Creating HEALTHCARE for the WORLD
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Transcript of Creating HEALTHCARE for the WORLD
Creating HEALTHCARE for the WORLD
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An- Najah National UniversityFaculty of Engineering
Industrial Engineering Department
Reem Asmr Nazmia Mana’a Ahmad ZaherShayma Smaaneh Sawsan Deek Rasha Abu-shanab
Developing Maintenance Management System in Al-Arabi Specialized Hospital
Eng . Tamer Haddad
Students
Supervisor
Sections :
5.Apply the 5S system to arrange the workshop and reduce the time taken in
maintenance.
Introduction
Maintenance management
Current Status for Maintenance System
Suggested Maintenance Management System
Conclusion and Recommendations.
Al-Arabi Specialized Hospital
History of Al-Arabi Specialized Hospital
Established in 2000 by a group of creative doctors
Located in Nablus ISO in 2001
ObjectivesThe main objectives of this project are :
1- Investigate implementing maintenance management systems in Healthcare Facilities. 2- Developing a new suggest maintenance system and compare it with the current used one. 3- Developing a new implementation framework for Healthcare Facilities. 4- Discussing the difficulties in the adoption of maintenance systems with proper solutions.
Maintenance Definition : to keep the equipment in
operational condition or repair it back into its‟ operational mode
Objective: increase availability of production systems, increase safety and optimized cost.
Preventive maintenan
ce Corrective
maintenance
Types of maintena
nce
Maintenance in Healthcare Facilities The Hospital maintenance department is a crucial
element to a high quality healthcare facility. The excellent functioning or, by other words, the
maximum reliability of facilities and equipment is a main rule for this department.
The policy that permits such performance must always be based on planned maintenance including preventive maintenance.
To be in advance to failures The other goal persuaded, it is to maintain costs as lower as possible.
CURRENT SYSTEM
Current system include
The Organizational Structure
Flow charts
The used reports templates
Performance indicator
Analysis of available data
Problems related to the current system
The Organizational Structure
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Medical maintenan
ce Engineer
Head if Maintenan
ce Departme
nt
Maintenance
technician (1)
Maintenance
technician (2)
The Maintenance Activities Process
Yes
No
Flow chart :
Repairing the failure
The end
Inform the maintenance department for the
failure orally
Sending request for maintenance department
Inform the service technician internally or externa
lly for the failure orally
Is it possible to maintain the fault
internally?
Filling the request of the external
maintenance report
Sending the request to the competent
authorities
Sending the service technician to the site of failure
Failure
Filling the request of general maintenance report
Start Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Report templates1- Devices and Machines List.
الصيانة قسم رئيس) والتاريخ) التوقيع :
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Report templates2- Annual Preventive Maintenance Plan. اإلعداد / / :تاريخ
) والتاريخ ) التوقيع الصيانة قسم :رئيس
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Report templates3- Summary of Preventive Maintenance Works.________: _________________ : _______________ السنة / الشهر الجهاز الماكنة /______ رقم الجهاز الماSكنة اسم : Organizatio
nal structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Report templates. 4- Request for General Maintenance report. Organizatio
nal structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Report templates5- Request for External Maintenance report.. Organizatio
nal structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Report templates6- Record of Maintenance Requests.
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Report templates7- Machine/Device Record.
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Report templates8- The “Under Maintenance” Card
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
الصيانة قسم" الصيانة "تحتUNDER MAINTENANCE
الجهاز / الماكنة هذه تستخدم الDo Not Use This Equipment / Device
Measurement of Maintenance Activities PerformanceThe Performance Indicator/ Maintenance Monthly report Organizatio
nal structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
The Performance Indicator/ Maintenance Monthly report Organizatio
nal structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Measurement of Maintenance Activities Performance
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Department malfunctions frequencies.
Analysis of Malfunctions Data
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Lab devices malfunctions frequencies.
Analysis of Malfunctions Data
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
A. Chemwell-Awarness
Malfunctions’ Causes Analysis
Failure of ChemwellAwarness device
Environment Poor Cleaning
Human
Poor cleaning of lamp Poor
cleaning of filter
Excess loadUntrained
staff
Dust in the surrounding
area
Bad preventive
maintenance
Cause-Effect diagram for Chemwell-Awarness device.
Chemwell-Awarness device has the highest number of failures
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
B. Blood Gas Analyzer
Malfunctions’ Causes Analysis
Cause-Effect diagram for Blood Gas Analyzer device
It’s the second highest device in number of failures
Failure of Blood Gas Analyzer Device
Poor Cleaning
Human
Poor internalcleaning
Excess load
Untrained staff Bad
preventive maintenance
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Malfunctions’ Causes Analysis
Cause-Effect diagram for Electrolyte device
It has the same number of failures as the Blood Gas Analyzer device
C. Electrolyte
Failure of Electrolyte device
Equipment Poor Cleaning
Human
Poor cleaning
after using
Insufficient self washing
Calibration
Wrong calibration
process
Excess load
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
These problems can be summarized as:
Problems related to the existent system
1.The general and external reports are written by hand
2.The reports are stored in a non-professional and unsafe way
3.All maintenance reports related to all hospital departments are stored together in one record.4.Many simple malfunctions could be fixed at the instant of occurrence instead of taking a long time in performing the maintenance operation.
