Applying Microsoft Power Platform to Improve Primary Medical Equipment Maintenance Processes.

Post-COVID, our hospital shifted to online systems using Microsoft Power Platform to mitigate errors and delays. SharePoint and Power Apps manage equipment maintenance records and submissions, enhancing immediacy and transparency. Power Automate automates report generation and reminders, improving task completion rates. Power BI visualizes data for streamlined management. Adjustments to real-time reporting enhanced efficiency, reducing manual efforts and improving completion rates.

Investigating Microbial Contamination of Indoor Air, Environmental Surfaces, and Medical Equipment in a Southwestern Ethiopia Hospital.

Introduction: Healthcare-associated infections, primarily caused by microorganisms, are widespread in healthcare facilities. These infections pose a significant challenge, especially in low and middle-income countries, and have a detrimental impact on patient outcomes. It is crucial to assess the level of microbial load and associated factors to prevent the spread of these infections. The objective of this study was to assess the microbial load and identify the factors associated with it in various wards at Jimma Medical Center. Method: A cross-sectional study conducted at Jimma Medical Center. Indoor air samples were collected using the settle plate method with a 1/1/1 scheme. Inanimate surfaces and medical equipment were sampled using Swabs from a 10 × 10 cm area. A total of 268 samples were collected from 10 rooms. Pertinent information regarding the associated factors was gathered using an observational checklist. A multiple linear regression model was used to identify any associations with the microbial load. Result: Out of the total samples, 181 (67.5%) tested positive for culture, and 270 microbes were isolated. The average load of bacteria and fungi in the indoor air ranged from 124.4 to 1607 and 96 to 814.6 Colony-forming unit (CFU)/m3, respectively. The mean total aerobic colony counts of bacteria and fungi from all surfaces in the wards ranged from 5.25 to 43.3 CFU/cm2. Crowdedness [ß = 2.748 (95% Confidence Interval (CI): 1.057-4.44)], the presence of waste material [ß = 1.747 (95% CI: 0.213-3.282)], and an unclean room [ß = 2.505 (95% CI: 0.990-4.019)] were significantly associated with the microbial load. Conclusion: The microbial load detected in indoor air, inanimate surfaces and medical equipment was posing potential health risks. Consequently, it is recommended to implement regular microbial surveillance of the hospital environment and enhance the infection prevention program to mitigate these concerns.

Single-use synthetic plastic and natural fibre anaesthetic drug trays: a comparative life cycle assessment of environmental impacts.

BACKGROUND: Single-use anaesthetic drug trays are used widely in Australia, but their environmental impact is unclear. METHODS: A life cycle assessment was completed for 10 different types of single-use anaesthetic drug trays made of four materials: the synthetic plastics polypropylene and polystyrene, and the natural fibres bagasse (sugarcane pulp) and cellulose pulp. RESULTS: Carbon emissions per tray from total life cycle with landfill disposal were 33-454 g CO2-eq, which equates to 152-2066 tonnes CO2-eq annually. Recycling mitigates this impact, reducing emissions per tray to 16-294 g CO2-eq. The tray with the least emissions for landfill and recycling was the small polystyrene injection tray. There was a significant linear relationship between the mass of a tray and its carbon emissions. For landfill, recycling, and incineration disposal, Pearson's r value was 0.98, 0.99, and 0.95, respectively. Composting natural fibres can give a carbon benefit over some synthetic plastics under specific disposal scenarios, but this benefit was not seen under all circumstances. There was a strong positive correlation between the increasing mass of a tray and its increasing environmental impacts for water consumption, particulate matter formation, and mineral depletion. CONCLUSIONS: Single-use trays with the lowest mass should be preferentially chosen. Recycling and composting will reduce environmental impacts. Natural fibre does not automatically confer any environmental benefit over plastic and sustainability claims should be carefully examined for accuracy. The practice of using a single-use drug tray for every procedure should be reconsidered.

[The problems and prospects of import substitution in medical industry].

