1. PO 005:Physical Therapy Material Control

2. Learning Objectives Develop a plan to manage physical therapy equipment including: – PT equipment inventory – Preparing loan cards – Organizing equipment storage areas – Planning for future equipment needs – Ordering equipment Maintain physical therapy equipment

3. Learning Objectives Continued... Understand the role of Biomedical in equipment maintenance and repair – Preparing form 63 Apply regular maintenance procedures to physical therapy equipment Facilitate the implementation of new equipment in the PT department

4. Material Control The system that ensures the provision of the required quantity of material of the required quality at the required time with the minimum capital investment (cost) It covers the following functions: – Stock control – Scheduling of requirements, maintenance and repairs – Purchasing – Receiving and inspecting – Storing and usage

5. Material Control Continued... When materials are not properly controlled, excess stock of some items is likely to occur As well, shortages of materials may arise when they are urgently needed resulting in delays in the provision of services Proper co-ordination of all departments involved in material purchasing, receiving, testing, approval, storage, issue and accounting, is essential

6. PT Equipment The head of the PT department will be responsible for facilitating the requisition of new PT equipment Requests will be send through the Chain of Command to Med Logistics It is essential to record all requests and ensure continuous follow-up is performed to guarantee orders are filled

7. Inventory Management The process of efficiently overseeing the constant flow of materials into and out of an existing inventory This process usually involves controlling the transfer of material into a department, to prevent the inventory from becoming too high, or dwindling to levels that could jeopardize the delivery of service

8. Inventory Listing A detailed list that describes the quantity, description and other important information of goods and materials on hand Inventory lists should include: – Item name and number – Item description – Item quantity – Item location – Date of purchase/installation – Date of required maintenance check

9. Inventory Listing Continued... Inventory lists need to be kept up-to-date which is a function of the PTTs – An SOP should be created to ensure this is done on a regular basis Lists can be on paper or electronically generated (i.e. Excel) The lists should be well organized and stored in an accessible location

10. Inventory List Example #Item Name BrandQuantitySerial Number Date Received LocationDate of Check/ Maintenance 1TreadmillPrecore278988326- 388 03/04/12Poly- clinic Rm 302 03/04/13 2TreadmillPrecore278988326- 388 03/04/12NMH PT Dept 03/04/13 3PlinthMedi-Plinth534245- 4254 02/01/10NMH PT Dept 02/01/11 4PlinthMedi-Plinth534245- 4254 02/01/10Poly- clinic Rm 301 02/01/11 5Hydro- collator Chattanooga123483274- 2384723 19/07/10Poly- clinic Rm 290 19/07/11

11. Inventory and Tashkil Specific PT equipment requirements will be outlined on the Tashkil It is up to the PT department heads to ensure the PT department is fully stocked with all equipment that is indicated on the Tashkil Deficiencies need to be addressed with the chain of command

12. Equipment Planning Equipment needs will be based on: – Tashkil requirements – Life expectancy of equipment – Functionality of equipment – Usage of equipment – Funding available – Available space – Department and patient requests

13. Storage of Equipment Proper planning is required for storage and issuing of equipment All PT equipment should be stored in a properly safeguarded designated location Access should be given only to PT staff or other staff for whom it is required

14. Loan Cards If there is a requirement for a patient to have access to a piece of equipment or a supply outside of the clinic, a loan card should be filled out This is a document with the particulars of the patient and the equipment Ensures equipment can be tracked at all times

15. Loan Cards Continued... Loan cards are patient specific and indicate: – Patient’s name – Patient’s contact information – Loaned item details – Date of issue – Date of required return They should be stored in the PT department They should be regularly reviewed and late returns investigated

16. Maintenance Various processes that are employed to keep equipment in proper working order Ensures that the items are in compliance with any safety regulations that may apply, and remain capable of producing the desired output Exact steps used in any equipment maintenance will vary depending on the type of equipment involved

17. Maintenance Continued... Four types of maintenance: – Reactive maintenance No actions or efforts are taken to maintain the equipment as the designer originally intended – Preventative maintenance Actions performed on a time- or usage-based schedule that detect, preclude, or mitigate degradation of a component or system, with the aim of sustaining or extending its useful life

18. Maintenance Continued... Predictive maintenance: – Measurements that detect the onset of system degradation, thereby allowing causal stressors to be eliminated or controlled prior to any significant deterioration in the components physical state Reliability centered maintenance (RCM) – A process used to determine the maintenance requirements of any physical asset within the context in which it is used

