Release date: 2006-10-27 Ensuring perfect equipment maintenance - Introduction to German clinical medical engineering management At present, the proportion of medical equipment in hospital fixed assets is increasing. Taking Zhejiang Province as an example, the medical equipment of major hospitals accounts for 1/3 to 1/2 of the total value of hospital fixed assets, ranging from tens of millions to several hundred million yuan. How to implement scientific and efficient application management of medical equipment in use has become one of the most important basic tasks in the normal operation of the hospital. At the same time, it is required that the medical equipment management department of the medical institution must have scientific, rigorous, efficient and development management ideas and management methods for the medical equipment in use, and the transactional management mode can no longer meet the needs of development, and must be fully managed. The system-based management model of the process-building system theory guides the standard, and can be self-improved to adapt to environmental development with advanced management concepts.
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In June 2005, the reporter went to Germany with a medical equipment management technology delegation organized by the Zhejiang Provincial Health Department to inspect a number of medical institutions, and learned about its medical equipment management model and management system, medical equipment procurement management, and medical equipment quality assurance. And risk management. German hospitals have many advanced concepts and methods in medical device management mode, strategy and daily management measures that are worth learning and learning.
The Department of Clinical Medical Engineering is an important department in the grassroots department of German hospitals to ensure the successful operation of medical equipment. It consists of project management personnel, biomedical engineers, and clinical engineers. According to the work focus, the department can be divided into: department 1 is mainly responsible for maintenance, parts replacement request, daily maintenance and maintenance, project management; department 2 is mainly responsible for procurement, equipment acceptance (including safety and function check), project registration, file management, Contract management, equipment loss and replacement. From the perspective of division of labor, it seems that there is no difference between many hospitals in China, but it is obviously superior to domestic hospitals in terms of the number of personnel and technical level.
â– Advanced facilities in Germany's medical institutions, the clinical engineering disciplines of the workplace from the practical work, the clinical medical engineering department is generally adjacent to the clinical medical technology department, in an emergency, it is easy to make timely response, which is in line with the equipment of many hospitals in China. There are obvious differences in the basement and corners.
At the University of Münster Hospital and the Clinical Engineering Department of St. Lucas Hospital, the maintenance area is equipped with cranes and various maintenance tools, instruments and a large number of monitoring equipment (such as electrical safety analyzers, ecg simulators, defibrillation analyzers, Infusion pump analyzers, electrosurgical equipment analyzers, digital multimeters, oscilloscopes and x-ray inspection equipment, etc., and a full range of machine tools, the facade design of the maintenance engineer's workbench is also very reasonable, with various interfaces, and There are perfect grounding protection measures.
â– Work initiative The working mode of the German Medical Hospital Clinical Medical Department has an obvious feature - passive maintenance of clinical medical equipment, active, planned, preventive maintenance (pm) is perfect. This is because the law forces hospitals to conduct safety and quality control. In Germany, medical institutions have legal restrictions on the management of medical equipment in use. Under the specifications of iec, iso and eu, there are a large number of standards, recommendations and pointers that must be managed in strict accordance with the prescribed procedures. Pm is one of the important things. Pm refers to the regular monitoring, maintenance and quality confirmation of medical equipment. Its main purpose is to reduce medical accidents caused by malfunctions in the use of equipment and equipment; to ensure safety and effectiveness; to extend equipment life and reduce equipment cycle expenses; Requirements.
Establishing such a set of pm management mechanism requires the following procedures: first, conduct risk analysis on the equipment, clarify the risk level, determine the test items, cycle, and steps; hire relevant staff, purchase necessary testing equipment; determine the testing cycle of the equipment, observe as needed Check the results and adjust the test items and cycles according to the status of the equipment.
The steps of pm are: regular maintenance (including lubrication, adjustment, etc.), performance testing, electrical safety testing, recording equipment testing data, labeling. For general equipment, only visual inspection, routine and environmental testing is required. However, for high maintenance sensitivity equipment, it is necessary to follow the above steps step by step. For example, in the Medical Engineering Department of the University of Münster Hospital, there is an independent ventilator pm department. After each ventilator is used, it is required to thoroughly clean and disinfect the internal and external ventilator, maintenance of the whole machine, preventive maintenance. , functional testing, and finally label, clinical engineer signature, to ensure that the ventilator can operate safely when the next patient is used, 100% intact. Due to proper maintenance, many old models of ventilators that have been basically eliminated in China are still in normal use, which not only ensures medical safety but also saves equipment investment. Of course, you also need to equip a certain amount of spare equipment for your turnaround.
In the large hospital in Münster, the Medical Engineering Department has established a pm program for computer program management; in the Medical Engineering Department of St. Lucas Hospital, label management is used in the equipment - barcode management equipment file labels, hand-held Barcode readers and PDAs for simple and accurate fixed asset management, as well as date management devices pm confirmation and maintenance confirmation marks.
â– Participation in the management of the German Hospital Clinical Medical Engineering Department includes not only routine procurement, acceptance, training, maintenance, maintenance and asset management, but also participate in hospital development decisions, such as hospital infrastructure projects, financial cost accounting, clinical research projects, In order to achieve high efficiency, low consumption and scientific and technological development of hospital operation, correspondingly, the department has also received the attention of the hospital management, and has received strong support from the hospital in terms of staffing and technical training.
Under the advice and management of the Medical Engineering Department, the hospital is very rational in purchasing equipment, but the quality control management investment is very large, including advanced testing equipment, cleaning and disinfection equipment; in addition, the equipment management department technicians have strong professional skills. From the routine operation of equipment, basic theory, computer application and even board level maintenance, metal processing, measurement and testing, there should be a certain degree of proficiency, which confirms that the improvement of the professional quality of medical engineers is the foundation of the development of the discipline.
Compared with the situation in China, the clinical medical engineering department of domestic medical institutions has experienced a development from scratch, and it has already reached a certain scale in the 1990s. However, in recent years, with the technological development and mass introduction of medical equipment, the hospital medical engineering department of our country has experienced the phenomenon of weakening functions and loss of personnel. The reason is that there are no laws and regulations for the quality management of medical equipment in medical institutions. Medical institutions have not established a complete scientific management model. Hospitals have led equipment purchases and light management. Engineering and technical personnel have not actively involved in clinical medicine and effectively implemented medical equipment quality control.
Under the constraints of relevant laws and regulations in various medical institutions in Germany, the clinical engineering department within the medical institution has the status of peer-to-peer development with medical personnel, and plays a leading role in the input, use, maintenance and quality control of medical equipment. This helps ensure the continued development of medical technology and the quality of medical safety. Shanghai Medical Devices