The achievement of economic sustainability and assurance of national security through activation of production sectors, medical industry in particular, is the integral component of successful strategy of state development. The importance of achieving autonomy in production of medical technique is targeted to reducing dependence of external factors, ensuring continuity of supply of critically important equipment and increasing level of technical characteristics of production. Besides it, expansion of medical production positively impact on innovative development, organization of new work places and level of scientific research in this industry. The development of national medical industry contributes to improvement of quality of medical care that directly affect population health. The necessity to maintain stability of health care through import substitution of medical products is indisputable fact in modern conditions, determined by strategically important direction from national security point of view. The article considers measures within the framework of import substitution plan in medical industry of the Russian Federation for period up to 2024. The analysis of volume of national production of medical equipment in dynamics over 5 years was carried out. The main problems of production of medical devices at the present stage were considered. The measures of state support targeted to development of national production of medical equipment and innovative medical technologies were discussed.

Sustained acoustic medicine treatment of discogenic chronic low back pain: A randomized, multisite, double-blind, placebo-controlled trial.

BACKGROUND: Sustained acoustic medicine (SAM) is a noninvasive long-term treatment that provides essential mechanical and thermal stimulus to accelerate soft tissue healing, alleviate pain, and improve physical activity. SAM increases localized deep tissue temperature, blood flow, cellular proliferation, migration, and nutrition exchange, resulting in reduced inflammation and an increased rate of tissue regeneration. OBJECTIVE: To assess the efficacy of SAM treatment of discogenic back pain in the lower spinal column to reduce pain, improve quality of life, and lower pharmacotherapy use. METHODS: Sixty-five subjects with chronic low back pain were randomly assigned to SAM (N= 33) or placebo (N= 32) groups. Subjects self-applied SAM device bilaterality on the lower lumbar region for 4 hours daily for 8 weeks and completed daily pain diaries before, during, and after treatment. Subjects recorded pain reduction using a numeric rating scale (NRS), medication use, and physical activity using the Global Rating of Change (GROC) and Oswestry Disability Index (ODI). RESULTS: SAM treatment significantly reduced chronic lower back pain from baseline relative to placebo treatment (p< 0.0001). SAM treated subjects reported significantly lower back pain at 4 weeks, with the highest pain reduction (-2.58 points NRS, p< 0.0001) reported at 8 weeks. Similar trends were observed in improved physical activity (3.48 GROC, p< 0.0001, 69-88% ODI, p< 0.0001) and 22.5% (15.2 morphine milligram equivalent) reduction in the use of opioid medication from baseline to 8 weeks. CONCLUSION: Daily, home-use SAM treatment significantly improves the clinical symptoms of chronic lower back pain, improves physical mobility, and reduces daily medication use. SAM treatment is well-tolerated by patients and may be considered a safe, non-invasive treatment option for chronic discogenic, lower back pain.

[Medical Equipment Management System Based on the Concept of Whole Life Cycle].

Objective: Strengthen the legal, compliant, and rational use of medical equipment and further guide the rationalization of medical behaviors. Methods: By utilizing the Internet of Things (IoT) and image analysis technology, collect real-time operation data of the equipment, establish a real-time running database for medical equipment, and cooperate with the 12 key links of the "whole life" of the equipment and the 8+6 management system framework to implement lean management of the efficiency, benefit, and effectiveness of medical equipment usage. Results: It realizes the improvement of the quality and efficiency of medical equipment, cost reduction and cost control, and provides data support for scientific decision-making. Conclusion: This study innovates the management model for the entire life cycle of medical equipment, providing a scientific approach to the management of hospital equipment.

Continuous quality improvement project to reduce the downtime of medical linear accelerators: A case study at Zhejiang Cancer Hospital.

