Asset and Facility Management in Hospitals

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Executive Summary

Table of Contents

Executive Summary

1 Introduction

2 Literature Review

2.1 Overview of asset management (ISO 14224)

2.1.1 Exchange of RM data

2.1.2 Benefits of RM data collection and exchange

2.1.3 Quality of Data

2.1.4 Data collection, training and boundary description

2.1.5 Taxonomy

2.1.6 Timeline issues

2.2 Overview of asset management (ISO 55000)

2.3 Maintenance Concepts in Hospitals

2.3.1 Asset Maintenance

2.3.2 Maintainable Items

2.3.3 Reliability

2.3.4 Maintenance Evolution through time

3 A Hospital in Victoria, Australia Case Study

3.1 Hospital Pharmacy

3.1.1 Minimize Hospital Pharmacy Costs

3.1.2 Patient safety issues and solutions in pharmacy department

3.2 Hospital Maintenance Management

3.2.1 Equipment Maintenance

3.2.2 Maintenance Planning

3.2.3 Maintenance Implementation

3.2.4 Maintenance Monitoring

3.3 Hospital Assets Tracking

3.3.1 Some proposed solutions to track hospital assets

3.4 Lack of asset managers in the hospital

3.4.1 Some proposed solutions for the lack of asset managers

4 Conclusion

5 References

6 Appendixes

7 All team meeting agendas and minutes

8 Peer assessment

1         Introduction

2         Literature Review

2.1      Overview of asset management (ISO 14224)

2.1.1       Exchange of RM data

A major objective of this International Standard is to make it possible to exchange RM data in a common format within a company, between companies, within an industrial area or in the public domain. Data can be exchanged on various levels from the actual failure and maintenance records to data on a more aggregated level. However, some data fields can be of a certain sensitive character and could be used for purposes for which they were not intended. Therefore, some appropriate security measures should be used to secure these data. In some cases, it is useful to define a “value measure” for an amount of reliability data by calculating the actual cost of collecting the data or value the data by combining the population with aggregated surveillance time. (BSI, 2016)

2.1.2       Benefits of RM data collection and exchange

Increasing clarity as to the causes of failure events is key to implementing corrective maintenance actions. This results in sustainable improvements in reliability, inspection and maintenance time, leading to improved profitability and safety. Improvements in decision-making, specifically when considering buying new equipment, reduced environmental impacts, more effective benchmarking and general aspects such as improved product quality.

2.1.3       Quality of Data

Data quality can be defined as confidence in the collected RM data and a high-quality data depends on completeness, Compliance, accuracy, sufficient population and relevance. Defining the objective, investigating the sources, defining the taxonomical information, identifying the installation date, population and operating period, defining the boundaries, applying uniform definition for failure and maintenance and defining the checks for verification are important before starting a data collection process.  During and after the data collection, it is important to verify consistency, reasonable distributions, proper codes and interpretations. The main issues with data quality are the source, interpretation method, data format, data collection method and competence and motivation factors. (BSI, 2016)

2.1.4       Data collection, training and boundary description

The data collection process is nothing but bringing data from several sources and compiling it together. The following are the steps in data collection, a) addressing all the data and extracting the most relevant data and storing into an intermediate storage. b) Interpretation and translation of data c) transferring the data to a safe data bank. d) Planning and testing before the main collection process. The personnel who are dealing with data collection needs to have knowledge about all the aspects of equipment and about the data collection process and software. As this influences the quality of data collected. Defining a boundary helps in what RM data needs to be collected. Also, it helps in communication between the equipment operators and facilitators or manufacturers. (BSI, 2016)

2.1.5       Taxonomy

Every company should be classified following the next steps

(As this tool doesn’t allow images and graphics, I’ll keep the graph saved) ??

