MEDICAL EQUIPMENT PLANNING THE BACKBONE OF A SUCCESSFUL

HOSPITAL DESIGN PROJECTPrepared by:

Engr. Mohamed Salah Aouididi(Masters Degree in BME/Germany)

Chief Biomedical Engineer

New and emerging medical equipmenttechnologies are not only radically changing the way healthcare providers care for their patients, but also the way in which health care facilities are being designed.Today's hospital construction projects involve thousands of medical devices (second largest component of a project’s total budget) and proper Medical Equipment Planning is vital to the success of the design.

Introduction

The design of health care facilities is governed by many regulations and technical requirements. Without:

1. the right planning2. objective perspective3. expertise4. and project management resources,

key elements can be overlooked, resulting in costly redesign work and project delays.

Project Management Prospective

Medical Equipment Planning goes beyond Equipment listings. It is a Process that involves equipment and facility assessment, budgeting, equipment specifications, procurement, logistics & installation.

Medical Equipment Planning

Equipment Planning Process

SPECIFY THE NEEDS

PLAN THE SPACE

PROCUREMENT

DELIVERY, COMMISSIONI

NG & ACCEPTANCE

CLINICAL USE

EQUIPMENT MANAGEMEN

T PLAN

DISPOSITION

INFRASTRUCTURE

INTERFERENCE

EQUIPMENT ASSESSMENT

The Chairman/ Owner(s) and the Board of Directors will determine/define/initiate:

The main clinical objective of the Project

The corporate plans and strategic directions

This should be the overall umbrella for any Medical Equipment Planning process

Project Initialization(the start-up 1)

From the BOD a Committee is created as an advisory

group consisting of following multi-discipline clinical and non-clinical staff: Nursing- ward staff Medical/Clinical staff- physicians, doctors Finance and Accounting Purchasing Management/Administration Biomedical Engineering Building, Plant and Facilities IT Clinical specialty (as required)

Medical Equipment Advisory Committee (the start-up 2)

It is the final step in the Process, but also the 1st step- medical equipment planning & lifecycle

Identification of equipment that can no longer serve its primary purpose

Assessment of a secondary and/or tertiary purpose within the hospital

Balance of the need for NEW versus USED

Equipment Disposition

1. Collecting data for assessment:

Lifecycle cost analysis

Historical utilization and consumption data

Installation and construction needs

Manufacturers profile/background

On-site demonstration, clinical trials and bench tests

Upgrading current technology-“forklift” upgrade

Alternative technologies

2. Evaluate efficiency and useful life of current equipment in terms of functionality and cost (applicable only by renovation and/or expansion of existing Facility)

3. Determine equipment reuse and relocation options

Equipment Assessment

It is the responsibility of Medical Equipment Advisory Committee to determine the needs, goals and direction and to confirm the budget.

In order to achieve this objective, the Committee:

Conducts department interviews/meetings to understand equipment preferences, concerns and priorities.

Builds a strong Liaison between architectural staff, contractors and the Committee

Establish a list of recommended improvements, based on their importance

Identify room-by-room fixed and movable equipment, with cost estimates

Specify Needs (1)

Develop and finalize list of new equipment as tailored

Document significant equipment

Architecture Drawing of Equipment in their locations (Complete Layout)

Prepare cross-referenced Equipment Catalog of new equipment, fully coded with all specifications

Prepare initial budget

Specify Needs (2)

Flexibility does have Higher first costs to invest in infrastructure that can support thelargest, tallest, heaviest pieces of equipment as well as having additional electrical andcooling capacities.

These early investments do pay rewards inreducing change orders, and providing the owner with a building that can adapt to a wider range of models in the future.

Infrastructure Interference

The Planning can have building implications If products bought are bigger than the space allows (Lab, Rad)

or they have different power or data requirements than planned.

A proactive planning to verify products will fit and plug in is an essential element to procuring these items.

Plan Space & Facilities

Having the medical equipment planner and the architect collaborate on the drawings is one of the best methods to ensure that equipment will fit and be coordinated with all rough-ins., showing the equipment tag and legend.

In addition to project wide drawings there is a need for specific equipment drawings from vendors during planning (CSSD, MRI ...etc)/ BME & FE review.

Space & Equipment Drawing

1. Clinical Effectiveness (Clinical use should be the No.1 consideration):

Availability – how frequent the Unit breaks, Downtime duration, Spare parts availability, Accuracy/Effectivenessof diagnosis and treatment, quicker patient flow reducing procedure time, a backup of critical equipment used for emergency purposes…etc

2. Cost of Ownership:

Consumables consumption (cost, volume and usage frequency), Speed (faster studies = more patient throughput), Medical Expenditure Limit- Cost of maintenance and repair versus replace and 2nd hand resale value/trade in price if available.