Objective: To analyse and continually improve existing issues in the quality improvement process of medical linear accelerators (LINACs) and enhance the quality control management of LINACs. Methods: Data were collected from eight LINACs (sourced from three manufacturers) at Zhejiang Cancer Hospital using Excel diaries between January 2019 and December 2020. The data description and analysis were performed using the analytic hierarchy process, SPSSAU and Excel software, and mean-time-to-repair (MTTR)/mean-time-between-failure (MTBF) metrics. Continuous quality improvement was executed using the quality control circle (QCC) quality management method. Results: After quality improvement, the risk frequency of 'LINAC down' events decreased by 43.63% and downtime was reduced by 40.45%. The weight of downtime risk improved by 73.69%. The MTTR recovery value increased by 31.90%, and MTBF reliability increased by 2.97 h. The simulation results demonstrated that the proposed quality improvement measures could effectively decrease the frequency and duration of downtimes, consequently extending the normal operational time of LINACs. Conclusion: Transitioning from instant repair to preventative maintenance can enhance the operational efficiency of equipment and yield economic benefits for hospitals. The QCC method and the event risk evaluation model are effective in reducing the downtime of LINACs and improving their quality control management.

[Nationwide Questionnaire Survey on Disaster Power Outage Countermeasures in the Radiology Departments of Hospitals].

PURPOSE: To identify the countermeasures and current status of disaster power outages in the radiology departments of hospitals. METHODS: A web-based questionnaire survey of 600 hospitals nationwide was conducted. The questionnaire survey covered 34 items, including availability of power in the radiology department in the event of a disaster and the impact of power outages on medical equipment in the radiology department. RESULTS: In all, 242 facilities (40.3%) responded to our survey. During power outages, 55.8%-68.2% of facilities were able to use CT, digital radiography, and angiography systems with their private generators. In 28.1%-40.7% of facilities, medical information systems were not available in all laboratories. In addition, power outages caused equipment malfunctions in 81.4% of facilities' radiology departments. CONCLUSION: We have identified the power supplied by private generators to the radiology department's medical equipment and medical information systems. Many medical equipment have malfunctioned due to power outages. Therefore, drills should be conducted to simulate various situations caused by power outages.

[Research Study on the Effects of Disinfectants on Medical Images and Medical Equipment in Infection Control Measures].

In this study, we investigated the effects of various disinfectants used to prevent infectious diseases on medical images and medical equipment. First, we investigated the effect of residual disinfectant on medical images in CT, mammography (MMG), and general imaging systems. Acrylic discs with various disinfectants attached were photographed using each imaging device, and visual evaluation and changes in image signal values were evaluated. We also conducted a questionnaire survey of each manufacturer regarding cleaning methods for medical devices. With CT/MMG, residual disinfectant could be visually confirmed on the image. Although this could not be confirmed with the general imaging system, a significant difference was confirmed in the image signal values of the general imaging system through statistical analysis. This is thought to be largely due to the influence of nonlinearity in the short-time imaging range of general imaging equipment. In addition, from the responses to a questionnaire survey of each medical device manufacturer, we were able to understand detailed cleaning methods that are not covered in medical device instruction manuals.

Medical equipment effectiveness evaluation model based on cone-constrained DEA and attention-based bi-LSTM.

This study constructs a composite indicator system covering the core dimensions of medical equipment input and output. Based on this system, an innovative cone-constrained data envelopment analysis (DEA) model is designed. The model integrates the advantages of the analytic hierarchy process (AHP) with an improved criterion importance through intercriteria correlation (CRITIC) method to determine subjective and objective weights and employs game theory to obtain the final combined weights, which are further incorporated as constraints to form the cone-constrained DEA model. Finally, a bidirectional long short-term memory (Bi-LSTM) model with an attention mechanism is introduced for integration, aiming to provide a novel and practical model for evaluating the effectiveness of medical equipment. The proposed model has essential reference value for optimizing medical equipment management decision-making and investment strategies.

[Data-Driven Construction of Operation Evaluation System for Large Medical Equipment in Children's Hospital].