Furthermore, specific reliability and maintenance parameters should be recorded according to each category

2.1.6       Timeline issues

Classify each piece of equipment according to reliability parameters such as “hot” standby, “cold” standby and in service. Data may also be collected for actual preventive maintenance if one wants the full picture of downtime caused by all maintenance actions. The surveillance period may also cover several states in the life of the item from purchase to disposal. (BSI, 2016)

2.2      Overview of asset management (ISO 55000)

Asset management contributes to make cost balance, and accomplish organisation’s objectives. By analytical approaches, it is possible to manage assets at different levels. Asset management has several benefits, which include enhanced financial performance, risk management, enhanced service and outcome, proved social responsibility, improved reputation, and enhanced efficiency and sustainability. Asset management is consisting of a set of cores, including value, alignment, leadership and assurance. Asset management can include both asset and value, and be estimated by organisation and stakeholders. Value can help to recognise the relationship between asset management objectives and organisational objectives. Alignment which is one of the fundamentals is possible to change the organisational aims to plans, decisions and activities technically and financially. Leadership is an important key for asset management to establish, operate and improve successfully. Because organisations need to be governed effectively, asset management offers assurance that assets will perform their requested purpose. Asset management is usually used management system, but some of the activities are not required to use asset management system. For this case, organisations will manage activities directly outside the asset management system, such as leadership, motivation, culture and behaviour. (BSI, 2014)

An asset management system can have many benefits including organizational knowledge and decision making, which are linked to data collection, although other benefits are also linked to improvements in other departments such as finance, human resources and purchasing. (BSI, 2014)

Elements of asset management systems can incorporate Leadership; the communication needs to flow both ways and the top managers need to support their asset manager to ensure the alignment with the other management systems within the company. A strategic asset management plan should be used to outline the objectives of the asset management system and address assets complete lifetime to define actions to be taken in relation to assets. An evaluation of asset management should be performed to ensure the effectiveness and efficiency of the system. Improvement opportunities are likely to be determined and nonconformities or potential nonconformities need to be addressed. Using an integrated system with the organization’s existing management systems can reduce costs and time and benefit from it. (BSI, 2014)

2.3      Maintenance Concepts in Hospitals

2.3.1       Asset Maintenance

The purpose of asset maintenance is to improve the physical condition of an asset according to its specified standard. Avoiding future deterioration or failure, repairing within specified constraints. Substituting items at the end of their useful life. Making repairs for safety and security for handlers and patients.

2.3.2       Maintainable Items

Includes equipment and components for hospital use. According to the Queensland Department of Health 2015 these should meet the following: maintenance must guarantee that the asset is kept in noble working condition during its useful life and/or to fulfil the Legislation of Australian standards or policy frameworks by the Government and/or the tracking of assets required for the life lasting of asset management and asset replacement.

2.3.3       Reliability

As per Mahfoud and Biyaali (2016) Reliability focused maintenance and productive maintenance concepts denote a meaningful step in getting the best of medical equipment compared with other business applications and could help hospital maintenance service create strategies based on evidence for the performance optimization.

2.3.4       Maintenance Evolution through time

As said by Mahfoud and Biyaali (2016) Failure maintenance was the prevalent policy, then preventive maintenance theory turns out to be well known. Preventive maintenance has time-based and involves scheduled activities of maintaining or replacing parts to extend the asset useful life. With the technologies development, the condition-based maintenance appeared to improve the monitoring systems. Lately, “prognostics” were presented by the maintenance management community which predicts a problem in the asset before a failure happens. Projective maintenance features more information on degradation of assets in the way to improve the useful life. Figure X shows the maintenance evolution through time.

Figure X: Maintenance Evolution

3         A Hospital in Victoria, Australia Case Study

3.1      Hospital Pharmacy

Every year, these hospital managers are faced with the repeated issue of finding tactics to decrease expenses.  Usually, the pharmacy department signifies one of a hospital’s biggest fee facilities. Caused by growing drug expenses and staffing requires the highest account from the pharmacy budget and are the primary drivers of annual budget increases requests. Though, while the medical side of the hospital focuses on gaining access to clinical advances and more recent, effective drug treatments, the financial department is focused on preserving the status quo in terms of pharmacy expenditure.