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
These problems can be summarized as:
Problems related to the existent system
5.When there is a need for external maintenance, then the request for external maintenance report must be documented and attached with the request for general maintenance report.
6.Record of Maintenance Request reports are not filled out.
7.The used performance indicator is not efficient and is not accurate.
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Problems related to the existent system
•The following items are not documented in most request for general maintenance reports:1.The name of the department that submitted the request for maintenance report.
2.The name of the person who informed of the malfunction.
3.The date and time of malfunction occurrence.
Organizational
structure
Flow charts
Reports templates
Performance indicator
Analysis of data
Problems
Problems related to the existent system
•The following items are not documented in most request for general maintenance reports:
4.The name of the technician who performed the maintenance.
5.Description of the malfunction and the reasons of its occurrence
6.Clarifying the need for local or external maintenance
SUGGESTED MAINTENANCE MANAGEMENT SYSTEM
Suggested Maintenance Management System
Include :
Job descriptionSuggested Organizational
StructureSuggested Flow charts
Suggested Tracking Serial Number
Suggested Report TemplatesSuggested Measurement of
Maintenance Activities Performance
5S ImplementationComputerized Maintenance
Management System (CMMS)
Job Description Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S
a) The Head of the Maintenance Department•Job Title:Head of the Maintenance Department:
•The academic qualifications and experiences required:1. Bachelor degree in Medical, Mechanical,
Electrical or Electronic engineering.2. Six years of experience in maintenance work of which two years in experience as head of a department in a hospital.• Main tasks:1. Planning, organizing, directing and monitoring all maintenance activities in the hospital.2.Determining the departments annual needs of devices, equipment and spare parts.3.Supervision of preventive maintenance programs and Documentation and archiving the maintenance reports.4. Assess the level of performance of the department
(CMMS)
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S
b) Medical Maintenance Engineer•Job Title:Medical Maintenance Engineer.
•The academic qualifications and experiences required:1. Bachelor degree in Medical or Electronic
devices engineering.2. Five years of experience in maintenance of medical devices.
• Main tasks:
(CMMS)
1. Developing a work program and distributing duties on medical devices technicians.2. Following-up on medical devices that are sent to outer repair shops.3. Provide the tools, inspection equipment and spare parts required for maintenance.4. Submitting the periodic reports to the head of maintenance department.5.Developing preventive maintenance programs associated with the medical maintenance department.
Job Description
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S
c) Medical Devices Technician•Job Title:
•The academic qualifications and experiences required:
• Main tasks:
(CMMS)
Medical Devices Technician
1. A two years diploma in medical devices.2. Five years of experience in maintenance medical devices.
Job Description
1. Preparing tools and inspection equipment that are necessary to inspect and maintain the medical devices. 2. Dismantling and cleaning of medical devices for testing, calibration or maintenance and their re-installment according to the established maintenance procedures and manufacturer’s instructions. 3. Making sure that the backup parts of a device are available before starting to repair it.
Organizational StructureJob description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
Flow ChartsJob description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
1.Preventive Maintenance process
Flow ChartsJob description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
Internal Maintenance Process2.Corrective Maintenance Process
Flow ChartsJob description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
External Maintenance Process2.Corrective Maintenance Process
Suggested Tracking Serial Number
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
serial number is a unique number assigned to facilitate identification the devices locations.
( EM 04 11 1011)
emergency department,
fourth floor
room number
Machine code #
Suggested Report TemplatesJob description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
1. Device list.
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
2. Annual Preventive Maintenance Plan.
Suggested Report Templates
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
3. Preventive Maintenance card “PMC”.
Suggested Report Templates
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
4. Preventive Maintenance Checklist. Daily preventive maintenance checklist.
Suggested Report Templates
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
Suggested Report Templates5. Request for General Maintenance report.
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
6. Request for Outside Maintenance report..
Suggested Report Templates
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
7. Records of Maintenance RequestsSuggested Report Templates
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
8- Device Record
Suggested Report Templates
Suggested Measurement of Maintenance Activities Performance
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
• Data Sheets1- Preventive maintenance data sheet.
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
• Data Sheets2- Corrective maintenance data sheet for devices..
Suggested Measurement of Maintenance Activities Performance
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
• Data Sheets2- Corrective maintenance data sheet for devices..
This chart helps in recognizing the most causes of failures and their frequencies. As shown it is obvious that the human causes have the highest frequency.
