Bio medical equipment maintenance & management

Ghulam M Kanhar 099041830
1
BIOMEDICAL EQUIPMENT MAINTENANCE & MANAGEMENT
(A case study of SMBBMU)
GHULAM MUHAMMAD KANHAR
A Project submitted in partial fulfilment of the regulations governing the award of the degree of
M.Sc. in Engineering Management, University of Sunderland 2011.
Project Supervisor: Mr AHMED ELMARAKBI

2
Abstract
Global healthcare pressure is triggering many hospitals to manage and keep eye on the available
competitive advantages of maintenance strategies. Planned preventive Maintenance is one of
them considered as most competitive strategy for maintenance in the hospitals. This paper is a
contribution to the review of the maintenance strategies and planned preventive maintenance’s
Tools and Techniques available to test, inspect, analyse the condition of equipments. The
Literature review is based on the latest academically peer-reviewed journals and conference
papers that summarise various aspects related to the maintenance strategies planned preventive
maintenance and tools and techniques available for analyzing the condition of medical
equipments in planned preventive maintenance strategy. The basic element of this project is to
suggest the best maintenance strategy and its utilization of tools and techniques for inspecting
the medical equipment condition, working behaviour and many other factors of equipment.
Moreover, the utilization of these tools can be more efficient accurate and cost effective for the
maintenance and their results are also impact on the operation and quality of equipment. The
success of this dissertation is due to the validation after evaluation of the overall objectives and
the client’s requirements which were fulfilled satisfactorily.

3
Table of Contents
Tital ................................................................................................................ Error! Bookmark not defined.
Abstract .........................................................................................................................................................2
Chapter 1 Introduction...................................................................................................................................7
Introduction...................................................................................................................................................7
1.1.Overview / Background...........................................................................................................................7
1.2. Research Area.........................................................................................................................................7
1.3. Purpose and objectives of the project.....................................................................................................8
1.4. Research Methodology...........................................................................................................................8
1.5. Dissertation outline.................................................................................................................................8
Chapter 2 Literature review.........................................................................................................................10
Literature Review........................................................................................................................................10
2.1. Maintenance Management Concept .....................................................................................................10
2.2. Background ..........................................................................................................................................10
2.3.Maintenance Strategies..........................................................................................................................11
2.3.1.The Reactive strategy or (Corrective Maintenance (CM))............................................................12
2.3.2. Proactive Strategy (PM and CBM)................................................................................................13
2.3.2.1. Preventive Maintenance .............................................................................................................13
2.3.2.2.Conditioned-Based maintenance.................................................................................................14
2.3.3Aggressive Strategy (TPM).................................................................................................................16
2.3.3.1.Total productive maintenance .....................................................................................................16
2.4.3.2.Reliability-Centred Maintenance.................................................................................................17
2.5.Tools and Techniques that are Used in CBM.......................................................................................18
2.5.1. The Ultrasonic Analysis ................................................................................................................19
2.5.2.The Motor Current Signature Analysis .........................................................................................20
2.5.3.Vibration Monitoring Analysis ......................................................................................................20
2.5.4.Oil Analysis....................................................................................................................................21
2.5.5.Thermography ................................................................................................................................22
2.5.5.1.Contact Temperature Measurement ............................................................................................22
2.5.5.2.The Non-Contact Thermal Measurement...................................................................................22
2.5.5.2.1. Electromagnetic Spectrum.......................................................................................................23
2.5.5.2.2.Infrared Energy.........................................................................................................................23
2.5.5.2.3.Infrared Thermography (IRT) ..................................................................................................23
2.5.5.2.4.Infrared Image ..........................................................................................................................23

4
2.6.Conclusion.............................................................................................................................................23
Chapter 3: Methodology..............................................................................................................................25
3.1 Introduction.........................................................................................................................................25
3.1.1:Focus groups ..................................................................................................................................25
3.1.2: Direct observation .........................................................................................................................26
3.1.3: In-depth interviews........................................................................................................................26
3.2: Research Approach .............................................................................................................................26
3.3: Description of Methodology ................................................................................................................27
3.4: Data collection of maintenance practices used within SMBBMU.......................................................28
3.4.1: Data collection...............................................................................................................................28
3.4.2: Interview with SMBBMU personnel: ...........................................................................................29
3.4.3: Data collected from SMBBMU.....................................................................................................30
3.4.4: Available Maintenance Tools: ......................................................................................................30
3.5: Discussion:...........................................................................................................................................30
Chapter 4: Proposed Maintenance Solution ................................................................................................32
4.1:Analysis of approach to maintenance equipment..................................................................................32
4.1.1:Maintenance history of equipment.................................................................................................33
4.2: PLANNED PREVENTIVE MAINTENANCE ...................................................................................33
4.2.1 Scope..............................................................................................................................................33
4.2.2 Setting up a planned preventive maintenance system ....................................................................34
4.2.2.1 Equipment inventory...................................................................................................................34
4.2.2.2 Definition of maintenance task....................................................................................................34
4.2.2.3 Establishing intervals of maintenance.........................................................................................35
4.2.2.4 Personnel.....................................................................................................................................35
4.2.2.5 Reminder system.........................................................................................................................35
4.2.2.6 Special test equipment.................................................................................................................35
4.2.2.7 Technical library..........................................................................................................................36
4.2.2.8 Surveillance.................................................................................................................................37
4.2.2.9 Patient and worker safety ............................................................................................................37
4.3: Proposal for Training of Technicians for Medical ...............................................................................38
4.3.1Equipment Maintenance..................................................................................................................38
4.4: Analysis of overall condition of machine.............................................................................................39
4.5. Prediction of Fault................................................................................................................................41
4.6. Discussion and Decision Making.........................................................................................................41

5
Chapter 5: Project Evaluation and Conclusion............................................................................................43
5.1. Project Results evaluation according to Client Need. ..........................................................................43
5.2. Project Results evaluation V/s TOR objectives..................................................................................44
5.3. Project Results evaluation V/s Customer’s Feedback and approval. ...................................................45
5.4. Project Evaluation ...............................................................................................................................46
5.5. Complications Encountered/Limitations..............................................................................................46
5.6. Lessons Learnt......................................................................................................................................47
5.7. Data analysis and Maintenance recommendations...............................................................................47
5.8 Conclusion.............................................................................................................................................47
5.9 Further Research Recommendation. .....................................................................................................48
References...................................................................................................................................................49
Appendix A: TOR .......................................................................................................................................54
Appendix B:Gantt Chart ..............................................................................................................................60
Appendix C: Schedule Chart.....................................................................................................................610
Appendix D: Risk Specification................................................................................................................621
Appendix E: Client Approval letter..........................................................................................................636
Appendix F:Sponsor Evaluation ...............................................................................................................647
Appendix G: Student evaluation.................................................................................................................69
Appendix H: Meeting record with supervisor.............................................................................................71
Appendix
Appendix A: TOR
Appendix B: Gantt Chart
Appendix C: Schedule Chart
Appendix D: Risk specification
Appendix E: Client approval
Appendix F: Sponsor evaluation
Appendix G: Student evaluation
Appendix H: Meeting record with Supervisor

6
List of Acronyms;
SMBBMU Shaheed Mohtarma Benazir Bhutto Medical University
TPM Total preventive maintenance
TQM Total quality management
CM Corrective Maintenance
PM Preventive Maintenance
CBM conditioned based maintenance
TPM Total Productive Maintenance (TPM)
RCM Reliability Cantered Maintenance
IRT Infrared thermography

