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.

Mathematical modeling and experimental validation of a novel Circulating Oxygenation Biofilm Equipment (COBE) for the management of decentralized wastewater treatment.

The difficulties of management were the key barriers to the promotion of decentralized wastewater treatment in remote areas. In this study, a novel decentralized Circulating Oxygenation Biofilm Equipment (COBE) and its remote management potential based on mathematical modeling were investigated. The COBE is an integrated biofilm reactor that employs drippage aeration and enables oxygenation, filtration, and effluent processes to be controlled, thus providing convenience for controlling. The model for the COBE describing drippage aeration, comprehensive ammonia-related microbes, and corncob carbon source release process was studied to uncover the impacts of operational conditions on decentralized wastewater treatment in the COBE system. The equipment regulation parameter (circulating oxygenation ratio) was found to be linearly correlated with the oxygen mass transfer coefficient. This discovery enabled highly accurate prediction of COD, NH4-N, and TN concentrations in the equipment effluent at various scenarios. The comprehensive ammonia oxidation biological model indicated that the model could duplicate the actual situation of the succession of ammonia metabolizing related microorganisms. Comammox and ammonia-oxidizing archaea (AOA) dominated ammonia metabolism in this equipment rather than conventional ammonium-oxidizing bacteria (AOB). This study could contribute to the Internet of Things system construction of decentralized wastewater treatment equipment, and provide a solution for timely decentralized equipment management in remote areas.

Medical Equipment Management in General Hospitals: Experience of Tulu Bolo General Hospital, South West Shoa Zone, Central Ethiopia.

Background: Medical equipment are vital items to deliver quality services in health facilities and the role of medical equipment is a well-founded reality. It is mainly used in many diverse settings in hospitals to diagnose, treat illnesses; support disabled and intervened acute and chronic cases. Effective maintenance and proper management are major utilization issues to provide quality services while saving scarce resources. However, managing medical equipment, especially, the utilization phase of medical equipment, was not well studied in this general hospital. Objective: This study aims to assess the utilization of medical devices in Tulu Bolo General Hospital. Methods: The study was conducted from December 25, 2021 to February 9, 2022. Data sources included health professionals and document archives in the hospital. Data collection method includes questionnaires and observations checklists. A census of 165 health workers was conducted, with a response rate 94.5%. Data was entered into epi-data; version 3.1, then analyzed by SPSS version 23 and presented using descriptive statistics. Results: Procurement, storage, and utilization were found to be 53.47%, 56.57%, and 45.88%, respectively. Only 114 (57.3%) of the 199 pieces of medical equipment discovered were functional. Pearson correlation indicated that procurement and utilization of medical equipment are related to a higher proportion of non-functional devices (P = 0.000, B1 = 1.47, OR = 4.349, and CI 95% = 2.047-9.241) and nonfunctional medical equipment (B2 = 0.790, OR = 2.203, and CI 95% = 1.065-4.556) for procurement and utilization, respectively. Conclusion: Procurement, storage, and utilization of available medical equipment in Tulu Bolo Hospital were low. While health sectors operating in a resource-limited were assumed to have a big shortage of medical technologies, procurement, storage, and utilization of the limited available medical equipment need the attention of health program managers.

Global Veterinary Diagnostic Laboratory Equipment Management and Sustainability and Implications for Pandemic Preparedness Priorities1.

Substantial investments into laboratories, notably sophisticated equipment, have been made over time to detect emerging diseases close to their source. Diagnostic capacity has expanded as a result, but challenges have emerged. The Equipment Management and Sustainability Survey was sent to the Veterinary Services of 182 countries in mid-2019. We measured the status of forty types of laboratory equipment used in veterinary diagnostic laboratories. Of the 68,455 items reported from 227 laboratories in 136 countries, 22% (14,894/68,455) were improperly maintained, and 46% (29,957/65,490) were improperly calibrated. Notable differences were observed across World Bank income levels and regions, raising concerns about equipment reliability and the results they produce. Our results will advise partners and donors on how best to support low-resource veterinary laboratories to improve sustainability and fulfill their mandate toward pandemic prevention and preparedness, as well as encourage equipment manufacturers to spur innovation and develop more sustainable products that meet end-users' needs.

Machine Learning Models Using SHapley Additive exPlanation for Fire Risk Assessment Mode and Effects Analysis of Stadiums.