Objective: Through data collection and analysis, the method of evaluating the operation quality of large medical equipment in children's hospital is explored and suggestions on the use and configuration of large medical equipment is put forward. Methods: Collect the equipment operation data through the Internet of Things, and combine the hospital HIS, RIS, HRP and other information system data to establish the operation evaluation system of large medical equipment of children's hospital. CRITIC method is used to quantitatively evaluate single type of equipment and single equipment. Results: Hospital big data platform realizes the longitudinal analysis of the operation data of a single large equipment and forms a visual chart, which is displayed on the PC and mobile terminals. Municipal platform can conduct horizontal analysis on the equipment operation data to realize the comprehensive quantitative evaluation of the operation level of large equipment of children's hospital and put forward suggestions for use and configuration. Conclusion: A large equipment operation evaluation system for children's hospital is established through data collection and analysis, and the fine management level of large medical equipment is improved.

Measurement of Bisphenol A Diglycidyl Ether (BADGE), BADGE derivatives, and Bisphenol F Diglycidyl Ether (BFDGE) in Japanese infants with NICU hospitalization history.

BACKGROUND: Bisphenol A diglycidyl ether (BADGE) and Bisphenol F diglycidyl ether (BFDGE) are used in medical devices, such as intravenous sets, syringes, and catheters. Several studies have reported that these compounds are endocrine disruptors, cytotoxic, and genotoxic, raising concerns about their adverse effects on infants, in a stage of remarkable growth and development. The present study aimed to measure the serum concentrations of BADGE, derivatives of BADGE, and BFDGE in infants and examine the factors that influence them. METHODS: Ten infants admitted to the neonatal intensive care unit (NICU) were enrolled in the present study. Blood samples from each infant and questionnaires from their mothers were collected twice, at 1-2 months and 7 months of age. BADGE, BADGE·H2O, BADGE·2H2O, and BFDGE were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). RESULTS: Serum BADGE·2H2O was identified in all infants, at both 1-2 months (2.30-157.58 ng/ml) and 7 months of age (0.86-122.85 ng/ml). One of the two infants who received invasive ventilation showed a substantially increased BADGE·2H2O concentration. There was no significant difference in BADGE·2H2O concentrations at 7 months of age between the group that ate commercial baby food at least ≥ 1 time per week and the group that did not. CONCLUSIONS: BADGE·2H2O was detected in the serum of all infants with a history of NICU hospitalization. Future studies are needed to determine the source of BADGE exposure and investigate its effects on infant development.

Integrating Dermoscopic Images into PACS Using DICOM and Modality Worklist.

Dermatology is one of the medical fields outside the radiology service that uses image acquisition and analysis in its daily medical practice, mostly through digital dermoscopy imaging modality. The acquisition, transfer, and storage of dermatology images has become an important issue to resolve. We aimed to describe our experience in integrating dermoscopic images into PACS using DICOM as a guide for the health informatics and dermatology community. During 2022 we integrated the video dermoscopy equipment through a strategic plan with an 8-step procedure. We used the DICOM standard with Modality Worklist and Storage commitment. Three systems were involved (video dermoscopy software, the EHR, and PACS). We identified critical steps and faced many challenges, such as the lack of a final model of DICOM standard for dermatology images.

Home Oxygen After Hospitalization for COVID-19: Results From the Multi-Center OXFORD Study.