7
Chapter 1 Introduction
Introduction
In this first chapter of introduction major tasks are discussed and an overall overview of the all
elements components that will used in project from start till end. The focus of the research and
task will be according to clients requirement, the projects main objectives are explained in TOR .
1.1.Overview / Background
It is a fact that biomedical equipments are one of the fundamental source elements for the
deliverance of health services in recent day. In addition, the major contribution in healthcare
service in recent time is of equipments beside with drugs or other services, in last 100 years
health care system has seen rapid progress. Being basic need of healthcare in recent time
biomedical equipments are repeatedly being installed to increase the treatment capacities for the
primary healthcare. The huge deployment of equipments like x-ray ultrasound and laboratory
units is over exceeding , due to this increase in deployment equipments are not receiving proper
attention in terms of planning, maintenance and management. The developing countries are badly
facing this situation.
In recent time there are a lot of techniques which are practicing these techniques to improve their
management the techniques which are used widely are (TPM), (TQM) and (OEE). The (TPM) is
total preventive maintenance , (TQM) is total quality management and (OEE) is Overall
Equipment Effectiveness.
SMBBMU (Shaheed Muhtarma Benazir Bhutto Medical University) is a hospital and dealing
thousands of patients every day . It is lacking behind in this maintenance of biomedical
equipment as per schedule issues. Due to maintenance problem hospital is unable to deliver
proper health care and facilities attention to the patients.
1.2. Research Area.
Preventive and scheduled based maintenance is implemented widely in recent time; most of the
developed countries hospitals are using these strategies and are captivating advantages of these
maintenance based strategies. But in developing countries these strategies and their effective tool
and techniques are far to be used in proper manner , means these techniques of preventive based
maintenance are not used efficiently and effectively in the hospitals, engineers are not seeking

8
any benifit of them, yet a few numbers of techniques are being exercised and practiced for
precise maintenance of performances like we can say power check of equipment, proper
programming and heat and light system of the equipment, the calibration of equipment is done
after a week time but not in proper way without using proper procedure of calibration.
The aims are listed by the sponsor for the project:
1. The Literature review in detail on preventive based maintenance and on existing tools ,
techniques and maintenance strategies that are performed in maintenance.
2. improvement of anticipated for using techniques professionally, provided by SMBBMU
3. To confirm the possibility of the techniques using them in SMBBMU departments.
1.3. Purpose and objectives of the project
The objectives were set in TOR to measure the project achievements. The objectives are given
as below :
 Evaluate overall project. By comparing different approaches that are used by the hospital
for maintenance.
 Recommendation for feasible change in current maintenance approaches.
 Focused study on equipment maintenance requirement.
 Collect data from concern officials of the client.
 Evaluation of collected data for the sake of improvement in maintenance schedule
 Put together the recommendations on maintenance
 To identification of future research areas.
 Evaluate overall project
1.4. Research Methodology
The research data will be gathered from useful journals, conferences on condition-based
maintenance and their Tools and techniques to produce recommendation and the useful
conclusion.
1.5. Dissertation outline
The project comprises of five chapters which are as follows;
Chapter one it is a brief introduction of the research work methodologies and objectives of the
project.

9
Chapter two describes the brief literature review of area of research regarding the tools and
techniques that are used in maintenance, their use of concepts and professional way of
application in industry. The data is collected from different journals, articles, conferences and
through websites.
Chapter three centre of attention in this chapter is the methods, techniques and how enquiries
are done and extra need of the enquires and investigations.
Chapter four analysis of the collected data from the client, then discussion on collected data
suggestion of maintenance with respect to equipment condition.
Chapter five The project evaluation’s summary, recommendations, suggestion and limitations.
Evaluation of project in comparison with the aimed objectives.

10
Chapter 2 Literature review
Introduction
It is a known fact that equipment is an essential element for the delivery of health services. On
the other hand, in the past hundred years equipment has been a major contributor to the rapid
growth in healthcare sector. Despite its immense importance, it has not received proper attention
by the management and planners. This situation is found most commonly in developing
countries. A research conducted by the World Health Organization (WHO) and other health
organizations have highlighted the fact that 25% to 50% of all health equipment that exists in
developing countries cannot be used due to various reasons, seriously impeding efforts to
improve the delivery of health services to their people. While some of the idle equipment has
been donated, a significant amount of equipment is purchased with loans provided by agencies
and will have to be paid back with great amount of interest. While one of the major causes of the
equipment idleness is the lack of funds, expert analyses has shoen that the main reason behind all
this is improper management. More specifically, the lack of established policies, planning, and
maintenance of health equipment is the main challenge. Wang, B., (1989).
Literature Review
2.1. Maintenance Management Concept
The meaning of maintenance is defined as to maintain or to sustain, maintenance can be taken in
different ways or it is used in different ways and contexts as we can say thattaking care of any
thing comes in maintenance either we take care of our helth our relation or take this in technical
way that we take care of our gadget products cars etc. Updating of the machine or keep them in
running condition by simply checking their basic requirements. It is the combination of different
skill like technical and administrative actions. Thes action are taken to fulfil the equipments
requirement. (Telang, A.D and Telang, A, 2010)
2.2. Background
Maintenance has same history and age as humans got. Maintenance is adopted by tradition from
the moment when men initiated to make efforts for making life easier to live. These initial efforts
were like making hunt weapons, cutting trees and making clay pots. Maintenance is always been
prior requirement for any professional work. It is maintenance that compels all field professional
to keep their tools ready and keep them in proper order, such activities of professionals grew

11
swiftly after the demand of the industry. Primarily, hospital administration does not consider
maintenance as a required department; it was just considered as irrelevant task and overload
work. In 1930 Chicago gave first official recognition to maintenance. But due to industrial
recession it was neglected. (Fernandez, O and Labib, A.W, 2003)
After First World War hospital systems bit improved to give proper medical aid to wounded
soldiers and it improved with respect to technology but the system of maintenance remains the
same it became back on emphasis. After the second world war equipment maintenance was
recognized as essential efficient maintenance management system, during war time healthcare
system was not in good condition so due to war a lot casualties were brought to hospitals due to
this the demand of equips increased while simple equipment efficiency decreased. These sort of
problems has supported mechanization. Keeping these past misshapes the maintenance and care
of equipment. To prevent the breakdown of any equipment these preventive maintenance (PM)
concepts were given..it was era of 1960, when maintenance underway to grow which was the
sign for maintenance management growth like; department of planning and control, this sort of
management has improved maintenance in keeping control on practice and exploration of
different strategies and techniques. ( Moubray, J, 1992)
2.3.Maintenance Strategies
In recent years attention towards patient safety has increased. Hospitals are using different
techniques and strategies to meet the standard of health care system and give satisfied care to
patients. This only can happen with help of medical equipments. To get appropriate results from
the equipments, they require proper maintenance. To maintain the equipment there is variety of
techniques are used.
In the present day, a range of management techniques are in practice in hospitals these
techniques are known as (TPM) is Total quality management , (TQM) is Total preventive
maintenance , (ERP) is Enterprise resource planning , (MRP) is Material requirement planning,
(BPR) is Business process reengineering , (JIT) is Just in time , etc. (Sharma, R.K, Roorkee,
et.al., 2005 ).
There are few maintenance techniques that are used use in common to prevent any misshape are
total productive maintenance (TPM). Like (CM) is corrective maintenance, (CBM) is
conditioned based maintenance we also call it predictive maintenance, (PM) is preventive
maintenance and the (RCM) is reliability-cantered maintenance. These techniques are