New policies and quality expectations are demanding pharmacies to assign more resources to guarantee that suitable actions are placed to provide the maximum level of patient care and safety. Similarly, the pharmacy signifies a major focus area for enhancing cost competencies and benchmarks for appropriate reimbursement. Furthermore, hospital pharmacies will have to enhance operational practices to ensure personnel time is used for the most optimum duties. (Blackmere, 2012).

3.1.1       Minimize Hospital Pharmacy Costs

The most effective method to minimise this hospital pharmacy costs will integrate a balancing mix of technology, computerization and governance to remove time-wasting, paper-based methods, whilst improving performance and productivity. The subsequent 4 techniques allow pharmacy managers to achieve that:

  1. Automate scheduling.

Pharmacy personnel scheduling is usually an ineffective procedure because of the complicated nature of the environment in terms of numerous shifts throughout several departments, fluctuating levels of personnel knowledge and different definitions of what creates suitable coverage throughout departments. Furthermore, pharmacy directors do not have the luxury of waiting till jobs slow down to apply schedule adjustments. As the pharmacy is such an essential department in the hospital and directly involved in patient care, scheduling matters should be fixed as soon as possible to not impact care quality.

Because of those difficulties, typical hospital recruitment systems are usually not suitable for pharmacy environments. Therefore, managers must frequently resort to manual processes that involve spreadsheets and consume the time and energy of the pharmacy’s highest waged personnel.

As departments search for approaches to generate better efficient operational practices, many are finding that automated tools created specifically for hospital pharmacy management are the solution to the scheduling issue. Supervisors have access to user-friendly techniques of revising and creating schedules as well as communicating with personnel thru an incorporated platform. Personnel have the capability to take ownership of the scheduling procedure through the usage of the platform to apply time-off requests, view schedules and verify shift adjustments. These platforms not just provide real-time, updated records for personnel, but they also free up the pharmacy supervisor’s schedule to allow for higher-level duties to be accomplished.

  1. Convert from paper to digital.

Paper-based documentation and monitoring procedures cause higher charges, as for storing, printing and documentation control, and are vulnerable to more errors. Therefore, when the pharmacy converts paper to digital, this is a better preference from a budget angle.

For instance, online formulary management portals streamline updates both the formulary in addition to guidelines and approaches, and boost up facility-wide communication of any modifications. Computerized reporting tools that screen clinical interferences, medication faults and unfavourable drug reactions improve quality and patient safety while freeing up personnel time and offering pharmacy supervisors with valued vision into how best to compute and enhance clinical programs and personnel. (Blackmere, 2012)

  1. Real-time medication tracking to eliminate waste.

Even though a relatively new arrival to the healthcare automation equipment, wi-fi medication monitoring systems have verified their capability to deliver administrative and clinical Return On Investment (ROI). Through supplying real-time monitoring of patient medications from preparation in the pharmacy to final delivery in the nursing department, these solutions dramatically effect productivity, expenses and patient satisfaction.

When real-time medicine monitoring is available throughout the hospital, pharmacy personnel is now not diverted from their core duties to respond to frequent status updates. Nurses have instantaneous access to the status of a medicine, and patients obtain needed medicines in a timely style.

Real-time tracking also removes waste related to duplicate orders and outdated inventory. It is critical to hospital budgets to have a clear tracing of these medicines to prevent the need to reissue, in particular because once dispensed, it is not likely the original could be suitable for any other patient.

  1. Deploy rules-based surveillance monitoring to identify less costly interferences.

Patient care is dynamic in nature. Frequently, each day reports of patient conditions turn out to be outdated fast. Surveillance technology offers a real-time tracking that may aware clinicians to instant chances for better care. Modifications to patient care may be made faster, enhancing quality and frequently preventing useless duplications.

