Evidence-based maintenance: a study applied to a city’s network of public hospitals
Maintenance management, evidence-based, medical equipment
Although the maintenance of medical equipment has been well planned and executed for over 30 years, however few studies have been carried out to measure and evaluate its effectiveness in terms of reliability and failure severity. The lack of empirical evidence limits the ability of clinical engineering (CE) professionals to review maintenance strategy and improve the effectiveness of their work, as well as focus on the equipment and tasks that could provide the greatest return on their limited resources. Using a small set of failure codes and performance indicators, divided into technological, organizational and financial, data was collected in 9 hospital units of the municipal public network over a period of 10 months, covering a total of more than 5000 work orders in 1134 equipment among the classes: anesthesia machine, electrocardiograph, multiparameter monitor and pulmonary ventilator. The careful analysis of collected work orders showed that the failures found for each type of equipment within the hospital network tend to converge to a stable pattern compared to studies already carried out in developed countries. Furthermore, failure patterns obtained from the network suggest a regularity of failure for the same type of equipment and seem to be within statistical variation of each other, although these hospitals may use different makes and models of equipment, and there are obvious differences in care and user training, intensity of use, and other environmental factors. The collected failure data can be used to design a maintenance scenario as well as to determine additional opportunities for CE professionals to contribute to patient safety as well as increase equipment reliability through maintenance.