12
categorized in manner like one is reactive strategy and the second is proactive strategy and the
third is aggressive strategy in which TPM and RCM are utilised. (Horner, R.M.W, et al., 1997),
(Pintelon, P, et al., 2006)
2.3.1.The Reactive strategy or (Corrective Maintenance (CM))
The basis of Reactive maintenance is breakdown of the equipment; to restore a failure of
equipment repairing is done to make equipment in function condition. This technique is
akwonldged as maintenance of failure or frequency based maintenance. Due to the breakdown
the equipment output becomes unstable and it increases the work load. Due to this maintenance
cost increases and proper health care is not delivered which exceeds the demand of patients. To
prevent this situation a maximum number of equipment should be in running condition. The
implementation of this strategy is an approach of action oriented. However, it is due to global
competition hospital officials that are required to think of efficient cost and regular maintenance
strategies. (Sharma, R.K, Roorkee, et.al., 2005 ).
The Reactive maintenance is appropriate to be used dispensary type hospitals where basic
equipments are used, the cost of maintenance is bit much expensive than the original price of the
equipment. After breakdown repairing may cause your equipment habitual of repairing. So, in
that situation it would be smartest decision to buy new equipment instead of repairing. (I.B, Utne,
2010).
Here are the advantages and disadvantages of Reactive Strategy.
Advantages
 Only breakdown incident would covered in reactive strategy. There is no need of
permanent staff for maintenance. This reduces the cost and other expenses.
 There are less chances of breakdown during installation of new equipment. So the cost of
maintenance and repair examined and other unwanted expenses are evaded.
 In this reactive case the objects are straight away replaced in particular cases, due to this
cost of labour and objects, items or the total cost for maintenance crosses the item cost.
So replacement would be better idea rather than investing money. (Slack, N, 2004),
Disadvantages
 Accidental breakdown of the equipment may cause high cost of equipment
 Break down of equipment require urgent repair or replacement so the Urgent
implantation, installation may cause more labour expenses.

13
 Wastage of money and time could be occurred during replacement or repairing of
equipment after breakdown.
 Attachment of the failure equipment may cause other equipment harm and resist them to
perform so this may increase the expenses and immediate repair and replacement of the
equipment.
 Maintenance means the time to time monitoring of equipment to prevent any misshape
but in this reactive maintenance action take place when they are required. This shows a
sign of conflict in maintenance. (Cooke, R, Paulsen, J, 1997)
2.3.2. Proactive Strategy (PM and CBM)
This Proactive strategy is well thought-out as preventive maintenance (PM) and Predictive or
condition-based maintenance. Such maintenance techniques and strategies are given in featured
as follows.
2.3.2.1. Preventive Maintenance
The Preventive maintenance is defined as regular and repetitive work done to retain equipment in
it good functioning condition in comparison to the corrective maintenance. This practice
improves the life and efficiency and accuracy of the equipment. This preventive maintenance
involves everyday routine cleaning testing lubricating, adjusting and calibrating, checking for
wear and tear and replacing of the equipment components to avoid the misshape or equipment
breakdown. The ratio of errors reduced with help of preventive maintenance. Due to this less the
number of errors takes place in the equipment. PM is effective, when the cost of maintenance is
less than the actual cost repair or replacement of the equipment. (Cooke, R, Paulsen, J, 1997)
The recommendation for the planned and the time based maintenance is referred by the PM. The
tasks for the Preventive maintenance takes place in accordance to programmed plane in regular
basis. Everything has advantages and disadvantages so few are given as under for the PM
preventive maintenance. (Horner, R.M.W, et al., 1997),

14
Advantages
 The planning and performance of Preventive maintenance can be altered with its ease.
 Due Preventive maintenance cost of repairing and maintenance reduces by decreasing
significant damages to the equipment.
 Preventive maintenance reduces the breakdown of the equipment.
As one thing has advantages so it has disadvantage also so preventive maintenance has some
disadvantages
Disadvantages
 A much number of unwanted tasks are performed to maintain the condition of equipment
which is much time consuming.
 Human error could cause unwanted situation during preventive maintenance.
 The extra labour and a number of spare parts are required in planned preventive
maintenance.
2.3.2.2.Conditioned-Based maintenance
The Condition based maintenance (CBM) is defined as manual or work based
maintenance. This type of maintenance is suppose to repair or replace the equipment in present
condition of equipment or in future, some modification are done regarding performance of the
equipment which is essential cause of maintenance. In situation like condition-based
maintenance the equipment differs from simple checks and inspections assess the condition of
equipment the multiplicity of monitoring tolls to be used. The main intention of CBM is to
lessen the expenses used for the inspections and repairing work by gathering data continually
concerning to the functioning condition of the equipment. (Bengtsson, M, et al., 2007),
(Baek,J.G, 2007)

15
In present time hospitals , the status and preference to employing maintenance strategies
as CBM in charge to propose a choice regarding maintenance the decision will evaluated
through the collected data through condition observation. The fundamental condition of CBM is
to reduce the cost of maintenance and to progress efficiency and performance of equipment by
minimizing the failures and the impact of failures. At present, a range of different sensors and
monitors are use to monitor and documentation data like; vibration, temperature, sound, pressure
and lubrication etc, to find out the current physical performance of equipment. A number of
techniques are introduced like; dignosing of evaluation of health and signal processing, research
is in progress to accomplish the desires of CBM. (Bengtsson, M, 2004)
The are few advantages and disadvantages are described as under
Advantages
 For the practical maintenance cost the most suitable strategy is of condition based
maintenance.
 Main focus of CBM activities is to evade equipment failure.
 Spare parts inventory is always ready in CBM so there is no need to make list of parts
availability when any incident occurs.
 Breakdown of equipment is limited in CBM strategy.
 Expenses decreases due to proper monitoring of equipment in CBM
 On time and Proper maintenance increase the life of equipment.
 efficiency and quality of equipment increases.
: <http:// www.vibrosystm.com/pdf/OLM_JUST.PDF/> [Accessed 23 Feb 2011].
Subsequent are the few disadvantages of condition-based maintenance.
Disadvantages
 By buying equipments for diagnosing the cost is increased.
 Staff trainer and staff trainings are required to be aware of the tools and techniques.
 There could be serious breakdown of equipment because there isn’t any warning of
breakdown.

16
 A number of standby maintenance team will be required and will cause cost losses if any
unwanted misshape or breakdown happens again and again.
 A jam of funds by keeping a huge stock of spares part when breakdown of equipment
undecided.
 A stand by plant for this required required.
Available at: <http://preventive-predictive-maintenance.blogspot.com/2010/01/predictive-
maintenance-implementation.html> [Accessed 23 Feb. 2011]
2.3.3Aggressive Strategy (TPM)
2.3.3.1.Total productive maintenance
Japanese scholars have worked a lot on Total Productive Maintenance. TPM is explained is
entire useful maintenance retaining of any equipment, machine or product. It is been used in
every part of life. TPM concept is basically encouraged by the Japanese institutions the vice
chairman of one of the Japanese institute knwn by maintenance by Nakajhima, he has done a
lot of work on the maintenance he is known as the father of maintenance strategies like TPM.
TPM. Nakajhima has defined maintenance in following points. (McKone, K.E, 1999)
 It stresses the most efficient use of equipments
 It sets ups a structure where preventive maintenance, and related maintenance is
enhanced.
 TPM is the collection of the whole management of technical side of the company like ;
designers and operators of the equipment and maintenance department labour.
(Blanchard, B.S, 1997)
Furthermore Edward Willmott from UK explained TPM. Study of maintenance practise is in UK
because of Edwards willmootts efforts. He has great contribution in promoting the TPM through
his literature. His literature was in support of all above discussed point but he himself has give
few more points to improve manufacturing quality in west.
 To acquire the standards of performance TPM search for efficiency of equipment and
process.