Machine learning methods can establish complex nonlinear relationships between input and response variables for stadium fire risk assessment. However, the output of machine learning models is considered very difficult due to their complex "black box" structure, which hinders their application in stadium fire risk assessment. The SHapley Additive exPlanations (SHAP) method makes a local approximation to the predictions of any regression or classification model so as to be faithful and interpretable, and assigns significant values (SHAP value) to each input variable for a given prediction. In this study, we designed an indicator attribute threshold interval to classify and quantify different fire risk category data, and then used a random forest model combined with SHAP strategy in order to establish a stadium fire risk assessment model. The main objective is to analyze the impact analysis of each risk characteristic on four different risk assessment models, so as to find the complex nonlinear relationship between risk characteristics and stadium fire risk. This helps managers to be able to make appropriate fire safety management and smart decisions before an incident occurs and in a targeted manner to reduce the incidence of fires. The experimental results show that the established interpretable random forest model provides 83% accuracy, 86% precision, and 85% recall for the stadium fire risk test dataset. The study also shows that the low level of data makes it difficult to identify the range of decision boundaries for Critical mode and Hazardous mode.

Competence-Based Assessment of Biomedical Equipment Management and Maintenance System (e-Upkaran) Using Benefit Evaluation Framework.

Introduction To establish a centralized inventory management system for the efficient functioning of all healthcare facilities, e-Upkaran (equipment management and maintenance system) was launched in 2015 in the state of Rajasthan. This study is conducted to assess the functioning of e-Upkaran in Rajasthan. Methods The assessment of the e-Upkaran system for primary and secondary healthcare centers was carried out using a systematic review of the literature and a multi-indicator stakeholder questionnaire. The benefits evaluation framework focused on the system quality, information and service quality, use and user satisfaction, and net benefits utilized for the assessment. A review of the literature was done to highlight the importance of computerized medical equipment management and maintenance systems and appraise the challenges and benefits associated with such systems as compared to the traditional pen-paper register. Information was gathered based on available documents, field observation, and data obtained from specific hospital staff, including the bioengineers and other users of e-Upkaran. Results The finding of this study suggests that e-Upkaran efficiently improves documentation, reporting, maintenance, and management of medical equipment. It is more efficient than the traditional paper-pen system. It is designed to minimize downtime and maintain equipment in good operating condition and has potential benefits in terms of improving information quality, use, and net benefit. The cost of service ratio is within the benchmark value. This system has also considerably reduced out-of-pocket expenditure. Computer proficiency and the workload of other e-health programs pose a challenge in the implementation of this program. Conclusion The e-Upkaran system is competent in terms of improving information quality, use, and net benefit. Other Indian states could also adopt this system to improve their biomedical equipment management and maintenance system.

IoT MEMS: IoT-Based Paradigm for Medical Equipment Management Systems of ICUs in Light of COVID-19 Outbreak.

Recently, COVID-19 has infected a lot of people around the world. The healthcare systems are overwhelmed because of this virus. The intensive care unit (ICU) as a part of the healthcare sector has faced several challenges due to the poor information quality provided by current ICUs' medical equipment management. IoT has raised the ability for vital data transfer in the healthcare sector of the new century. However, most of the existing paradigms have adopted IoT technology to track patients' health statuses. Therefore, there is a lack of understanding on how to utilize such technology for ICUs' medical equipment management. This paper proposes a novel IoT-based paradigm called IoT Based Paradigm for Medical Equipment Management Systems (IoT MEMS) to manage medical equipment of ICUs efficiently. It employs IoT technology to enhance the information flow between medical equipment management systems (THIS) and ICUs during the COVID-19 outbreak to ensure the highest level of transparency and fairness in reallocating medical equipment. We described in detail the theoretical and practical aspects of IoT MEMS. Adopting IoT MEMS will enhance hospital capacity and capability in mitigating COVID-19 efficiently. It will also positively influence the information quality of (THIS) and strengthen trust and transparency among the stakeholders.

Construction of exchange integrated information chain management model leading by information nurse for large instrument and equipment in operating room.