Human
Envir
on...
P .clea
ning
05
1015
fauiler casues-freq(for each device)
Failure causes
Frequency
Suggested Measurement of Maintenance Activities Performance
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
• Data Sheets3- Corrective maintenance data sheet for departments.
Suggested Measurement of Maintenance Activities Performance
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
• Data Sheets3- Corrective maintenance data sheet for departments.
The following chart represents the frequency of failures of the labs’ devices as an example.
Blood g
as an
alyze
r
Chemwell
awarn
ess
Electr
olyte
analy
zer
Modon
ic
Micros
cope
easy
lyte
Hettic
h cen
trifug
e0246
Devices vs Failure freq
Device name
FailureFrequency
Suggested Measurement of Maintenance Activities Performance
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
• Data Sheets4-Corrective maintenance data sheet for the maintenance department
Suggested Measurement of Maintenance Activities Performance
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
• Data Sheets4-Corrective maintenance data sheet for the maintenance department
The following chart is used to facilitate identifying and the number of failures in each department in addition to notifying the maintenance type performed for each failure whether if it is internal or external.
Lab
Sleep
ing W
ard
Emerg
ency Men
Cardiac
Surg
ery
Matern
ity
Nursin
g024
Internal&External maintenance Vs failures frequency
InternalExternal
Departments
Failure frequency
Suggested Measurement of Maintenance Activities Performance
5S ImplementationJob description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
Definition : It is an approach to keep the work place in the different departments and in the maintenance workshop in a suitable condition to perform the required work efficiently.
There are five primary phases of 5S: sorting, straightening, systematic cleaning, standardizing and sustaining.
5S ImplementationJob description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
1. Sorting Eliminate all unnecessary tools, parts, and
instructions. Go through all tools, materials, and so forth in the plant and work area.
2. Straightening or Setting in order There should be a place for everything and everything should be in its place
3. Systematic cleaning or shining Clean the workspace and all equipment, and keep it clean, tidy and organized.
5S ImplementationJob description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
4. Standardizing (Seiketsu) Work practices should be consistent and standardized. All work stations for a particular job should be identical.
5. Sustaining the discipline or self-discipline Maintain and review standards. Once the previous 4 S's have been established, they become the new way to operate.
5S ImplementationJob description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
To assess the level of the maintenance workshop in the hospital based on the 5S modeling, the following checklist form should be followed.
5S ImplementationJob description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
The workshop table. The workshop shelves
As shown, the table is dirty and untidy.
As shown the shelves are in a
very bad
CMMS
Computerized Maintenance Management System (CMMS)
Job description
Organizational Structure
Flow charts
Serial Number
Report Templates
Activities Performance
5S(CMMS)
Definition(CMMS) is a type of management software that performs functions in support of management and tracking of maintenance activities.
A suggested CMMS interfaces has been developed for the maintenance department in the hospital to facilitate managing and documenting the operation since there are huge amounts of information should be extracted and documented.
Example:
Maintenance Department
ADD A NEW MAINTENANCE REQUEST
VIEW THE RECORD OF MAINTENANCE REQUESTS
EDIT REQUEST
PREVINTIVE MAINTENANCE CHECK LIST
DEVICE RECORD
RECORD OF MAINTENANCE REQUESTS
PERFORMANCE INDICATORS
MAINTENANCE DEPARTEMENTGENERAL MAINTENANCE REQUEST FORM
-INQUIRY FORM -
Date of reporting:Time :
Department:
Employee name:
Floor number :
Device number :
Device code :
Date of fauiler : Time :
Mechanical
medica electrical
civil
clear proceedsave
Failure classification:Failure classification
Failed device informationDevice information
MEDICAL MAINTENANCE DEPARTEMENT -MEDICAL MAINTENANCE ENGINEER -
Failure description :
………………………………………………………………………………………………...
Failure causes:
Poor cleaning Human
Environment calibrration
Otherwise
Type of needed maintenance
Internal
External fill the external maintenance request form
nextNext back Exit
Fill the maintenance activity form
Request number :
MEDICAL MAINTENANCE DEPARTEMENTEXTERNAL MAINTENANCE REQUEST FORM
Request number : Date :
Device name :Device code :
supplier name:
Notifications:
…………………………………………………………………………………...
save back proceed
MEDICAL MAINTENANCE DEPARTEMENTEXTERNAL MAINTENANCE ACTIVITY FORM
The executed maintenance description : …………………………………………………………………...