17
 The dynamic participation of the equipment operator improves the TPM.
 TPM is used to improve product quality, to avoid waste in between maintenance and
production, manufacturing cost reduced, increase equipment accessibility, maintenance
improves by decrease in breakdown or failure of equipment.(Bamber, C.J, et al.,1998)
2.4.3.2.Reliability-Centred Maintenance
RCM is the methodology that is exercised to improve the production and the utmost utiliation of
techniques like preventive maintenance and predictive maintenance. These programs are used to
improve the efficiency and helps equipment to work long lasting means increase the life time
like; (uptime, reliability, performance and quality) whilst spotibg on cost reduction of the
maintenance. The approach of RCM, is to maintain the objective of the system function as a
substitute of repairing finding the defects when problems occurs in equipment and then RCM
takes measure to bring back the equipment to its ultimate functioning condition. In recent days
great changes and prospect regarding maintenance has occurred due to RCM in operational
industries. The proper precedence to safeguard system function is given by the RCM. To bring
back that precedence a number of failure sources that compose purposes letdown. In accordance
to show importance of operations to notify the action causes. So, different tools like (FMEA)
Failure mode effect analysis (FTA) fault tree analysis are used in RCM to make maintenance
system more capable. (Tsang, H.C.A, 1995), (Sharma, R.K, Roorkee, et.al., 2005 ) in other word
RCM is explained
To find out the risk and risk of equipment system failure RCM technique is used. By this RCM
technique we can spot the unseen failures of equipment and we can asses and identify the faults
so to minimize the failure impact on the equipment. (Narayan, V, 1998)
Here are few RCM’s basic principles;
 Function oriented. It defines as the involvement in assembly system in functioning
condition or in practical condition.
 Device group persistent. generally functions of the system are spotted focused in its place
of repairing particular device.
 Reliability centred. By using failure statics Comparison between operating age and failure
period is done in a actual way. RCM search for the odds of breakdown at precise periods
and even not exceptionally alarmed with effortless breakdown rate.

18
 recognizing design restrictions. A level given by design is attain and maintained by the
RCM. The main objective of RCM is to maintain the natural uniformity of designed
equipment; instead of the maintenance known for that modification in consistency is the
area of design.
 Safety and economics. Cost effectiveness will be significant factor but Safety must be
certain at any cost.
 unacceptable condition for failure. as a result, failure could be any a breakdown of proper
function or may be a failure of supplying satisfactory quality.
 Usage of logic tree for monitoring the tasks of maintenance. For maintenance of all
kinds of the equipment, it is a reliable approach.
 Valid tasks . all the tasks should dealt with the breakdown mode and look upon as the
breakdown mode features.
 Efficient tasks. Chances of failures must decreased and the system should be cost
effective.
 Types of maintenance regarding maintenance failure. The cycle of the task should be in
condition based. The meaning full decision in the proper and appropriate equipment in
the RCM.
 A alive system. Data is collected to give proper result to improve the maintenance. This
reaction is a important part of the Proactive Maintenance constituent of the RCM
program.
Available at: <http://www.ebme.co.uk/arts/rcm/index.htm> [Accessed 23 Feb 2011]
2.5.Tools and Techniques that are Used in CBM
Tools and techniques plays important part in CBM, discussion of several tools and techniques
will be carried out in this part and these tools and techniques are discussed and observed. The
tools and techniques are measured as the most helpful for getting the desired objectives and
goals. Each one of technique is particular for definite type of equipment, so it is easy to classify
the core problem in appropriate manner. Problems like this can be classified as;
Improper alignment, distort or unbalance , damaged gears, shortage of lubrications, contaminated
oil , loose fitting of electrical connections, power shorting. (IAEA, 2007)
Every machine, equipment has its own practical boundaries to get monitored so it is significant to
be conscious of these Condition monitoring techniques. The most effective and reliable condition

19
based techniques of human observations are used manufacturing industries. These human
observations are visual observation, listening and touching. There is a number of technologies
that could be adopted as element of a whole CBM programme. It is since when manufacturing
industries are dealing with mechanical systems or machines then theses condition based
maintenance based techniques are required for a successful programme. following techniques are
the main techniques:
 The Ultrasonic Analysis
 Motor Current Signature Analysis
 Vibration monitoring analysis.
 Oil Analysis
 Thermography.
 Other non-destructive testing techniques.
2.5.1. The Ultrasonic Analysis
Ultrasonic or ultrasound waves are sound waves that has frequency of >20 KHz. These are also
known as ultrasound waves and are used in most efficient electrical and mechanical equips to
sense pressure in fluid state. This is used for sensing high pitched vibrant noise, with the help of
this in which most efficient mechanical devices points out the defects in contact plane and the
biased obstruction could be detected if the device produces most efficient ultrasonic sound in
most efficient pressure fluids. The level of frequency level could be identified with use of a
scanning device that interpret the ultrasound, in that way identifying any corrosion in given
mechanical equipments. (IAEA, 2007)
This sort of techniques could be positive with these sort of systems, hydraulic, steam, vacuum
and bearings systems, but there is a bit problem that it usually fails in identifying weakly seated
valves, leakage of air and steam. This Ultrasonic analysis technique is useful and easy to use and
much cost efficient but sensitive scanners are the for most requirement so that can detect least
frequency of noise, for this trained staff is required for the monitoring and analysis. This
technique has few restriction regarding usage. This can be usable with equip that construct ultra
sonic sounds and those should be measurable sounds. (IAEA, 2007)

20
2.5.2.The Motor Current Signature Analysis
This technique converts one form of the energy in to the other form of the energy that is why it is
slightly complicated in nature. This conversion of energies from one form to another is done with
the help of the transducer. In these techniques the conversion of vibrations into electrical current
is done. So the use of this technique is to identifying the major defects like electrical defects and
mechanical defects from rotating equipments which are forced by motor.
To sense the current a current sensing devices is required like ammeter to record variations. To
use this and to record the vibrations well trained staff will be required. This current sensing
device will be used in internal parts of the equipment winding of equipment, any damage like
misalignme. (IAEA, 2007)
2.5.3.Vibration Monitoring Analysis
The analysis of vibration mode is exercised for the modal analysis. The vibration testing is done
to gather collect the instrument data to analyse the results. Force and resonat are the two different
types of the vibration analysis. Forced vibrations are described as the a handsome amount of
force applied to the mechanical system like external loads on the system, machine misbalances’,
excitation due to internal forces are executed. The resonant vibrations is explained and defined as
first input energises the system and then it allow system to vibrate. (Tsang, A.H.C, 1995)
All through vibration analysis the output is like a aspect of high signal frequency in which there
are different single frequencies. To find out the vibration range of the used equipment in
compatibility to prevent and maintain a new equipment for long time period. The assessment of
the vibration range from new equipment besides the one which is used equipment which was
used and this assessment will give necessary basics to know how to improve the maintenance
skills and to improve continuation as it is essential. The vibration analysis is dependent of the
consistent recordings, the constancy of amplitude and measured frequencies. With the help of
this we can identify the shocking alignment, misbalancing, poor maintenance and severe
functioning condition. The use of this analysis is carried out in many application of maintenance.
(Jardine, A.K.S, 1993)
Cost reduction can be considered in this practice. With help of this technique functioning time of
instrument could be delayed by few months which is a lot percentage like 50 to 100 of per annum
cost. The use of apparatus would be taken at required and comprehensive period and this act will
increase the equipments accessibility.