BACKGROUND: In the first months of the pandemic, prior to the introduction of proven-effective treatments, 15-37% of patients hospitalized with COVID-19 were discharged on home oxygen. After proven-effective treatments for acute COVID-19 were established by evidence-based guidelines, little remains known about home oxygen requirements following hospitalization for COVID-19. METHODS: This was a retrospective, multi-center cohort study of subjects hospitalized for COVID-19 between October 2020-September 2021 at 3 academic health centers. Information was abstracted from electronic health records at the index hospitalization and for 60 d after discharge. The World Health Organization COVID-19 Clinical Progression Scale score was used to identify patients with severe COVID-19. RESULTS: Of 517 subjects (mean age 58 y, 47% female, 42% Black, 36% Hispanic, 22% with severe COVID-19), 81% were treated with systemic corticosteroids, 61% with remdesivir, and 2.5% with tocilizumab. About one quarter of subjects were discharged on home oxygen (26% [95% CI 22-29]). Older age (adjusted odds ratio [aOR] 1.02 per 5 y [95% CI 1.02-1.02]), higher body mass index (aOR 1.02 per kg/m2 [1.00-1.04]), diabetes (yes vs no, aOR 1.73 [1.46-2.02]), severe COVID-19 (vs moderate, aOR 3.19 [2.19-4.64]), and treatment with systemic corticosteroids (yes vs no, aOR 30.63 [4.51-208.17]) were associated with an increased odds of discharge on home oxygen. Comorbid hypertension (yes vs no, aOR 0.71 [0.66-0.77) was associated with a decreased odds of home oxygen. Within 60 d of hospital discharge, 50% had documentation of pulse oximetry; in this group, home oxygen was discontinued in 46%. CONCLUSIONS: About one in 4 subjects were prescribed home oxygen after hospitalization for COVID-19, even after guidelines established proven-effective treatments for acute illness. Evidence-based strategies to reduce the requirement for home oxygen in patients hospitalized for COVID-19 are needed.

Tracheostomy-related durable medical equipment: Insurance coverage, gaps, and barriers.

PURPOSE: Tracheostomy care is supply- and resource-intensive, and airway-related adverse events in community settings have high rates of readmission and mortality. Devices are often implicated in harm, but little is known about insurance coverage, gaps, and barriers to obtaining tracheostomy-related medically necessary durable medical equipment. We aimed to identify barriers patients may encounter in procuring tracheostomy-related durable medical equipment through insurance plan coverage. MATERIALS AND METHODS: Tracheostomy-related durable medical equipment provisions were evaluated across insurers, extracting data via structured telephone interviews and web-based searches. Each insurance company was contacted four times and queried iteratively regarding the range of coverage and co-pay policies. Outcome measures include call duration, consistency of explanation of benefits, and the number of transfers and disconnects. We also identified six qualitative themes from patient interviews. RESULTS: Tracheostomy-related durable medical equipment coverage was offered in some form by 98.1 % (53/54) of plans across 11 insurers studied. Co-pays or deductibles were required in 42.6 % (23/54). There was significant variability in out-of-pocket expenditures. Fixed co-pays ranged from $0-30, and floating co-pays ranged from 0 to 40 %. During phone interviews, mean call duration was 19 ± 10 min, with an average of 2 ± 1 transfers between agents. Repeated calls revealed high information variability (mean score 2.4 ± 1.5). Insurance sites proved challenging to navigate, scoring poorly on usability, literacy, and information quality. CONCLUSIONS: Several factors may limit access to potentially life-saving durable medical equipment for patients with tracheostomy. Barriers include out-of-pocket expenditures, lack of transparency on coverage, and low-quality information. Further research is necessary to evaluate patient outcomes.

Application of intelligent information technology in the field of medical equipment management / 西安交通大学学报(医学版)

With the rapid development of information technology, what has been widely used in the field of medical and health care includes the home detection of aging population in communities, intelligent health management, special patient positioning care management, information sharing, and interconnection management, which has also brought new opportunities for the innovative management of medical equipment in recent years. We have taken "sense, knowledge and action" as the core, and effectively improved the level of lean management of medical equipment through data acquisition, data modeling and analysis, and remote service or decision response. This paper aims to summarize the application and research progress of intelligent information technology in the lean management of medical equipment in order to provide new ideas for the refined management of medical equipment.

