Making medical equipment work Andrew Gammie Clinical / Biomedical Engineer Fishtail Consulting Ltd THET Birmingham 26/9/14

The THET toolkit focuses on donations

The Management Cycle The whole life cycle of medical equipment is broader. Ref: Ziken ‘How to Manage’ guide

Using ZOPP ??? A B C D Goal Strategy Resources Assumptions and risks 1. Blah 1.1 Do this $$ ??? 1.2 Do that 1.3 Do the other Goal oriented project planning – the last column is the least used

Workshop Outline Good Practice Guidelines B C D Goal Strategy Resources Assumptions and risks 1. Blah 1.1 Do this $$ ??? 1.2 Do that 1.3 Do the other Take each stage of the lifecycle, examine assumptions in western context, apply mitigations to low-resource context. Because there are many projects that have used the lifecycle, but things have not changed in the long run. Also chance to share insights and experience Good Practice Guidelines

Example Assumptions in our context People are used to technology People have had full medical training Training is seen as good for skills and prospects Mitigations for other contexts Cover essential safety and care Begin by assessment of current knowledge Build motivation for future

Assumptions in our context Safe electrical supply and clean water available Data available on which to base decisions. Consensus on what is actually required Equipment is appropriate – action can be taken by using it Mitigations for other contexts Robust, back-up, withstand surges. Non-electrical if possible Additional purchases e.g. water filter, aircon unit Do a collaborative needs assessment incl. inventory check Coordinate with other agencies Service-delivery approach – consider all elements of service

Assumptions in our context Hidden costs covered, e.g. maintenance, HR Financial management and rules understandable and available Budget is usable and realistic Budget implies responsibility for future Mitigations for other contexts Clarify responsibilities & cost allocation Spare parts, consumables, maintenance services accessible Local/historical knowledge & ownership e.g. local purchasing Transparent processes Flexibility on allocations Make sure priorities reflect what’s possible

Assumptions in our context Can buy what you want & can trial it People know how to use it Availability of what’s advertised Trusting the market and standards for quality Honesty & ethics of manufacturer Consumables continue to be available Mitigations for other contexts Pilot it, info-sharing (equip, standards, honesty) Establish training needs Specifications appropriate Assessment includes local production availability

Assumptions in our context Transportation effective/reliable, timely, Logistics costed in (including customs) Supplier honesty & efficiency Specification is relevant & appropriate Company honours warranty User knows warranty is there, can use information Mitigations for other contexts Follow local rules e.g. customs and use local experience. Include transport in spec Get references - use consumer power. Pre-purchase demo/loan. Check MHRA, ECRI etc. User involvement in every stage Include user knowledge of requirements/obligations

Assumptions in our context Facilities exist and are appropriate, e.g. doors big enough. Needs assessment has been done. Someone will receive it at site. Will get set up on site. Mitigations for other contexts Cross-dept communications. Do Needs Assessment Plan for user approval on delivery Take it out yourself, or supervise Financial penalties clarified

Assumptions in our context People are used to technology People have had full medical training Training is seen as good for skills and prospects Mitigations for other contexts Cover essential safety and care Begin by assessment of current knowledge Build motivation for future

Assumptions in our context Training followed, assimilated, practiced, knowledge shared Governance & ToT in place Safety culture. People will say when they need training Shared service-provision goals Mitigations for other contexts Plan for refresher training, ToT Instil a leadership culture with responsibility Use partnership model – pass on skills, instil confidence

Assumptions in our context Environment assumed Maintenance culture exists Device used as intended e.g. single-use Mitigations for other contexts Prepare for environmental challenges Contractual obligations to support maintenance. Leadership & responsibility, use documentation Check supply chains for service support exist Specification – planning equipment for context

Assumptions in our context Disposal channels available Environment considered Mitigations for other contexts Awareness-raising Research disposal channels / mechanisms

Assumptions in our context Knowledge available & desirable Information leads to action Information digestible Mitigations for other contexts Appropriate information (can be acted on) Robust training and support for data collection

Bedtime reading