Planning Considerations(1)

3. Strategic medical technology direction:

Equipment standardization and Uniformity - bundled consumables/service contracts/ ease of user training, etc

Technology lifecycle of the equipment Latest medical technology- marketing value Connectivity- internally and externally Mobility and portability- multi-location

4. Patient and Medical Staff Perception:

Age Appearance Technical look/feel

Planning Considerations(2)

Delays created by the delivery of the wrong equipment can't be afforded by the owner.

That’s why the Committee ensures that the correct equipment is specified

from the start.

Equipment Specifications (1)

Have a various equipment options helps selecting the most cost-effective solution while maintaining the highest level of functionality.

Prepare final reports, including room-by- room summary and cut sheets

Prepare Item Distribution Report by code number indicating room/department location of equipment

Assign a bid category numbers (Purchasing Job)

Prepare specifications (maximum detailed one)

Equipment Specifications (2)

Purchase Outright

Operating Lease

Vendor financing

Revenue sharing

Group Purchase (GCC)

Investigate best financial option for the hospital

Acquisition Options

1. evaluate vendors, products and services … recommend those who best meet the needs and standards of the organization

2. insure inclusion of necessary terms and conditions in agreements with vendor and regularly insure vendor compliance with those terms/conditions

3. insure vendor makes available any information, software, documentation, specialized tools, and education necessary to operate or service technology

4. verify integrity of technology supplied

5. monitor vendor quality and integrity of services delivered

Vendor Management

The most costly part of the equipment planning process is often the purchase of the equipment itself ( 25% to 50% of the Project total cost 10% assigned to general equipment & 40% for Radiologyequipment.

The main objective is to procure equipment at the lowest possible cost, taking into consideration your priorities and

preferences.

Procurement

1. Create detailed master procurement schedule database

2. RFQ process, bidding, offers evaluation and selection (Suppliers to be involved with

their site visits providing Demo Units…etc.)

3. Prepare, execute and expedite purchase orders

4. Provide budgetary reporting and reconciliation

5. Refresh equipment list

6. Review shop drawings and schedule required site visits of suppliers (Pre-installation

requirements)

Procurement Steps

Develop detailed receiving and installation schedule

Expedite equipment delivery

Storage services and equipment receiving

Inspect incoming deliveries and record damages or deficiencies

Use detailed action plan for equipment placement

Monitor relocation of existing equipment (Expansion case)

Provide biomedical/ electrical equipment inspection commissioning and acceptance (Warranties, S & OP, PPM schedule during WP)

Coordinate training of concerned Staff (incl. BM) on all new medical equipment

Receiving & Logistics

Orientation, education, and training of Clinical Staff on equipment are essential parts during

the transition period – but not limited-, of assuring that:

safe, effective

care and treatment are rendered to Patients.

BME assessment of Equipment and Clinical Staff is an essential part of assuring that

medical equipment is safe and reliable.

Clinical Use

Equipment Management Plan (1)

Prepare the Environment where the huge number of Equipment will be managed & maintained on a high level standard.

USA Gulf Region

Gulf RegionGulf Region

Equipment Management Plan (2)

Dr. Sulaiman Al Habib – Takhassusi Hospital/ RiyadhRoyal Commission Hospital - Yanbu

Jeddah Clinic Hospitals - Jeddah

Renovation to State-of-Art BMED

Dr. Sulaiman Al Habib – Takhassusi Hospital/ Riyadh

1. Equipment Inventory Control System2. Centralized Filing & Documentation System3. Maintenance Strategies:

Assign responsibility for performing the maintenance and operation programs;

Develop a system for recording the use of parts and supplies

Establish a scheduled maintenance program that includes daily, weekly, and monthly maintenance tasks

4. Develop PPM Program5. Inspection and Acceptance of new equipment6. Medical Device Tracking ~ Dealing with hazards and recalls7. Emergency Procedures8. BME Team Building (as a SDT)9. BME Staff trainings & Education10. End-User Trainings

Equipment Management Plan (3)

Relocation

Trade-In

Sell

Donate

Dispose/Scrap

Disposition Options

The key to the success is proactively identifying tasks, resources and managing the timing of decisions for owner provided medical equipment.

We believe that when environment, art, community and economics are combined in harmony with the dictates of any Hospital construction and society needs, magical places result, places that lift the spirit, sustainable places of beauty, significance and quality.

Conclusion

THE END

QUESTIONS? THANK YOU.. VERY

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