Medical Equipment Lifecycle - Essay Example

? Medical Equipment Life Cycle This research paper will describe the phases of the repairable equipment life cycle from the user's perspective. Included in this research paper will be the description of the various sub cycles in the medical equipment life cycle. These sub cycles will be connected together in order to describe how to ensure reduction of overall clinical risk. A description will be given of how this perspective fits into the clinical governance framework. Introduction Health care facilities have evolved into being very complicated, high technology surroundings where the application of inherently dangerous equipment is routine. The advantages which are connected with medical technology are substantial. There exists a disturbing rise in the index of patient moratlity of which medical facility error has been a causal attribute. Medical Technology Equipment from the User's Perspective Academic articles and books have recommended that user participation by means of the inclusion of the ergonomic engineering inside of the medical component architecture and production process (MDDD) presents many advantages which facilitate the production of less hazardous and more efficient medical technology components which cater to the user's needs in a more effective manner. There has not been a great deal of research which has been completed with regards to the user participation in this procedure, the efficacy of the participation of the medical equipment user in providing feedback (Money et al., 2011). Medical technology equipment usage at the planning phase was discovered to be the greatest due to the participation of the users. Participation of the users at the planning stage is regarded to be of great importance. The most elevated user involvement during the planning phase was to formulate user directed designs which are applied to implementing new efficient product designs. The design outcomes are applied to the manufacture of medical components which have increased equipment user security and that may be effectively applied. Another purpose for the increased user participation at the planning stage is the need for formal planning procedures which should be initiated and concluded with the customer requisites as per regulation ISO 9001. Nonetheless, each phase of the medical component life cycle is integral and required (Shah, 2006, p. 506). In considering a holistic perspective to the comprehension of the interactions between individuals and system components, it becomes feasible to classify the technological characteristics that will best comply with the user's requirements. This holistic perspective will augment the quality of the medical technology equipment experience and the well being of the user when applying the medical technology. The user centered perspective which is applied by practitioners with respect to ergonomics may enable health care organizations to possess a methodology of application when procuring and applying medical technology. This users perspective includes the ascertaining if the medical technology equipment complies with the ergonomics requisites of the user and if there will be any adverse impact on the technology system of which it will become an integral element (Shaver and Braun, 2008). The Nielsen -Schneiderman Heuristics Perspective The Nielsen- Schneiderman Heuristics are the following elements of evaluations which should be applied from a user's perspective on the ergonomics of medical technology equipment: 1. Consistent results- The users should be aware that the actions which are performed will provide empirically assessed results. 2. Visible operation of the medical technology equipment. 3. Mental compatibility of the user's perception of the medical technology equipment concept. 4. Minimal information requisites. 5. Minimal memorization of the medical technology equipment required. 6. User feedback on the efficiency of the medical technology equipment. 7. Resiliency- The user should be able to custom tailor the medical technology equipment's application. 8. Communication- Error messages should be included with equipment misuse. 9. Mistakes and Accidents- there should exist failsafe systems in order to protect the user from the outcomes of misuse. 10. Completion- The user should be able to ascertain when the task has been completed. 11. The capacity of undoing operations- The user should be able to reverse the errors. 12. Language- The language of information should be simple. 13. Control- The users of the medical equipment technology. 14. Documentation- An introduction manual should be included with the medical technology (Shaver and Braun, 2008). The Subcycles of Medical Technology A methodological manner of administrating medical technology is to observe and maximize all of the phases in the life cycle of medical equipment or to observe the life cycle of medical technology. The technology life cycle of a medical component initiates in the design and acquisition phase, by means of the acceptance process. The technology life cycle of the medical component extends through it's application in the clinical environment . Subsequently, it reaches the obsolescence phase where it is replaced and discarded after reaching it's maximum life utility. The acquisition, approval and obsolescence of a medical technology occurs only once in it's useful life (Chan, 2003, p. 13). The optimal application of technology incorporates a number of occupations and can occur over a variety of instances. This optimal application of medical technology can be deconstructed into two sub cycles. These sub cycles are the acquisition and application sub cycle. The acquisition sub cycle consists of the following events: Technology evaluation- Technology evaluation is a classification of policy study which reviews the short term and long term outcomes which are societal, ethical, legal and economic. These aspects constitute the comprehensive evaluation of the technology (Banta, 2009, p. 8). The gold criteria for clinical research assessment of novel medical technology is historically recognized as the Randomized Control Trial (RCT) (NHTSA, n.d.). A primary tenet of technology evaluation is “buying smart, not cheap”(University of Boston Massachusetts, 2010, p 9). In the technology evaluation, the following details are delineated: The designation of the company. The entity conducting the assessment. The date of the evaluation. The parameters and conclusions of the assessment (Sample Assessment, n.d.). The evaluation can contain the following items: Lean assessment. Precise inventory review Utilization capacity review (Canadian Manufacturers and Exporters, n.d). . Technology Design- The areas of professional capacity which can be included in the Medical technology field are the following elements: Learning. Preparation and delivery of medical technology subject matter. Management, data administration and