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

2. The THET toolkit focuses on donations

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

4. 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

5. Workshop Outline Good Practice GuidelinesB 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

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

16. 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

17. Bedtime reading