19. Reliability Centered Maintenance (RCM) Recognizes that all equipment in a facility is not of equal importance to either the service or facility Reliant on predictive maintenance but also recognizes that maintenance activities on equipment that is inexpensive and unimportant to the reliability of a facility may best be left to a reactive approach

20. RCM Continued... Maintenance breakdown: – <10% Reactive – 25-35% Preventive – 45-55% Predictive Advantages: – Can be the most efficient maintenance program – Reduces probability of sudden equipment failures – Able to focus maintenance activities on critical components – Minimizes frequency of overhauls

21. RCM Hierarchy Reactive Element Applications Preventive Element Applications Predictive Element Applications Small parts and equipmentEquipment subject to wearEquipment with random failure patterns Non-critical equipmentConsumable equipmentEquipment with random failure patterns Equipment unlikely to failEquipment with known failure patterns Equipment not subject to wear Redundant systemsManufacturer recommendations Systems which failure may be induced by incorrect preventive maintenance

22. How To Perform RCM? 1.Develop a Master equipment list identifying the equipment in your facility 2.Prioritize the listed components based on importance or criticality to operation, process, or mission 3.Assign components into logical groupings

23. How To Perform RCM? 4.Determine the type and number of maintenance activities required and periodicity using: Manufacturer technical manuals Equipment history Root cause analysis findings - Why did it fail? Good engineering judgment 5.Identify tasks that may be performed by PTTs and those that require the services of Biomedical Staff

24. Functional Checks Functional checks are a quality assurance processes Testing of all features and functions of a system or piece of equipment to ensure requirements and specifications are met PTTs will be responsible to perform functional checks on department equipment on a regular basis

25. Functional Checks Continued... Functional tests should: – Be completed prior to each use on a patient – Require PTTs to inspect all components of the equipment to check for damage or excess wear – Connect all accessories or attachments – Connect the power source – Test to see if the equipment works the way it is intended – Store equipment appropriately when check is completed

26. Biomedical (Bmet) Biomedical technicians inspect, maintain, and repair diagnostic, monitoring, therapeutic, and life-saving medical equipment They conduct preventative maintenance and repair broken equipment They conduct safety testing & standards compliance of medical equipment

27. Repair Requests If it is determined during a functional check that a piece of PT equipment is not working properly, a repair request is required The appropriate form for repair requests is the MoD 63 form When completed, the form is then submitted to MEMD who will process the request

28. MoD Form 63 Forms need to be submitted to MEMD in a timely manner when a piece of equipment is deemed in need of repair A tracking system is required in the PT department to ensure adequate follow-up on repair requests Outstanding requests need to be presented to the chain of command to be investigated

29. MoD Form 63

30. Replacement Equipment Broken equipment needs to be identified to Bmet for inspection/repair If Bmet deems that piece of equipment is non- repairable, they are responsible for submitting a replacement request – Only Bmet can decide if a piece of equipment can be fixed or requires replacement It is the PTT’s responsibility to follow-up on outstanding replacement requests with Bmet

31. Equipment Implementation When new equipment arrives at the PT department: – The PTT needs to verify that the equipment is what was ordered and recorded on the Tashkil – Inspect the equipment for damage or missing parts – Record the new equipment on the inventory list – Read any user manuals that apply – Schedule appropriate maintenance and checks at the frequency suggested in the manual – Assist with familiarizing other PT staff with the proper use of the new equipment

32. Summary Material control is essential for proper control of PT equipment All PT equipment must be recorded on a regularly monitored central inventory list PT equipment must be stored in designated areas with restricted and monitored access Reliability centered maintenance on PT equipment is necessary to keep equipment functioning properly

33. Summary Continued... PTTs must perform regular function checks on PT equipment MoD form 63 must be filled out for non- functioning equipment and submitted to MEMD Bmet will repair, or deem broken equipment non-repairable, and will submit requests for replacements PT staff require training on new equipment

34. Questions?

35. Comprehension Check 1.What is the purpose of the material control process? 2.What is the purpose of an inventory list? 3.On what document are the equipment requirements of the PT document outlined?

36. Comprehension Check… 4.What are the 4 types of equipment maintenance? 5.Which form is used to request repair of equipment 6.Who determines if broken equipment is repairable, or must be replaced?

37. Answers 1.To ensure the provision of the required quantity of material of the required quality at the required time with the minimum cost 2.To record the quantity, description and other important information (eg. Location, date of purchase, required maintenance) of goods and materials on hand 3.The Tashkil

38. Answers 4.Reactive, Preventive, Predictive, Reliability Centered Maintenance 5.MoD 63 6.Bmet