For instance, a pharmacist operating from a report printed at eight in the morning may go to deal with a patient issue only to discover that a physician had previously looked after it or ordered something different. Similarly, pharmacists using manual systems would have to print out a listing of patients on a specific drug to determine if there’s a better interference, including an oral medicine. With surveillance technology, the system automatically warnings pharmacists to these requirements and chances, decreasing expenses and enhancing patient care. (Blackmere, 2012)

3.1.2       Patient safety issues and solutions in pharmacy department

An effective asset management system can be helpful for hospital pharmacy department to manage inventory effectively, and promote to use medicine properly. According to Strickland, as hospital apply an asset management system, there are some benefits, which include identifying the usage of medicines, making good decisions about which medicines are needed, records that have been tested, records about medicine location, identifying the maintenance’s costs (2014). However, because some hospitals have poor asset management system in the pharmacy department, patient safety issues are presented.

The institutes of medicine (IOM) presents that patient safety is the prevention of injury to patients, including accidents, infections and errors. According to the National Patient Safety Foundation survey (as cited in Strickland, 2014), 42% of patients had experience of a medical error, and 32% of patients said that the error had a negative effect on health. It is noted that patient safety issues are serious in hospital, and hospital needs to find a proper strategy to manage pharmacy.

According to Wolters Kluwer Pharma Solutions (as cited in Strickland, 2014), 3.9 billion prescriptions are filled by U.S. pharmacies, and there are wrong-drug errors about 325,000. Wrong-drug errors can cause serious problem to patients, such as death or long-lasting injury. It is noted that poor medical management can be critical drawbacks for patient safety. Figure 1 shows that medication use errors can occur any points of the process. It means that appropriate asset management system is necessary to cover diverse errors. In order to improve management system, hospitals and pharmacy department need to follow these strategies.

Figure X. Flowchart of the medication use process (Fiumara, 2007)

Hospitals need to make a single asset register to manage the medicines using standard classifications and record the details of medicines. In this process, alert system will be included base on the past records and classifications. As asset register divides the medicines by standard classifications, when staffs prescribe the ‘high alerts’ medicines, they can pay attention to use these, so can reduce the medication error (WHO Drug Information, 2012). Additionally, electronic medical records (EMRs) system is one of the common methods to manage drug safely. This system needs to combine with drug alert system to improve patient safety, because alert system will help staff to make better decisions, and use medicines effectively (Lee, 2010).

3.2      Hospital Maintenance Management

3.2.1       Equipment Maintenance

According to Cruz (2014), medical equipment maintenance is an increasing demand in hospitals budgets with the quality of such services being vital for a qualitative delivery of health care to patients. At a privet hospital in Victoria, maintenance is a part of general management and it is usually overseen as being an independent department and it might not be supervised as much as other departments. Without an appropriate incorporation system including systematic replacement and retirement processes, unsuitable equipment could be installed in a way that is not effective and/or efficient for the patient care, possibly causing risk for patients and users for using an equipment beyond its useful life. Crucially, without proper maintenance management, reasonable resources could be lost by healthcare organizations, also increase operational costs and dangers to handlers and patients are consequences of poor maintenance. (Wang, 2012)

3.2.2       Maintenance Planning

Wang says that a maintenance strategy should be implemented to either the complete asset and/or to each piece of equipment. Three main elements for a maintenance plan are: first, patient safety, protecting the patients from possible harm due to equipment failure. Second, Intrinsic maintenance needs, this would include preventative maintenance as well as performance and safety inspections. Third, criticality to the organization’s mission, the impact of the failure of organization’s equipment could affect patient satisfaction and institutional finances as well as their reputation. The hospital’s mission is to provide the community with high quality, progressive healthcare

3.2.3       Maintenance Implementation

Following an adequate maintenance strategy plan, the implementation should include appropriate human resources, adequate material resources, financial resources and documentation. At the private hospital, there is only one maintenance department and it is usually overloaded of equipment to be accessed and not always the priority is chosen wisely. The Hospital also does not use any computer system and all the maintenance requests are manual via writing in a book.