communications. Resource dissemination and application. Technical maintenance of the medical technology equipment (Missouri Department of Elementary and Secondary Education, 2011; Microsoft, 2012). Guiding adaptation and application in medical equipment technology goes hand in hand. The important factor in being successful is carrying out a comprehensive and thorough planning procedure (NSBA, n.d.). Efficient technology designs are directed towards applications, instead of technology. The technology should be based on inputs and not results (See, n.d.). A new medical technology equipment system should be able to surpass expectations. During the design phase, it would not be feasible to calculate return on investment because the various aspects of the design benefits are not tangible (Violino,2012). Procurement- The increased potential of project failure, the deficiency in allocated resources and abrupt modifications in the systems and platforms have evolved the circumstances that managers need to migrate from constructing to purchasing technology. The purchase of technology delineates third party risk (Eskelin, 2012, p.1). As an outcome, when IT is correctly designed and administered, the result is improved working surroundings and improved decision making ability (Rahrdjo, 2006, p. 7).. The technology acquisitions department directs itself toward strategic technologies and supply chain elements. The strategic technologies and the supply chain elements which have priority are those evaluated to be important to the organization's mission (UC Berkeley, 2012). Research has demonstrated a correlation between acquisition and innovation outcomes (Hitt et al., 1991, 1996; Hoskisson et al., 1994; Ahuja and Ritta, 2001, p. 210). When a medical organization procures an incorrect medical technology release, purchases components which do not meet specifications or over pays for medical technology equipment, expense and risk are added to the acquisition procedure(Bell Technologix, 2012). Approval- It is of the utmost significance to ensure that the employees of an organization accept the technologies in an organizational environment (Ventakesh, 2012). The technology acceptance matrix is a variation of the theory of reasonable activities (TRA). The TAM (technology acceptance matrix ascertains that the estimated utility and facility of application for an individual's willingness to apply a system to actual usage (York University and Appalachian State University, n.d.). The technology acceptance matrix has a paradigm which can be demonstrated as stimuli- organization- response (Chattur, n.d.). The theory of reasonable activities debates that a motivational outcome is determined by the user's attitude toward the implementation (Ramayah, n.d.). Research has demonstrated that there are moderating aspects in the TAM/TRA paradigm (Sun and Zhang, 2006, p. 56). Obsolescence and recyclable disposal- As of 2004, eighteen states and the City of New York have enacted legislation which makes fabricators accountable for the disposal of electronic hardware. This prevents toxic agents from contaminating the ground water (Kaufman, 2009). At any given moment, the components which are considered to be state of the art are on the brink of obsolescence (Carroll, 2008). The Utilization Sub cycle The utilization subcycle is composed of the following elements: Training- The given training in the different specific objectives produces improved performance that the “do your best” objectives (Ballard and Howell, 1997, p. 6). Maintenance- The computerized components which are inherent in software architecture, have brought the ability of self diagnosis for the medical technology component (Wear, 1999, p. 14). Quality Assurance- As of 2001, New Jersey medical x- ray establishments have been applying a quality assurance (QA) implementation with the objective of diminishing the patient radiation exposure and subsequently augmenting the x-ray quality of the images (NJDEP, 2012). Risk Assessment- Health care facilities are producing medical technology administration programs which require the necessary information and design methodology in order to incorporate new components into the current operations and diminish patient hazards (David, Jahnke and Blair, 2004, 3504). Medical equipment technology may proceed through the utilization sub cycle a number of times prior to reaching obsolescence. The option of retiring the medical equipment technology is frequently performed in the procurement sub cycle, however, this is impacted by the results of the application sub cycle. The life cycle perspective of medical technology can be performed upon any technology. The life cycle of repairable medical equipment is governed by two opposing factors and is reliant upon a number of aspects which include: The intricacy of the component- The administration of the medical equipment life cycle is inclusive of administrating all of the aspects of the medical equipment life cycle from the assessment of requisites to the discarding of the equipment. Improved procurement decisions improve the administration of the medical equipment life cycle, especially toward the initial phases of the medical equipment life cycle (Thompson Lecture 2, 2009). The skills sets and expense of the medical technology equipment support personnel- The average salary of a medical technology equipment repairer is $44, 390.00 a year or $21.39 per hour. The level of education which is required is an Associate's degree in biomedical technologies. The responsibility of the medical technology equipment repairer is to install and provide peripheral support services for medical equipment technology. The requirement for trained medical technology equipment repairers is anticipated to increase over 31% between 2010 and 2020 (US Bureau of Labor Statistics, 2012). The amount of medical technology equipment downtime which is permissible- Approximately 25- 35% of medical technology equipment is not applied as a result of downtime. Important improvements can be achieved in increasing the medical technology equipment technical support staff availability, in order to manufacture, repair and provide technical maintenance for components is one of the viable options. In this manner, the components may be acquired quickly and this may effectively diminish the downtime of medical technology equipment (WHO, 2010, p. 6). The accessibility of replace components for medical technology equipment- Increased availability and improvements in medical technology components is a factor which attracts more and more equipment purchases. As an outcome, notwithstanding the issues facing the world's economies, the re- manufactured medical technology equipment sector is demonstrating significant increase. Research has demonstrated that between 2012- 2017, the re-manufactured medical equipment sector will be appraised at $8.45 billion (MedWow, 2012). Clinical hazards- Clinical hazard s are delineated as