21
Vibration analysis has certain limitations like it requires an supplementary manpower and the
method of this is fairly complexes. It also has certain limitations to certain functions and
apparatus is costly, but it is reasonable to utilize with introduction of PDA but most of the
companies are yet not ready to function this technique.
The Equipments which are required to analysis and to perform are signal raise up devices and
signal recording devices, signal analyzer, computer and its software can record the data. (Tsang,
A.H.C, 1995)
2.5.4.Oil Analysis
In the condition based maintenance oil analysis classified the rate of contamination or constituent
part in oil. Contamination can be caused by the different minerals water particals and other
vegitable substances. To find out the results analysis of oil sample taken from the machine
equipment to indicate the appropriateness for supplementary use and it gives information
regarding the condition of constituent parts of the equipment. Viscosity of oil could be done in
manner like low or high. The Low viscosity shows that oil has lost its ability of sealing and
contamination control and the high viscosity point out a high level of contaminants are in the oil.
(Macián, V, et al., 2003)
This process of identifying the problem in machine is very much similar to human body blood
circulating system which helps in diagnosing the disease. Transformers and oil lubricating
circuit breakers are the example of oil analysis in these carbon sets down which are formed
underswiting after oil analysis.
Inspection of collected oil from machinery goes through chemical and physical inspection. This
inspection of oil detects upcoming possible mechanical issues, by which we can produce plan for
preventative measures to prevent misshape and machine failure. The equipments which are
under major consideration are engines, gearboxes etc. With effective and appropriate
inspectionsa equipment availability would be improved and will be able to reduce the
unscheduled repairs costs and equipment failure. Oil analysis classifies the imperfections in oil
choice, unsuitable managing techniques, the filtering system and inappropriate maintenance.
With the help of this technique we can cut down unnecessary load and can increase the operating
procedures on equipment. (Sharma, B, 2008)
Exact analysis is the main advantage of this technique, significance and location of equipment
problem. It predicts the failure of machine and informs us about the rectification of the particular

22
breakdown component. This technique is only can performed on circulating oil system
equipment it takes various tests of oil samples and is expensive too it need reliable and suitable
sample. (IAEA, 2007)
2.5.5.Thermography
Different technologies are used for measurement but the thermal measurement technology
classifies the entire or comparative temperatures of the basic parts of the equipment in other
words the simple and important parts of equipment are monitored. With use of an odd
temperature of the equipment points out initial problems. In thermography the maintenance of
equipment is dependent to the thermal behaviour and to the temperature. Due to these basic
reasons the temperature is suppose to be the key to the success in maintenance for any plant and
that is considered as complete measured quantity. Two types of equipments are used in this
technology; one is contact and second is non-contact. In contact measurement we measure
temperature by using thermometers and thermocouples; these thermometer and thermocouples
are normally used in so many applications. Though, infrared sensors are used in non-contact
measurement with more attractive and alternative usual methods. (Lo, T.Y, 2004)
The few methods are illustrated as follows ;
2.5.5.1.Contact Temperature Measurement
Measurement of inner temperature or surface temperature is concerned with contact temperature
measurement by sensing conducted heat energy. To measure temperature in earlier days, two
different types of thermometers were used one was mercury and other was alcohol thermometer.
Both thermometers of bimetallic are utilized for the temperature measurement. The expansion of
two different metals is taking place in bimetallic thermometer. This would be observed when a
bimetallic thermometer is connected with metal having different temperature. And
thermocouples functions on electrical principles. In thermocouple two welded different metals at
the same side same end voltage outcomes are comparative for complete temperature. In certain
range thermocouples gives extremely perfect temperature measurement. (IAEA, 2007)
2.5.5.2.The Non-Contact Thermal Measurement
To explain it there are few fundamental perceptions are given as under:
 Electromagnetic spectrum.
 Infrared energy.
 Infrared thermography.
 Infrared image.

23
2.5.5.2.1. Electromagnetic Spectrum
The term radiation of electromagnetic or electromagnetic radiation is described that it has lengthy
wavelength in comparison observable light. Electromagnetic radiation has so many types like
frequency based rays and waves like radio waves, ultraviolet rays, x-rays etc. These spectrums
are categorized by their respective wavelengths or occurrence. So, with the help of frequencies
or with different wavelengths these electromagnetic radiation temperatures are calculated.(IAEA,
2007)
2.5.5.2.2.Infrared Energy
As it is well known that, the discharge of infrared emission from all objects as element of their
comparative temperature. With the motion of atoms molecules Infrared energy is produced.
Release of radiation is directly proportional to temperature. Infrared cameras are used to detect
the radiation energy . These cameras only detects thermal radiation, they are not able to detect
temperatures. (Tsang, A.H.C, 1995)
2.5.5.2.3.Infrared Thermography (IRT)
The measurement of radiant thermal energy release from the object and it is defined as infrared
thermography. Different heat variations are required to sense the thermographer.
The execution of invisible infrared light image is done in infrared thermography
This is happening because of free shell or surface which is appropriate to the thermal state
(Tsang, A.H.C, 1995)
2.5.5.2.4.Infrared Image
Radiosity is characterized as the approach of infrared energy as of position adjusted by the
dominant atmosphere. It is stands of free reproduce and occasionally transmitted IR energy. IR
takes screening images of the radiosity. It has an electrical tape is placed on the bus bar by the
thermographer to examine the temperature exactly for solid substance. (Tsang, A.H.C, 1995)
2.6.Conclusion
Maintenance is the basic requirement of any organization to survive in market with quality of
standards. Every organization need a maintenance technique which is in its favour. For my client
the planned preventive maintenance would be the reliable and will be better than other

24
techniques in comparison. It very much cost effective. The planned maintenance is better for
hospitals because its maintenance strategy is for most need of equipments. This maintenance is
preventive maintenance if this maintenance is practiced regularly there would be less chance of
any misshape. This strategy enhanced the efficiency of the equipment and increase accuracy in
output.
Furthermore, there is variety of option is present regarding planned preventive
maintenance tools and techniques. This technique helps technician to recognise and predict the
fault in equipment. This technique compels to equipment operator to learn basic regular
equipment maintenance. This planned preventive maintenance is source for equipment longer
life. This maintenance technique reduces the chances of equipment breakdown or any other loss
or other incident.
This research project is highlighting the planned preventive maintenance to be the proposed
maintenance strategy. The research has briefly described the tools and techniques of the
maintenance and has give all supportive date regarding their advantages and disadvantages. The
recommendation of this maintenance technique and its implementation will be beneficial for the
client.

25
Chapter 3: Methodology
In this chapter the related issues will be discussed regarding project’s methodology.
3.1 Introduction
The word methodology is defined as the tactic or a proper set of practices. This is to realize the
proper use of theoretical and practical aspects in the project. To execute any project a proper
methodology is essential part of it. There are two essential types of research one is quantitative
and other is qualitative. There is bit of difference in between them.
Quantitative research: this type of research deals with the number of things like counting things
and measuring thing by estimating their differences and averages in between the groups. (Like
maintenance of the equipment with two different techniques)
Qualitative research: this type research deals with deep interest in the understanding of any
problem and its impact on the beliefs and knowledge and behaviour. (Like why people get
involved in decision making for their aims and goals.).
The research that will be carried out in this project is qualitative. In this research methodology
the new concepts will be produced to improve the maintenance of equipment by applying new
planned maintenance tools. The reason of selecting qualitative research is that this research tends
to subject to deeply involved in study to produce accurate view point in response to any query or
question. This provides a very informative and valuable ideas and answer to few research
queries.
The three main methods that helps in collecting data for qualitative research are as under
Focus group
Direct observation
In depth interviews
3.1.1:Focus groups
A number of concern topics and subject is collected to analyse the interest of the selected topic.