BACKGROUND: This study aims to explore the information chain management model of large instrument and equipment inter-working in the operating room (OR) led by information nurses. METHODS: Through the chain management process of large instruments and equipment in the OR, which was based on information nurses, the management model of inter-working and integrating information chain was established, the key links were controlled, and the whole life cycle management of instruments and equipment from expected procurement to scrapping treatment was realized. Using the cluster sampling method, 1562 surgical patients were selected. Among these patients, 749 patients were assigned to the control group before the running mode, and 813 patients were assigned to the observation group after the running mode. The related indexes for large instrument and equipment management in the department before and after the running mode were compared. RESULTS: In the observation group, the average time of equipment registration was (22.05 ± 2.36), the cost was reduced by 2220 yuan/year, and the satisfaction rate of the nursing staff was 97.62%. These were significantly better, when compared to the control group (P < 0.05). Furthermore, the awareness rate of the whole staff for equipment repair application was 95.12%, and the arrival time of maintenance personnel and the examination and approval time of equipment management were greatly shortened (P < 0.05). CONCLUSION: The integrated management model of large instrument and equipment interworking in the OR based on chain flow realizes the whole life cycle management of instruments and equipment, which is essential to improve management efficiency.

[Exploration and Minging of Large Medical Equipment Operation Data under Internet of Things].

With the technology development in Internet of Things (IoT) area, it is good to try to use IoT and cloud computing technologies to improve the efficiency of medical equipment management. This article described using CT as sample to do the data capture and data analysis with the IoT technology. The positive result got shows the benefit of the exploring.

[Meticulous Management of the Whole Life Cycle of Medical Equipment in Hospital].

OBJECTIVE: Aiming at the different characteristics of the various stages of medical equipment life cycle in hospital, research on the targeted and meticulous management mode. METHODS: Divides the whole life cycle of medical equipment in hospital into four phases, which are the selection demonstration period, purchase acceptance period, maintenance period, and retirement disposal period, and comparison with human fetal period, infant stage, adult stage and old age. RESULTS: With the meticulous management mode, the service quality of medical equipment in hospital has been improved, and the service benefits have been enhanced. CONCLUSIONS: According to the respective characteristics of different stages, the corresponding meticulous management mode is implemented to make the management more scientific and standardized, and the operation is safer and more reliable, which escorts the whole life cycle of medical equipment in hospital.

[Exploration of Medical Equipment Management Development in Public Hospitals].

With the continuous improvement of the hospital diagnosis and treatment level and the continuous renewal of medical equipment in China, the mismatch between medical equipment management personnel training and the introduction of medical equipment, the development of medical technology and the requirements of modern hospital management is increasingly prominent. This article is based on a current situation survey of medical equipment and management personnel at all levels of hospitals in Shanghai. It discusses joint with professional colleges and universities, and gives suggestions about needs, objectives and practice of personnel training. It provides references to improve the personnel training of medical equipment.

Exploration of Medical Equipment Management Development in Public Hospitals / 中国医疗器械杂志

With the continuous improvement of the hospital diagnosis and treatment level and the continuous renewal of medical equipment in China, the mismatch between medical equipment management personnel training and the introduction of medical equipment, the development of medical technology and the requirements of modern hospital management is increasingly prominent. This article is based on a current situation survey of medical equipment and management personnel at all levels of hospitals in Shanghai. It discusses joint with professional colleges and universities, and gives suggestions about needs, objectives and practice of personnel training. It provides references to improve the personnel training of medical equipment.

Meticulous Management of the Whole Life Cycle of Medical Equipment in Hospital / 中国医疗器械杂志

OBJECTIVE@#Aiming at the different characteristics of the various stages of medical equipment life cycle in hospital, research on the targeted and meticulous management mode.@*METHODS@#Divides the whole life cycle of medical equipment in hospital into four phases, which are the selection demonstration period, purchase acceptance period, maintenance period, and retirement disposal period, and comparison with human fetal period, infant stage, adult stage and old age.@*RESULTS@#With the meticulous management mode, the service quality of medical equipment in hospital has been improved, and the service benefits have been enhanced.@*CONCLUSIONS@#According to the respective characteristics of different stages, the corresponding meticulous management mode is implemented to make the management more scientific and standardized, and the operation is safer and more reliable, which escorts the whole life cycle of medical equipment in hospital.

Exploration and Minging of Large Medical Equipment Operation Data under Internet of Things / 中国医疗器械杂志

With the technology development in Internet of Things (IoT) area, it is good to try to use IoT and cloud computing technologies to improve the efficiency of medical equipment management. This article described using CT as sample to do the data capture and data analysis with the IoT technology. The positive result got shows the benefit of the exploring.

[The Whole Life Cycle Information Management of Medical Equipment Based on HRP System].

Starting from the research on the whole life cycle management of medical equipment, based on the development and application of HRP management system, according to the characteristics of medical device management, this paper studies the specific implementation method of medical device life cycle management based on HRP system. Then, it provides an asset management solution of decision, management and operation for the decision, management and executive layer of the hospital.