any medical technology equipment which has the possibility of causing harm to the health care facilities' patients in a health care facility. The aspects are avoidable and this is the important characteristic of clinical hazard administration. Clinical hazard administration is “an approach to improving the quality and safe delivery of health care by placing special emphasis on identifying circumstances that put put patient at harm and acting to prevent or control those risks (The Royal Children's Hospital, 2008). An efficient cost repair evaluation of the medical technology components needs a complete comprehension of the challenges and limitations. A challenge which occurs frequently which deters the repair of the medical component is the deficiency of technical specification available to an in house support staff (Chan, 2003, , p. 19). Information and Technical Specifications Technical specifications are usually included in the components service booklet which is accessible from the components fabricator. Frequently, a procurement staff is not mindful of the significance of the technical specifications. Consequently, support booklets were not procured or detailed on the purchase agreement. The majority of medical technology equipment producers would provide support booklets at no charge to the purchaser, id this was specified in the purchase agreement. Notwithstanding, the quality and quantity of information received in the support booklets is distinct with each medical technology equipment fabricator. Consequently, health care facilities should detail and assess the medical technology component information in their medical technology equipment procurement procedures. The medical equipment support booklet should contain a minimum of the following elements: Component Characteristics. A detailed explanation of the functions and hazard admonishments. A comprehensive hypothesis of the component operation which is inclusive of a detail of the functional obstructions and the signal movement between the unit and parts. A performance validation process. A rudimentary challenge resolving paradigm. A schematic diagram of the medical technology equipment and components. A wiring schematic diagram A schedule of the operating components. The effectiveness of an in house modification of the medical technology equipment is reliant upon the following factors: The accessibility of the correct test equipment and implements. The accessibility of technical data (ie., comprehensive service booklets). Replacement parts which are easily accessible and have a cost avoidance characteristic. The collaboration of the various users. Collaboration from the medical technology equipment administration with regards to the delegating of resources (Chan, 2003, p. 19). Procedure for Classifying Component Dysfunctions There is a requisite to follow challenges which are connected with certain components. The users should be motivated to classify the dysfunction which characterizes the medical technology equipment challenge and document these dysfunctions in the medical technology equipment's serve request. The user who is documenting the medical technology equipment challenge should elaborate with a comprehensive serve requisition and forward it with the following details along with the malfunctioning medical technology component. The following elements should be contained in a medical technology equipment service requisition: A detail and classification of the component which requires service. A synopsis of the malfunction which characterizes the challenge. The name of the user who is documenting the malfunction. The schedule which includes the date and hour of the medical technology equipment service request. The area that the component is used in, the accountable parties with their contact information (Chan, 2003, p. 20). In the utilization sub cycle, the following phases are connected by the inquiry which must be performed before endeavoring a technology replacement. These phases are: 1. Technology evaluation. 2. Technology design. 3. Procurement. 4. Acceptance. 5. Obsolescence (Chan, 2003, p. 147). Sub Cycle Analysis and Clinical Risk These sub cycles and their analysis in the overall clinical risk carry the following questions: Does the medical technology equipment technology meet the criteria of care? Has the medical technology equipment reached it's point of obsolescence? Has the medical equipment technology been supplanted by a modified or novel technology? Is the quantity of component dysfunctions and downtime excessively expensive? Does the medical equipment technology have a cost avoidance characteristic? Can the installation or replacement of the medical equipment component be financially rationalized? What will be the method of financing the novel medical equipment technology? What shall be done with the obsolete technology? The implications of the operator on the efficient and cautious application of medical technology has been minimally considered. Research has demonstrated that in a majority of accident involving heart defibrillator medical technology equipment, that the majority of the accidents were caused by inadequate operation and technical support (WHO, 2000). This study demonstrated that in 200 incidents which had adverse outcomes involving defibrillator medical technology equipment that 9% were attributed to the defibrillator malfunction. In two reports on the application of critical patient care with medical technology equipment, 19% of critical care personnel and 12.3% of critical care nursing personnel reported that they had incorrectly operated the medical technology equipment (Wu et al., 2005).. Research has also demonstrated that among 323 registered nursing personnel who participated in the health care processes in a 500 bed tertiary health care facility, who were surveyed in order to ascertain how much and what they knew about the medical technology equipment that they were applying and the outcomes. Research demonstrated that 90% of the respondents acquired the knowledge of the operation of the medical technology equipment while applying it to a health care facility patient. Many of the respondents reported that they acquired knowledge about the medical technology equipment by reading the user support manual. An additional 87% of the respondents indicated that they had received training on the medical technology equipment from a coworker who was usually a registered nurse (Succi and Walters, 1999). Conclusion The systematic method of managing medical technology equipment and technology is to observe and to maximize all of the phases of the life cycles. The technology life cycle of a medical component begins in the architectural and acquisition phase. This life cycle of the medical equipment technology continues into the acceptance phase, where the medical technology equipment is put into clinical application. 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