It would be worthwhile for the hospital to access their budget for the maintenance department and allocate staff with adequate technical competency as well as upgrading the department to cater for different criticality of equipment and using computer systems to maintain records for every maintenance request and requirement.

3.2.4       Maintenance Monitoring

The misunderstanding of “maintenance guarantees the patient safety” is reflected by the pressure on scheduled maintenance completion rate, which should be changed to measured outcome. The main characteristic of equipment monitoring is reliability, which can be measured by the equipment availability for clinical use (total time for use).

As said by Wang, another way to tackle the maintenance monitoring, would be using root-cause analysis and repair performed assigning the following codes to each service record: Preventable and predictable failure (PPF), Potential failure (PF) and Hidden failure (HF)

  1. “Preventable and predictable failure (PPF): a failure that is typically caused by wear and tear that can be predicted or detected. The appropriate solution is scheduled maintenance for detecting—safety and performance inspection—and/or replacing the worn part(s)—preventive maintenance.” Wang (2012, p. 27)
  2. “Potential failure (PF): a failure that is either about to occur or in the process of occurring but has not yet caused equipment to stop working or problems to patients or users. The appropriate solution is scheduled inspection that would determine the need for replacement of defective or worn part(s) or calibration adjustments.” Wang (2012, p. 27)
  3. “Hidden failure (HF): a problem that could not be detected by the user unless running a special test or using specialized test/measurement equipment. The appropriate solution is scheduled inspection that would attempt to detect the failure and, if found, correct the failure.” Wang (2012, p. 29)

At present the private hospital does have any monitoring procedure and maintenance is scheduled according to necessity. This would be a good procedure to be implemented to improve the life of the assets and provide economical, reliable, safe and efficient services.

3.3      Hospital Assets Tracking

As technology evolves, the number of machinery used per patient has skyrocketed up to 13 devices by 2010 in big hospitals and up to 7 in small hospitals like the one contemplated in the case of study. Hence, equipment investment has increased from $1,656 in 1995 to $3,144 in 2010 (Horblyuk et al., 2012). What still concerns asset managers is the poor implementation of the machinery. In some occasions, less than 50% of the equipment is used during a year. This means that equipment is been purchased without a thorough planation. Moreover, some hospitals are even keeping under inventory obsolete equipment due to inefficient equipment tracking and maintenance information. As human health represents a priority, costs are inadequately optimized and equipment is the main investment that is dragging hospitals budget (Efe, Raghavan, & Choubey, 2009). A report by Healthcare Information and Management System Society said that hospitals were wasting almost $2.3 billion in unsolicited inventory ((Lee, Kim, Jeong, & Kang, 2011).

Furthermore, the majority of hospitals spend large amounts of money tracking and recovering misplaced or stolen equipment (Wicks, Visich, & Li, 2006). In the private hospital in Victoria not even paper tracking is implemented which increases the probability of equipment moss. Many hospitals have reported expenses up to $4 million annually just for lost equipment, this due to mismanagement and a poor tracking system (Glabman, 2004). Only in the United States there are reports of 15% equipment lost per year (Kumar, Swanson, & Tran, 2009). Time wasted on recovering devices costs money and valuable staff time that could be implemented in patients’ attendance. Furthermore, lost equipment leads to unnecessary purchases and expensive loans (Davis, 2004) that end up decreasing the overall hospital quality. Besides lost devices, there is another major concern in this hospital and that is the maintenance and reparation of medical devices. 1% of this hospital expenses are invested in equipment maintenance (Wang, W. Eliason, M. Richards, W. Hertzler, & Koenigshof, 2008) including preventive and corrective.