26
In this method discussion is carried out to explore the proper range and impact of the data that
was collected for the topic. This method helps a lot in finding out the main point for the selected
topic.
3.1.2: Direct observation
In this method we collect data from other researcher or observer too to get in the depth of the
topic for delivering it in much clear detailed understood data, so that most of the readers can
understand the theme of the topic. In this method researcher physical practices the things to clear
his concepts and finds out the difficulties and queries. Like to observe the job of a male nurse in
the hospitals researcher do the job of male nurse to observe the difficulties that they faces during
duty.
3.1.3: In-depth interviews
This method is same like focus group but the pattern of this method is bit different from the focus
group. In this method the concern personnel are individually interviewed. In this method no
formal questions are asked. In this interview the concern person is asked to mention real even
instead of giving generalizations. This is how researcher come to conclusive point after
interviewing all of the concern personnel individually.
There more few methods that are used in qualitative research like diary method, case study
method, problems and check list. These methods helps the researcher to find out the solution to
the problem.
Research approach
Description of methodology
The gathering of information from SMBBMU staff about current maintenance strategy.
The gathering of information about the tools and techniques that are used for planned -based
maintenance.
In this chapter different techniques will be discussed to get the best solution by analysing the
different researches and practices regarding maintenance.
3.2: Research Approach
The first approach to any research is an idea about research. This approach of producing any
research model in mind is like first step accomplish of research questioner. As any research starts

27
it has to go through a lot different questions. By studying most of research of papers they got this
sort of questioner. So few questions came up regarding research that are
What is the basis, need for the research?
What sort of data I should gather to produce a proper and right solution? type of information
shall I gather to come up with a design solution? The collection of data regarding current
situation of the hospital and the tools and techniques that are used for planned preventive
maintenance.
What will be the positive and negative facts of this research?
What sources will be used for gathering all information?
After completion of the research model, analysis of the planned preventive maintenance
management method will be the next phase of this project. The research approach will be
qualitative and all concepts terminologies will be taken from different source like journals
publication of different authors from different sites like emerald, science direct IEEE journals
and webs that can help in extracting data regarding maintenance. By getting all this material n
data will search for current maintenance practices that are going on in different leading hospitals
in the developed countries and then will look for current maintenance strategy that is being used
in SMBBMU for maintenance of their equipments. The collection of the possible given
information and data will be the main goal to achieve. The whole research material patterns,
practices, investigation are described in detailed below. This diagram will clarify the project
main aspect like research and practical.
3.3: Description of Methodology
Research section 1: Maintenance strategy and Tools
and Techniques of Planned preventive Maintenance
 Literature review
R
e
s
e
a
r
c
h

28
------ ----- -------------------------------------------------------------------- -------------------
Figure 3.1. Description of Methodology
3.4: Data collection of maintenance practices used within SMBBMU
3.4.1: Data collection:
1. Data was collected through telephonic interviews to be aware of the current maintenance
performance.
Research section 2: Study of Planned preventive maintenance and its
Tool and techniques
 Data collection method, Interviews and Observation
Face-to-face interviews
Observation
Face-to-face interviews
Observation
After observation to provide current condition of
machine and to provide suggestions and
recommendations for effective maintenanceP
r
a
c
t
i
c
a
l
Deliverables to client
 A brief report on the planned preventive maintenance for equipments
which are available within SMBBMU, after collected data analysis.

29
2. All data was gathered via telephonic interviews regarding current maintenance practices in the
hospitals.
3. Lack of proper maintenance was observed after analysis of collected data.
4. No proper documentation was not in use for scheduling of maintenance.
5. No previous maintenance record was present.
3.4.2: Interview with SMBBMU personnel:
All the interviews were conducted via telephonic source from all the maintenance engineers who
were the head of the maintenance department. The interview was not that much formal so there
was no such questioner was produced. The reason of interviews was to collect data regarding
equipment and their maintenance procedures. To analyse the current methods and techniques
which are used for maintenance procedure for all medical equipment, to point out the problems
that are being faced in maintenance practices and their proper resource utilization which are
available? The interviews were conducted from all responsible who were performing their duties
in their respective maintenance section.
Due to time difference in between Pakistan and UK it was hard to talk to all official personnel.
There was no proper timing to get in touch with them but with lots efforts this problem has been
solved. There are six different laboratories and several operation theatres available in SMBBMU
and all six departments and operation theatres has almost different equipment to get on work but
with the help of Head of the maintenance department all issues were solved. Head of
maintenance department has arranged timing with each of the concern maintenance personnel to
help me out in getting the proper data regarding their maintenance procedures. During interview I
asked them about their current maintenance techniques and their practices. The SMBBMU is
using much more advanced medical equipment. They have different laboratories in every
department. Every personnel to whom I interviewed told me that they are practicing condition
and planned maintenance to keep their equipments updated. They do have plans for the
maintenance of equipments. By interviewing all of them the conclusion came to this point that
there was no proper procedure that they were carrying for maintenance which was in practice.
Due to huge number of patients they were not able to follow the maintenance procedure for the
equipment. The hospital is dealing more than huge number of patients every day. Head of
department informed during the interview that they follow some of the techniques of
maintenance like they do calibration of their equips every weekend. Equipment like CT scan
MRI are calibrated with due time and other radiology equips like x-ray ultrasound are kept up to

30
date before use. They just require their power plug inn set or they are meant to check before use.
The laboratory of each department is well equipped. I asked them about their current
maintenance strategy in SMBBMU. Head of department told me that we follow condition based
maintenance. I asked from radiology department head of department about their current
maintenance strategy then he replied that this lab is new so we have all equipment under
warranty if there any problem or uncertainty occurs we will contact to the company and they will
repair the equip or they will replace the equip but for normal routine we follow preventive
maintenance to keep our equipment updated for the normal use. There is wide range of medical
equipment is used to facilitate the patients but the strategies for the maintenance are not that
much effective. There are different section and different laboratories in SMBBMU and
interviews are done with most of their officials heads and maintenance officials.
3.4.3: Data collected from SMBBMU
In all laboratories of SMBBMU and operation theatres condition based maintenance and
preventive maintenance strategies were common, in few laboratories reactive maintenance was
carried out. During interviews I asked each official from each department regarding their
maintenance tools and techniques. The maintenance kit that they are using in laboratory to update
the equipment for better output. They were using basic maintenance tools like Ammeter volt
meter oscilloscopes and some screw drivers kit. They were using pressure meter, flow meter as a
calibration kit in the radiology department.
3.4.4: Available Maintenance Tools:
The SMBBMU is using collective maintenance tools regarding their demand of equipment
maintenance. The tools they use for their common maintenance are like screw drives ammeters
voltmeters to just check their equipment condition either it is in condition of working or not. For
laboratories like radiology and operation theatres they use pressure and flow meters. In operation
theatres they use preventive maintenance kit. They do weekly and monthly maintenance of all
useful equipments. All equipment are in much more in use so each and every equipment require
proper maintenance to be operated which is lacking in SMBBMU.
3.5: Discussion:
As the SMBBMU is semi government hospitals so it is suppose to fulfil the paitient demand but
the sum of my interviews is that due to lack of proper maintenance strategy equipments are not
being used as they needed to be used. A lot of equipment are not in working condition at the
moment in the hospitals so hospital buy new equips to reach the demand of the public patients. A

31
proper maintenance plan and strategy is needed to reduce these expenses and to make most out of
these unused equipments. By comparing all laboratories and operation theatres has some critical
equipments which require proper and regular maintenance strategy. SMBBMU need to improve
their maintenance practices to meet the demand and to provide a better health cure to needy
patients. This is possible for SMBBMU to improve their current policies for maintenance by
providing proper training and education to their technicians and operators to stand by shoulder to
shoulder with leading hospitals of the developed countries. This can be only possible with whole
hearted efforts of governing management of the SMBBMU to overcome on these week laps of
maintenance by implementing a proper maintenance strategy.