Application and Control of FMEA in the Risk Management of Instruments and Equipments of Drug Inspection Organizations / 中国药学杂志

OBJECTIVE: To investigate the application and control of failure mode and effect analysis (FMEA) in the risk management of food and drug inspection institutions. METHODS: A 25-people team was set up and the factors related to equipments in the management review report and external review were analyzed through brainstorming and expert consultation. Thirty-four large risk factors were idendified. RESULTS: The top five risk factors in respect to risk priority number(RPN) value were as follows equipment not undergoing period verification, lack of experience, communication risk between inspection department and equipment management department, daily use and maintenance not meeting the requirements, inadequate consciousness of equipment management. CONCLUSION: The application of FMEA can identify and deal with the failure mode in the process of equipment management and timely detect high risk projects in the equipment management to achieve better control of quality of laboratories.

Function of the national big data platform for medical and healthcare management in medical equipments management / 国际生物医学工程杂志

Medical services, medical insurance institutions, medical administrations, pharmaceutical and medical device manufacturers, pharmaceutical and medical device research institutes, and health-related service providers produce large amounts of data in the operation, which constitute medical and healthcare big data. Medical and healthcare big data is the important basic strategic resource of a country. The construction of the national big data platform for medical and healthcare management is of great significance to the development of healthcare in China, and will bring new development and change. Medical devices and equipments are essential to the provision of quality services, the lack of safe and effective and functional medical equipments will affect the quality of healthcare services, affect the diagnosis and treatment of patients, and even threaten the healthy development of the entire healthsystem. Application of IoT technology and big data technology, and with the help of the national big data platform for medical and healthcare management, can solve many problems existing in the supervision and evaluation of medical devices, medical device adverse event control, hospital medical equipment maintenance (such as maintenance, condition monitoring, accident retrospective, evaluation and scrap) and medical device acquisition process, so as to improve the management efficiency and management level of medical devices and improve the efficiency of medical equipment production enterprises in product registration, after-sale service and adverse events protection. This process has a realistic driving significance and long-term strategic significance to our medical system. In this paper, the problems in the management of medical equipment in China were analyzed, and the function of the national big data platform for medical and healthcare management in medical equipment management were introduced and analyzed.

The Whole Life Cycle Information Management of Medical Equipment Based on HRP System / 中国医疗器械杂志

Starting from the research on the whole life cycle management of medical equipment, based on the development and application of HRP management system, according to the characteristics of medical device management, this paper studies the specific implementation method of medical device life cycle management based on HRP system. Then, it provides an asset management solution of decision, management and operation for the decision, management and executive layer of the hospital.

Effect of"Five in One"mode on managerial improvement of medical equipment in operation room / 医疗卫生装备

Objective To explore the influence of the comprehensive and continuous management on the quality improvement of medical equipment in the operation room.Methods The"Five in One"mode,which consisted of organization scheme, regulations implementation, operation training, utilization supervision and maintenance, was applied in an observation group,and a control group was established with conventional management mode.The two groups were compared in the times per week of medical equipment utilization, maintenance and hidden risks elimination, the incidence rates of failures and adverse events as well as the medical staffs'satisfaction.Results The observation group had the times per week of medical equipment utilization and hidden risks elimination significantly more than those of the control group, while the times in a week of medical equipment maintenance,failures and adverse events less statistically(P<0.05).The medical staffs' satisfaction in the observation group was enhanced obviously when compared with that in the control group (P<0.05). Conclusion The new"Five in One"mode is effective in solving the problems that occur when the old decentralized mode is adopted for medical equipment management in the operation room. [Chinese Medical Equipment Journal,2018,39(5):84-86]

Overall design of whole process management system of medical equipment / 医疗卫生装备

Objective To design a whole process management information system of the field medical equipment.Methods According to the problems found in the management of medical equipment, the functional requirements of different user systems were determined.The system was developed with combined Java and C languages,Eclipse and Visual Studio 2012, and was connected into military integrated information network according to security requirements.Results By applying the whole process management system of the field medical equipment, all process data could be managed from purchasing, warehousing,distribution,use,maintenance,R&D and so on.Conclusion By applying this system,the management of the field medical equipment is improved, functional requirements are met of all levels of health equipment management, the platform for data sharing among relevant departments is set up,and the static mode is transformed into a real-time,dynamic and whole process one for field medical equipment management.