Maintenance schedules imply time without equipment functioning. This downtime represents a huge liability for hospitals as devices oversee patients’ life. Besides time, money can represent another drawback for maintenance protocols as they tend to be expensive and time-consuming reaching almost $26.1 million in 2001(Victoria, 2003). It is vital, especially in the healthcare sector, to program accurate maintenance schedules, minimizing downtimes and corrective maintenances.

3.3.1       Some proposed solutions to track hospital assets

  1. Barcodes

As the private hospital analysed in the case of study does not have a tracking system, barcode might be a temporal solution while adjusting to more developed technologies. Barcode is a method that reduces labour hours, human mistakes, and organises all data in a single electronic sheet. Therefore, devices can be tracked and located easier by a quick search in the system. Even though, many hospitals are moving to radio frequency and Wi-Fi tracking that are more reliable and give real-time data, these systems tend to be expensive and tedious, specially for a private, low-budget hospital. In the next image, a comparison between barcode and RFID is done

  1. Radio Frequency Identification (RFID)

Radio Frequency Identification (RFID) is new gen innovation in the field of healthcare. It is becoming widely popular as it can do both data collection and asset tracking. RFID uses radio waves for its operation, also it does not need any kind of human intervention for data capture and transfer. It is different from the barcode scanner as it does not need any barcode tag in line to scan. A tiny tag on the asset, patients, doctors or nurses can track down the location and can be managed using a central database which can be used even on a mobile phone. RFID can recognize a number of tags at the same time from longer distances (Yao, Chu, & Li, 2012). A RFID system consists of a hardware and a middleware. The RFID can be either active or passive. The hardware consists of two main parts, the tags and readers. The middleware stores and processes the information of the tagged objects(Ngai, Moon, Riggins, & Candace, 2008).  Adoption of the RFID system increases the operational efficiency of a hospital which in turn improves the performance of the organization (Lavine, 2008). The system can have various applications such as tracking, identification and verification, sensing, interventions, alerts and triggers (Hakim, Renouf, & Enderle, 2006; Hosaka, 2004).

Implementing the RFID in a hospital has numerous advantages such as

  • reduced medical errors improved the medical process
  • patient safety
  • patient satisfaction
  • resource utilization
  • real-time asset monitoring
  • cost saving,
  • time saving

(Booth, Frisch, & Miodownik, 2006; Chen et al., 2005; Hosaka, 2007)

Adopting RFID in an organization comes across various challenges. Some of them are,

  • Electromagnetic interference- The other devices in a hospital may fail or may not work properly due to the high power of the device reader (Van Der Togt et al., 2008).
  • Ineffectiveness- It can be due to lack of reading range or existence of more than one tagged object (Cangialosi, Monaly Jr, & Yang, 2007).
  • Standardization- The other devices in the hospital might not be of the same standard which decreases the compatibility (Cangialosi et al., 2007).
  • Cost- It can cost up to $200,000 to $600,000 for medium hospital and can go up to a million-dollar depending on the size of the hospital.
  • Privacy and legal issues-The discarded tags may contain the personal health issues of a person. Also, the high surveillance potential of the device can lead to misuse (Fisher & Monahan, 2008).

Figure X: RFID and Barcode Comparison, Adapted from (“Replacing barcoding: Radio frequency identification,” 2006)

3.4      Lack of asset managers in the hospital

One of the key issues in the hospital is the lack of an asset manager. Even though there is a manager in the selected hospital, it is not easy for him to manage all the departments in the hospital.  The management of processes i.e., management of policies, procedures and regulations may not be efficient in the absence of an asset manager. Management of record especially details of equipment, compliant registration etc. is the major issues in the selected hospital. Since they don’t have a separate asset manager, complaints related to assets are directly forwarded to the manager of the hospital. This is a burden for him since he must manage all the department. Absence of an asset manager is clearly visible in their record keeping systems. For example, still they are using books to record the details. An efficient asset manager can change these systems and implement new and improved technology. Since the manager of the hospital should deal with all departments, he may not be able to communicate with all staff in the hospital. An effective communication between staffs and different departments will get to know the issues with the assets in the hospital. In addition to that an asset manager has a major role in financial management of the hospital. If there is an asset manager in the hospital, he can investigate the issues with the equipment and can allocate the budget to the right area.

