With the gradual development of China’s medical and health undertakings and the continuous improvement of medical quality service requirements, hospitals at all levels are also increasing the renewal and investment of medical equipment. Medical equipment assets account for a considerable proportion of hospital fixed assets. The advanced level of medical equipment in a sense represents the level and medical level of the hospital.
With the rapid growth of hospital equipment ownership, the scientific and technological content of equipment is becoming higher and higher, and the maintenance expenditure of equipment is also increasing correspondingly. How to strengthen the maintenance of medical equipment, which can not only achieve timely and effective maintenance, but also save the maintenance expenditure of the hospital, has become a difficult problem faced by the hospital management department.
1、 Situation analysis
First, external factors: with the advent of the digital era, the wide application of computer technology, the increasing degree of circuit integration, the application of various high and new technologies in medical equipment, and the manufacturer’s technical blockade and various technical protection of equipment, our understanding and mastery of equipment are limited to the theoretical and application levels, and maintenance work is often impossible to carry out.
Second, external factors: the hospital attaches importance to the maintenance of medical devices, but does not have enough understanding of the re education, re training and re training of maintenance personnel. In addition, maintenance personnel have a low status and poor treatment in the hospital, which affects their work enthusiasm and is easy to cause brain drain. The lack of technical data makes it difficult to carry out maintenance and accumulate maintenance experience, which also leads to low enthusiasm of maintenance personnel. In addition, medical equipment is the product of the combination of medical knowledge and engineering technology, involving computer, electronic, electrical, mechanical, optical and other aspects of knowledge and technology. The maintenance personnel are not aware of learning again, and the knowledge update can not keep up, resulting in the lack of theoretical knowledge.
Various factors make it more and more difficult for the hospital to carry out maintenance, the scope of maintenance is becoming smaller and smaller, the degree of dependence on manufacturers is becoming higher and higher, and the hospital becomes more and more passive in the use process after purchasing equipment.
First, improve the workflow and improve the functions of maintenance personnel. In actual work, most maintenance personnel are only limited to post maintenance. If they cannot repair, they contact the manufacturer for maintenance. They become telephone repair specialists. The maintenance personnel have a single function. The management function of maintenance personnel for equipment should be strengthened and improved. Maintenance personnel should participate in the introduction, installation and commissioning, daily use, maintenance and final scrapping of equipment.
Grasp the equipment performance parameters before the equipment purchase, installation and acceptance, and carefully check the equipment and accessories according to the contract during the acceptance; During the equipment installation and commissioning, the maintenance personnel of the Institute and the manufacturer’s engineers complete it together, which is not only the assistance to the manufacturer’s engineers, but also a rare opportunity for in-depth learning and understanding of the equipment, but also the process of supervising the manufacturer; In the process of use, it should actively contact with departments and pay attention to daily maintenance; The objective analysis of equipment operation provides reference for hospital equipment updating and equipment scrapping.
Second, the responsibility for equipment maintenance shall be assigned to each person, and the equipment maintenance shall be managed by department or category. Closely integrate maintenance personnel, application departments and equipment. The responsibilities are clear, and the maintenance personnel also have more targeted learning. At the same time, participate in the quality control and quality management of the Department, guide and standardize the use of equipment from the engineering point of view, and give full play to the performance of equipment. In addition, the management of equipment archives should be strengthened. Detailed records should be made from equipment purchase to scrapping, especially maintenance records, which can provide valuable references and accumulate experience for future equipment management and maintenance.
Thirdly, make different maintenance strategies and methods according to different equipment. Take the existing dialysis machine, gastrointestinal machine, Dr, CT and MR in the Department as examples. The fluoroscopy machine and gastrointestinal machine are early products, which have been used for a long time and are widely used in China. Some maintenance materials can be found. The core part of DR is imported from abroad, assembled in China, the software is open, and we also have some maintenance information. Therefore, we should strive to achieve independent maintenance.
CT has a long service life, heavy workload and high failure rate. Through comprehensive consideration of failure rate, maintenance cost analysis and impact on clinical departments, the corresponding warranty contracts of manufacturers or third-party maintenance companies can be purchased to improve maintenance efficiency. At the same time, the equipment maintenance rights are partially open, and their own maintenance personnel can obtain permission to carry out equipment maintenance and accumulate experience.
Fourth, strengthen the training and self-study of equipment maintenance personnel. When purchasing equipment, try to obtain technical training from the manufacturer for hospital maintenance personnel, which is a direct way to obtain technical data and maintenance experience. Participate in the equipment maintenance training courses held by the company, obtain maintenance information indirectly, and expand the scope of communication. Maintenance personnel should also strengthen their business learning. Medical equipment involves many fields, and they should constantly reserve and update their knowledge. Only by accumulating experience can we become a qualified equipment maintenance engineer.
At this stage, the dilemma faced by the maintenance of hospital medical equipment is not that it cannot be repaired, but that it cannot be repaired. Equipment manufacturers impose technical restrictions and blockades on the grounds of intellectual property protection.
There are fewer and fewer things that hospitals can repair independently. Many hospitals turn to manufacturers or third-party maintenance companies to purchase warranty contracts.
The socialization of hospital equipment maintenance may be the development trend in the future, but cooperative maintenance means that the hospital purchases maintenance authority and accessories from the company, the company provides technical support to the hospital, and the hospital’s own engineers carry out maintenance is equal cooperation, which is in line with the interests of the hospital. The construction of the hospital’s own high-quality engineer team can meet the long-term development needs of the hospital.