32
Chapter 4: Proposed Maintenance Solution
In this chapter a brief discussion of maintenance will be carried out by giving all possible
solutions utilizing planned preventive maintenance and all of its tools strategies and techniques.
Maintenance is like life source to every equipment and all tools and techniques of maintenance
are greater sources for the equipment health, with this equipment efficiency improves and all
unwanted costs like repairing and all misshapes would be prevented. Maintenance makes perfect
and it increase the life of the equipment. The life of equipment is totally dependent of the proper
and regular maintenance. To precede proposed solution of maintenance few useful outlines will
be analysed which are detailed below:
 Analysis of approach to maintenance equipment.
 Analysis of planned preventive maintenance
 Proposal for Training Of Technicians For Medical Equipment Maintenance
 analysis of overall condition of machine
 Prediction of fault
 Discussion and decision making
The proper facts of maintenance strategies will be explained further and all flaws will be
discussed to produce an effective solution for better maintenance plan.
4.1:Analysis of approach to maintenance equipment.
A proper maintenance strategy is very much essential for any kind of equipment. Maintenance is
used to keep equipment in sustaining and working condition and it keep quite good impact on
equipment quality of output. There are so many obstacles that compels for the proper
maintenance of equipment. These maintenance problems gets complicated if they are kept
ignored so proper and regular maintenance is must for medical equipments. As day by day new
inventions and creation are taking place in the field of health care but situation of maintenance is
getting worst in the developing countries in the field of health care. In these developing countries
they have two mainly sources for maintenance one source is the company from they buy
equipment and they totally rely on that company for maintenance of equipment and this varies
their expenses. Second approach is the common technician who do not have any knowledge
regarding the equipment and the customer demands technicians to repair the equipment. This is
only because of lack of knowledge in their technical staff. A proper training is must before hiring
any technical staff for maintenance of the equipment. A busy hospital need their equipment in
working condition so they need someone who can take care of their equipment and keep

33
equipment in working condition by providing a proper maintenance that a equipment requires
before use or after use. Maintenance of equipment is very much essential to take most out of it. If
suppose any minor problem occurs in the equipment and hospital is facing huge number patients
so they need a proper technician who knows how to repair the equipment will save your time and
reputation and will benefit you. If your technician does not know anything about equipment it
will be costly for you to hire another technician or to concern to company for repair and company
will take time to repair it and this will cost you reputation loss and will increase your expenses
too. It is necessary to have trained technician for the maintenance of the equipment. It is because
of less number of proper technical staff the maintenance standards of hospital has fallen down.
So the proper training of maintenance of equipment should be given to all who operates the
equipment and as well as to technicians too.
4.1.1:Maintenance history of equipment
Maintenance is very much essential for equipment to fulfil the patients and doctor’s demand.
Regular maintenance of equipment keeps you aware of the history of the equipment and you can
predict the fault and errors in the equipment. The service record of equipment is quite helpful in
terms of diagnosing fault and errors in the equipment. Maintenance history of equipment helps
you in setting standard and consideration about equipment history tells you about the life and
efficiency of equipment that how capable and long lasting this equipment is. As today’s time
almost all health care equipment are computerised and they a memory chip inside them in which
they keep their work history and their repairing data. Today’s equipments are compact and bit
easy to use but bit difficult to diagnose the fault. It is difficult to repair or operate except the
trained technician or the trained operator. The operator of equipment must be trained to perform
the simple regular routine maintenance of equipment. This practice of regular maintenance will
reduce the number of faults and will prevent equipment from breakdown. This is what happening
in developed countries and need to promote this in developing countries to develop this
maintenance pattern in the equipment operators to improve the standards of health care.
4.2: PLANNED PREVENTIVE MAINTENANCE
4.2.1 Scope
A regular and repetitive maintenance of any equipment is carried out to sustain and stabilise the
good working condition and to improve the efficiency, accuracy of equipment to give proper
output is known as planned preventive maintenance. This planned preventive maintenance is
combination of small regular activities like adjustment, calibration, tests lubrication check,

34
routine cleaning, checking of power plug and wear tears and the replacement of part sans
components to evade the chances of equipment breakdown. In planned preventive maintenance
including of the proper choice for selection of equipment is referred by the productive preventive
maintenance. What choices should be made to find out to lessen the cost and those economical
units which are not part of planned preventive maintenance can easily be repaired or easily
replaced in case they break down. Cost effectiveness is the prime consideration. Full involvement
and dedication of the operator towards the equipment is the prime aspect regarding planned
preventive maintenance. The preventive maintenance is totally dependent of the operator and this
is all operators’ responsibility to take care of the equipment by keeping preventive maintenance
strategy in mind. Regular use of preventive maintenance by both operator and technical
personnel. This preventive maintenance should be regularly weekly monthly performed by the
technical staff to avoid any mishap. Operator technician and engineers are suppose to follow the
preventive maintenance strategy for the life of equipment. Operator must perform it regularly,
technician must perform it weekly and monthly and engineer must perform thi after every six
months or before six months if needed.
4.2.2 Setting up a planned preventive maintenance system
To improve the effectiveness and efficiency of planned preventive maintenance computerised
filing system is required. The manual system of record may not keep the proper data of
equipment so the system should be computerised to keep the history and record. This system of
planned preventive maintenance necessitate the few point which are discussed as under:
4.2.2.1 Equipment inventory
A system should be produced to keep all record of hospital regarding equipment. A pass or a
card system should be introduced on which all equipment numbers must be entitled which are in
working condition or in spare at workshops. The card system will help the staff in checking the
repair and maintenance history of equipment. The card must keep equipment number and all data
regarding equipment to minimise the work load.
4.2.2.2 Definition of maintenance task
The maintenance task is defined in simple word as; all the task that are carried out in the terms of
maintenance and the repairing of equipment must be kept as a record to find out the condition of
the equipment that either this equipment is in order to use or out of order. This all can be done by
seeking knowledge from literature guide and through product information.

35
4.2.2.3 Establishing intervals of maintenance
A proper procedure must be produced for maintenance scheduling. After getting know how about
all equipment available at hospital a systematic task must be produced that what to do first what
to do after. All heavily used equipment must be checked and cleaned as a first priority rather than
cleaning those equipment which are less in use. The system must suggest the referral of
manufacturer literature guide for use, but operator of an equipment must perform maintenance
procedure which is required. Operator can use Planned preventive maintenance as user guide.
4.2.2.4 Personnel
A list of qualified staff who knows how to do preventive maintenance must be available. This list
must be scheduled according to shifts and presence of the technical staff. According to assigned
duty list of staff, the staff who is on duty must know what to do and what not to. All tasks should
be placed on notice board for the duty staff as daily order of the assigned tasks. All staff should
be trained and must know their duty. Duty staff must be experienced and must be familiar with
all equipment that is in his duty premises. Duty staff can easily give training to new comers who
are on internships.
4.2.2.5 Reminder system
The maintenance of medical equipment or any other instrument is mean to be a continuous
process. When any equipment is invented any and brought in to the market to use right from that
time the program of that equipment must continue. This might be needed to build up reminder
system in equipment. This reminder system then will help the operator to inform about those who
has been performed earlier. To build up reminder system we can use card index system or any
software program through computer to record the data for preventive maintenance of
equipment’s each item. This reminder system helps the operator in identifying the error in
equipment. This reminder system needs to be scheduled for weeksly and monthly basis.
4.2.2.6 Special test equipment
The technical staff and the operator of the equipment must be equipped with full maintenance kit
to check electric safety standards, the condition of equipment and to make sure that equipment is
in condition of use or not. There is different frequency level of each continent and they different
brand specifications. The equipment with different specification have a certain electrical
standards to be tested. These basic electrical test defines the compatibility of equipment
according to international electro technical commission. All handling of equipment is done by a
fully trained technician to do different test and to measure the all values to find out the fault
conditions. Different types of equipments are used to assess whether, like analyser simulators and