 

3.4.1       Some proposed solutions for the lack of asset managers

Appointing an asset manager in the selected hospital will improve not only the asset management department but also, all the related departments in the hospital. The responsibility of an asset manager includes management of process, management of policies and procedures, management of documents, management of staff, service provider management, and finance management and so on. These responsibilities and how it improves the hospital systems are discussed in detail in the following sessions.

MANAGEMENT OF PROCESSES

The main responsibility of an asset manager is the management of processes and documents in the organisation.

The lack of technical knowledge, as well as administrative skill of an asset manager, may affect the entire system. Creation and modification of policies, procedures, rules and regulation regularly maybe time-consuming and inefficient. This can be solved by adopting a hierarchy like the following which is explained in ISO 9001 (Binseng Wang,2001).

Or Follow flowcharts as the following which is given in detail in ISO 14224

 

POLICIES AND PROCEDURES

There should be some policies and procedures in a hospital to follow. This will help for the management and maintenance of hospital instruments. Procedures can be defined as the description of processes which are used to implement the principles in the policies. The procedures should clearly define the answers to the following questions: who, what, why, when and how. For better efficiency these procedures can be published in the hospital websites or in any other services which the employees can access easily. The policies and procedures define the requirements, goals, and objectives of the Hospital. (Binseng Wang,2001)

These policies and procedures should be reviewed regularly and approved by authorised persons. Clearly defining the work instructions is also important.

MANAGEMENT OF DOCUMENTS

Keeping a service document or manuals improves the efficiency. The manuals include scheduled and proper maintenance instructions and other relevant data like instructions for use, cleaning, warranty details and so on. So, these manuals or service documentation should be under the control of asset manager.

Maintaining a proper record keeping system improves the service performance. These records can be of 2 types:

  • Full records:

This includes a comprehensive detail of the service performed. Example are scheduled actions or unscheduled actions, replaced parts etc. Full records can be in papers/books or in electronic devices. It is better to adopt electronics devices for efficiency. Nowadays almost all the hospitals are replacing their recording keeping using conventional methods like books and papers into electronics devices like computers. This reduces the human efforts and reduces the time required. But when opting for computer systems the asset manager should ensure the data security, information backups and recovery options.

  • Abbreviated records:

These can be defined as a label or a sticker. These records provide only basic information such as key dates (date of the last service, date of next service etc). Record retention policy of Hospitals says that after the retention period these records must be destroyed to reduce the risk or to keep the confidentiality of the hospital. An asset manager of a hospital should ensure this since the records can be considered as an asset of the hospital.

MANAGEMENT OF STAFF AND DEVELOPMENT

Similar to any other organisations, a hospital management should also manage their staff, provide training to staff and maintain the human resource department. In this competitive world, the managers should select the best employees with adequate qualification and practical knowledge in their hospital. In the case of managers (human resource managers or asset managers) good knowledge and skills in the area are mandatory.

Some of the certifications are listed below:

  1. Certified Biomedical Engineering Technician (CBET)
  2. Certified Radiology Equipment Specialist (CRES)
  3. Certified Laboratory Equipment Specialist (CLES)
  4. Certified Clinical Engineer (CCE)
  5. Qualification from the International Certification Commission (ICC)
  6. Qualifications from Healthcare Technology Certification Commission (HTCC)

Give priorities to people with the listed qualifications during the recruitment processes will be advantageous for the hospital.