The used parts -if exists
quantitytypenumber quantitytypenumber
Maintenance action date :
Delivered date :
Delivered to:
spent Time :
save next Back to menu
supplier name:
MEDICAL MAINTENANCE DEPARTEMENT PREVENTIVE MAINTENANCE CHECK LIST
Failure frequency VS minthType of maintenance check list
Department name
WeeklyMonthly AnnualSemi-annual
Daily
Date
Back to menu Back to menu Proceed
MEDICAL MAINTENANCE DEPARTEMENT PREVENTIVE MAINTENANCE CHECK LIST
Failure frequency VS minthDaily preventive maintenance check list
PM code
Department name
Date
Device name Maintenance status Result
NO . Of incomplete maintenance activity
Back to menu Back to menu Print
MEDICAL MAINTENANCE DEPARTEMENTRECORD OF MAINTENANCE REQUESTS
Choose a year :
Choose a month : Feb March April .….
20082009
20112010
jan
Back to menu Back to menu Proceed
Frequency for internal maintenance request :
RECORD OF MAINTENANCE REQUESTS
Request number
Department name
Device name /Serial number
Maintenance type
(ext \ int)Executer name
Failure reporting Failure maintenance
Date
Failure occurrence
Time Date Time Date TfTs Tspent
Data for department Select department:
lab
Departments :emergency
Menoutoscope
Print Back to menu Back to menu
NO. of external maintenance requests in all departments t :
NO .of internal maintenance request in all departments t :
NO. of failures :
Number of failure :
Number of external maintenance request :
Number of internal maintenance request :
DEPARTEMNT MAINTAINANCE REQUESTS
Save Exit Back to menu
DEVICE RECORD
Choose a device : Chemwell- awarness Modonic Pressure device ECG Electrolyte …….
Start using date:
Serial number :
Back to menu Back to menu proceed
NO. of internal maintenance:
Request # Failure causes
Maintenance type
used parts Cost
Failure reporting Failure maintenance
Date
Failure occurrence
Time Date Time Date TfTs Tspent
Print Print Back to menu Back to menu
Executer name
Device name:
DEVICE RECORD
Device number :
NO. of failure:
Mean Down Time
NO. of internal maintenance:
NO. of external maintenance:
Frequency of failure causes: causes frequency
.human
.Environment
. Cleaning…….
Mean spent time
Mean inactive time
Mean time between failures
Month :Year:
PERFORMANCE INDICATORS
Performance indicators :
Preventive Maintenance indicators.
Corrective Maintenance
indicators for departments
Corrective Maintenance indicators for devices.
Corrective Maintenance indicators of the Medical maintenance department.
Choose indicator :
Back to menu Back to menu proceed
Select department
Lab EmergencyMaternityNursingMen …..
Lab
MaternityNursingMen …..
Select department
Pressure device Outoscope …..
Select deviceEmergency
Show graph :
No
Yes
Starting date End date
Year : Month :
NO. of incomplete daily preventive maintenance:
NO. of incomplete weekly preventive maintenance:
NO. of incomplete monthly preventive maintenance:
NO. of incomplete semi-annual preventive maintenance:
-if exist in this month -
NO. of incomplete annual preventive maintenance:
-if exist in this month -
Back
PERFORMANCE INDICATOR CORRECTIVE MAINTENANCE SHEET FOR DEPARTEMENT
Year
Month
Department name
No. of devices
Total No. of failuresFor the department
No . Of internal maintenance operation
No . Of external maintenance operation
proceed back
Device FrequencyOf failure
Frequency of failure for each device in the department
NO. External
NO. Internal
No . Of total maintenance operation
CORRICTIVE MAINTENANCE ACTIVITYPERFORMANCE INDICATOR FOR DEPARTMENT
Select indicator
Print Graph Back to menu
Department failure frequency VS month
operation frequency VS month
Devices in the dep VS failure frequency
Select type of operation
Internal maintenance operation
External maintenance operation
All maintenance operation
PERFORMANCE INDICATOR CORRICTIVE MAINTENANCE ACTIVITY
Month Frequency of failure
jan
feb
march
April
May
Failure frequency VS minthDepartment failure
frequency VS month
Print Print back End
0
2
4
6
8
jan feb march april may
month - frequency of failure for the departement
month
freq of fauilers
Department name
PERFORMANCE INDICATOR CORRICTIVE MAINTENANCE ACTIVITY
Failure frequency VS minth Devices Vs failure frequency in the department
Device name Frequency of failure
electrolyte1
Modonic
Microscope
Easylyte
3
5
2
Print Print back End
Department name
Table of values :
05
10
modonic microscope easylyte electrolyte
Frequency
device name
fauiler -freq(for each device)
RECOMMENDATIONS
Recommendation 1.Creating a computerized system to deal
with the data and to ensure the documentation of information to save time.
2.Review the approved coding system and replace it with a new system to facilitate
dealing with the hardware.
3.Hold training sessions for the maintenance crew every now and then.
4.Change the (organizational structure) used previously and apply the new
organizational structure which regulates and determines the crews’ responsibilities
5.Apply the 5S system to arrange the workshop and reduce the time taken in
maintenance.