have not had any more failures than we had when we did them quarterly. We saved ourselves time and the materials we would have had in replacing those quarterly parts. Certain sterilizers, like the washer-sterilizers, still undergo quarterly PM due to their fairly heavy use and the fact that we only have two in the OR. If one goes down, the impact to our customer is significant.I am making my suggestions based on the assumption that your facility has a good preventive maintenance program and some sort of a program that enables you to track equipment. By tracking equipment repairs, you can monitor the results if you reduce your facility's PM schedule. Our facility continuously monitors work requests through a program in our database. This program allows use to “write” almost any report one can imagine. For example, one of our performance indicators is repeat work requests. We have a report that compiles all such requests during a given period—three months, in our case. Each technician is given the piece of the report related to the equipment that he or she is responsible for. The technician then checks the work requests for that equipment, looking for anything that can be incorporated into a regular PM schedule and prevent a failure. This allows your facility to “hold all the cards,” so to speak. If someone at your facility periodically monitors your success, you will be able to adjust your PM program accordingly.As for what parts can be reduced, that depends on several factors such as use, steam quality, water quality, and maintenance program effectiveness. Our water here tends to be higher in calcium than most parts can tolerate. So we keep water traps and water solenoids on a semiannual schedule. That said, our steam quality is fairly good, and we push our steam parts as long as possible. When we looked at ways to reduce cost, we looked along the line of steam—not water.Another key factor is staff care with equipment. For example, we once had someone in the instrument room who would slam the doors of the sterilizers so hard that the machines shook. We talked to him on several occasions, but he slammed the door right up until his last day at our facility. If that was not bad enough, after slamming it one time, this now-former employee cranked hard on the handle and then brought it to me to report, “It's broke.” Ha, ha! While he worked at our facility, we stepped up the PM frequency on the doors. We would check the handles for tightness, the arms that wind out to make sure they were not missing their holders, the door seal which would snap if brittle and the door was slammed, and the door cover to make sure it had not been bent.But let me end by returning to the big picture. You can and should alter your PM schedule to maximize your resources. Working with a good database, a good PM program can save you time and money. Remember: Garbage in, garbage out.
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