Design and application of medical equipment procurement demonstration scheme based on fuzzy deci-sion / 现代医院

The procurement demonstration process for large-scale medical equipment is a time-intensive and laborious system project,necessitating more effective methods to enhance efficiency.This study introduces a fuzzy decision-making expert system to optimize the procurement process of medical equipment for large hospitals,thereby elevating procurement efficiency and lowering costs.Firstly,an expert database is established using a natural language fuzzy preference scoring method tailored to the characteristics of the hospital's experts.Secondly,weights are assigned to expert decisions,and both subjective and objective in-dices describing equipment characteristics are developed.Lastly,a discriminant function is constructed for decision-making.An application analysis of a particular procurement process yielded a series of rational outcomes based on the overall design,data configuration,and discriminant function.The decisions proposed by the scheme and validated through on-site demonstration and comprehensive assessment,are deemed appropriate.This method has proven to some degree its potential to enhance the efficiency of medical equipment procurement and reduce costs,warranting further research.

Research on the Equity of Class B Large Medical Equipment Allocation in China Based on Agglomeration Degree / 中国卫生经济

Objective:To analyze the current allocation situation and equity of Class B large medical equipment in China,and provide references for reasonably optimizing the allocation of medical equipment.Methods:Based on the allocation data of Class B large medical equipment in China at the end of the 13th Five Year Plan period,the agglomeration degree method was used to evaluate the equity of equipment allocation in various regions from the dimensions of geography,population,and economic development.Results:The current allocation of Class B large medical equipment per million population was 3.19,and the eastern region(3.64)was higher than the central region(3.42),the central region(2.24)was higher than the western region.The agglomeration degree of medical equipment based on geographical area showed that most of the equipment in the eastern region was in a rich state,and the allocation equity was relatively good in the central region,but generally poor in the western region.The agglomeration degree of medical equipment based on population distribution was higher in the eastern region than in the central region and even higher in the western region.The equipment in the eastern region could basically meet the demand of the local population,while the allocation in the central and western regions was slightly insufficient.The distribution of medical equipment agglomeration degree based on economic development varied significantly among different regions,and the allocation equity of central region was generally better than that of eastern and western regions.Conclusion:The total allocation of Class B large medical equipment in China is not high,and the government needs to continue planning and improving it.The distribution of medical equipment allocation based on geography,population and economic development is unbalanced among the eastern,central and western regions.Improving the equity of medical equipment allocation also needs to consider regional differences and characteristics according to local conditions.

Investigation and analysis of the current situation of medical equipment allocation in 103 tertiary public hospitals / 中国医学装备

Objective:To investigate the current situation of medical equipment allocation in 103 tertiary public hospitals,analyze and compare the proportion of medical equipment in different regional hospitals in our country,and provide basis for scientific and reasonable allocation of medical equipment.Methods:A questionnaire was designed by literature research and expert consultation,and an electronic questionnaire was released through the public account of"China Medical Equipment"and the platform of"Good Medical Workers"to analyze the correlation between the number of medical equipment configuration,the proportion of domestic products,the region where the hospital was located and the number of hospital beds.Results:A total of 103 valid questionnaires were collected,involving 103 tertiary public hospitals in East China,North China,Central China,South China,Southwest,Northwest and Northeast China,of which 18%were in North China,37%were in East China and 9%were in South China.In North China,South China and East China,the average number of medical equipment in the tertiary public hospitals in the region was 9785 units per hospital,9245 units per hospital and 8153 units per hospital,and the number of the expensive equipment was relatively small,which had no correlation with the number of beds.There were statistically significant differences between North China and East China in the number of beds,the number of pieces of equipment per 100 beds and the amount of equipment per 100 beds(t=-2.582,2.939,4.653,P＜0.05).The number of life support equipment configuration was significantly positively correlated with the number of beds,and the domestic share,especially the domestic share of life support equipment,increased.Conclusion:The analysis of medical equipment allocation in public hospitals in China can provide data support for hospitals to better adapt to the adjustment of the new expensive medical equipment catalogue,provide reference for the demonstration and promotion of large medical equipment allocation and localization in tertiary hospitals,and provide reference for relevant health management departments.