After the recruitment, proper training should be provided to the new employees. This training should start from the basic structure of hospital to the policies and procedures. Also for existing employees, regular evaluation should be conducted. If required, extra training should be conducted at appropriate time intervals. (Binseng Wang,2001)

SERVICE PROVIDER MANAGEMENT

Another important duty of asset manager is ‘service delivery strategy planning’. It can be defined as the careful consideration of expenses with respect to external services.   Wang et al. [2008] reported that the total expenditure on service contracts for medical equipment is often 50% or more of the hospital’s total expenditure on medical equipment maintenance and management.

In general, 3 different options are available for servicing medical instruments.

(i) Onsite staff16

(ii) The manufacturer

(iii) An alternative vendor.

The selection of the best option depends on the following factors.

  • Technical competency
  • Technical documentation
  • Parts and tools
  • Response time
  • Cost
  • Quality

FINANCE MANAGEMENT

Even though a finance manager will be present in every hospital, asset manager should do his part in finance management with efficiency. The asset manager is responsible for the control of the budget to his/ her department i.e., purchase and maintenance of hospital asset.  This requires careful selection of manufactures, transportation charges, warranty of the equipment etc. (Cram, N.,1998)

RELATIONSHIP WITH OTHER DEPARTMENTS

An asset manager should be communicating to other departments or with staffs, doctors of the hospitals or even with the patients in the hospital to know about their perception about his/her departments. This communication will help to know about the defects or issues with any asset under his control.

Some of the methods adopted by hospital to maintain the relationship are the following

  1. Regular visits to different departments
  2. Chat with doctors, nurses and even with patients
  3. Email services to collect the complaints about asset
  4. Mutual understanding and improved communication between departments
  5. Feedback methods

INTERACTION WITH TECHNOLOGY

In order to avoid the issues with asset management, it is better to incorporate technology to solve the issues. For example, in this case study, in order to solve the issues with record keeping system computers and internet services can be introduced in the hospital. In addition to that to maintain the link between the hospital and pharmacy, this computer and internet services will help. An advanced system called RFID (Radio Frequency Identification) which uses radio frequency waves helps to track the assets in the hospitals. (ECRI Institute – ECRI, 2012)

4         Conclusion

5         References

Binseng Wang (2001), “Medical Equipment Maintenance,management and oversight”, Morgan and claypoolpublisheres

Blackmere, J. (2012). 7 Steps to Reduce Hospital Pharmacy Costs Without Eliminating Staff. Retrieved October 4, 2017, from https://www.beckershospitalreview.com/hospital-management-administration/7-steps-to-reduce-hospital-pharmacy-costs-without-eliminating-staff.html

Booth, P., Frisch, P., & Miodownik, S. (2006). Application of RFID in an integrated healthcare environment. Paper presented at the Engineering in Medicine and Biology Society, 2006. EMBS’06. 28th Annual International Conference of the IEEE.

BSI. (2014, March 31). BS ISO 55000 SERIES. Retrieved October 5, 2017, from https://bsol-bsigroup-com.ezp01.library.qut.edu.au/Bibliographic/BibliographicInfoData/000000000030300451

BSI. (2016, October 31). BS EN ISO 14224:2016. Retrieved October 5, 2017, from https://bsol-bsigroup-com.ezp01.library.qut.edu.au/Bibliographic/BibliographicInfoData/000000000030324520

Cangialosi, A., Monaly Jr, J. E., & Yang, S. C. (2007). Leveraging RFID in hospitals: Patient life cycle and mobility perspectives. IEEE Communications Magazine, 45(9).

Chen, C.-I., Liu, C.-Y., Li, Y.-C., Chao, C.-C., Liu, C.-T., Chen, C.-F., & Kuan, C.-F. (2005). Pervasive observation medicine: the application of RFID to improve patient safety in observation unit of hospital emergency department. Studies in health technology and informatics, 116, 311-315.

Cram, N (1998), Computerized Maintenance Management Systems: A Review of Available Products, J Clin Eng 23:169–179.

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6         Appendixes

7         All team meeting agendas and minutes

8         Peer assessment

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