36
calibrators. In both developed countries like UK and USA they have two different equipment for
calibration in USA they used Bio-Tek and in UK they use Ultra medic. With help this can check
the functioning of ventilators and the calibration is done of all intensive care units equipment that
are used for monitoring purpose. A different range of analysers is used to find out the efficiency
of the equipment like defibrillator, Ultrasonic phototherapy and al instrument that are used in
electro surgery. For the assessment of the infusion device a special kind of analyser is developed
and due to low flow rate this analyser is been difficult till now. Due to this it is not suitable to be
used in maintenance department at lower level this can be used in those departs which are fully
equipped and these maintenance departs must of provincial level or national level. The items that
are used for testing of equipment are as under:
 Multimeters: this is used to measure the current of equipment. It has digital display and
clamps with wich one can measure the current.
 Milliampere meter: this used to measure the milliamperes
 Line resistance meter: this is used for low value to measure the requirements of
equipments.
 Electro cardiograph simulator: this is used to check electrocardiograph performance it is a
lead II simulator.
 Spectrophotometer standards : with this wavelength calibration is checked. it is used to
filter the standards rather than solutions and effortless use and shifting.
 pH meter standards: to find out accurate readings a buffer solution is used.
 Oscilloscope: its frequency is 50-Mhz, it has dual trace and used for testing, fault findings
and mainly used for calibrations.
 Dc power supply; this supply of direct current dependent of each equipments own
requirements.
 Signal generator: the frequency range is from 0-10MHz this used for calibration with help
of saw tooth waveform generator.
 X-ray phantoms: these are used for the picture quality.
 Defibrillator tester: this used for measurement of output in joules.
4.2.2.7 Technical library
Full collection all repairing, manual and installation guides must be kept at one place in form of a
library in with a given specific portion for different equipments to assist the technicians when
they needed it. All technical guide lined books must be kept in this library.

37
4.2.2.8 Surveillance
To ensure the proper working periodic surveillance is must. After the implementation of the
program a timely surveillance of the set is must to check the proceeding and all data record of
entries that is being carried out.
4.2.2.9 Patient and worker safety
In health care institutes safety is their first priority. In hospitals a lot of efforts has been taken
with respect to potential hazards from administration and hospital management for the safety of
patient and other workers . The potential hazards are the part of the hospitals some areas. These
potential hazards occurs when utilization of
 Radiation,
 Electricity
 Biological materials.
All hazards have very much enclosed premises. There is law for all hospitals to provide full
safety to everyone who is present in hospital. All of these are sheltered from national standards.
In accordance to standards the use of all electrical equipment that can cause any uncertainty so to
avoid all these mishaps a clear policy is made for the safety of both patient and technician. In this
advanced era it is very much impossible at some extent to that this sort of mishap occurs. This
mishap only can occur when a technician can touch the naked electric wires otherwise medical
equipment highly safe in term of these mishaps. A low level current could much more hazardous
so a proper care is need while using the maintenance kits or operating any equipment. It is duty
of the electrical engineer to properly grounded the all electric connection to avoid any mishap.
Leakage of any electric can cause a loss. Whole medical staff must aware of all these thing and
must be trained enough to face any mishap. At the start of equipment operator must check each n
every plug and pin of the equipment to minimise the mishap occurrence. These standards for
hazards are not constant they are being changed time by time to meet the current issues. So it is
the duty of the hospital administration to get in touch with the responsible officials to improve
their hazardous potential. Planned preventive maintenance is key to avoid these mishaps while at
the of installation of any big medical equipment the installer must keep one thing in mind that
proper allocation current and earth must take place. It is must to use three plug in lead. All
external stuff like adopters and extension least must not brought in to use because with use of
these there is probability of any mishap. This electrical safety is must to carried out in every
department of the maintenance.

38
4.3: Proposal for Training of Technicians for Medical
4.3.1Equipment Maintenance
Maintenance of medical equipment is very much essential so for maintenance fully trained with
all of technical abilities a technician is required. It is very much important to hire fully trained
technician who can maintain the equipment and make equipment for ready to use. It is very much
expensive to hospital to train a technician and it is been experienced in so many fields that when
u train a technician on your own then they switch to other companies for the sake of higher
salaries. So hire those technicians who always have much knowledge about equipment and its
maintenance. When you hire lower staff so give then a front line training about maintenance to
overcome on regular basis maintenance. This type of policies is less costly and less time
consuming. The training must of current equipments which are available in the hospital and for
those which are currently in use. Design the training in a manner that they cover each and every
equipment and all of its working and it maintenance skills. The hospital management can make
most of the trainees by giving them chance to work with fully skilled technicians this can help
technicians in repairing too. Technician training must comprise of following main points:
Medical equipment management
English
Mathematics
Technical drawings
Workshops
Electronics and electrotechnician
Mechanical services
Medical equipment
Hospital field work
English in this training includes knowledge about grammar, reading, writing and speaking to
understand the user guide.
Mathematics : mathematics is important to understand the graphical representation.
Technical drawings: it is important to understand visualization.
Workshops: in this all sort of training must be give to regarding internal wiring, installations and
includes all workshop maintenances.
Electronics and electrotechnicians: in this whole knowledge about AC current and DC current
all conductors and semi conductors, amplifiers optocuplors to understand the basic circuitry of
the equipment.

39
Mechanical services: in this knowledge will be given about servicing of lubricants and changing
of hot and cold water standby generators and other repairing services in hospital plant.
Medical equipment: a brief knowledge about all medical equipment which are currently in use
in hospital about their operating system and their repairing and the all maintenance techniques.
Hospital field work: a brief knowledge about the hospitals all departments and all equipment
which are under supervision and their simple repairing and maintenance.
The operators of the equipments must be trained with the trainee technicians to overcome on
daily basis maintenance that a equipment requires before use. By training operators this will be
much more helpful in means of maintenance and will increase the ratio of medical equipment
care. The life and output efficiency equipment can be improved with these collective efforts of
the trained operators and trained technicians.
4.4: Analysis of overall condition of machine
There are certain conditions to observe the condition of equipment one condition is to observe
equipment personally and other condition is to ask the person who is currently operating the
equipment or the equipment is under his observation. The all data that we observe or collect from
observer must be very informative to understand the condition of equipment.
In my analysis I have interviewed the observers and the operators of the equipments which being
used in SMBBMU. After analyzing the collected data from SMBBMU the condition of
equipment is not satisfying. Because of the tough scheduling of equipment use and their working
environment was at lower maintenance standard. There is a wide range of equipment available
from basic equipments to highly sophisticated equipments in SMBBMU. The basic diagnostic
equipments are thermometers, blood pressure apparatus and the stethoscope. These diagnosing
equipments are in every time need to hospital. These equipments are use to diagnose the causes
of illness and other physical change problem. But the maintenance for these simple and basic
equipment was not that much effective. The other equipment which are used for scanning
diagnosis are x-ray, magnetic resonance imaging (MRI), computed axial tomography (CAT
scanner). While these equipment are very much demanding in means maintenance and they are
very much expensive too so there maintenance strategy was not also that much impressive. To
improve the maintenance of these basic and sophisticated equipment proper strategy should have
these points which are described as under:
 A brief report must be made about equipment parts, components and its current working
condition.

40
 A list should be made which categories the priority of work according to situation of the
equipment either in use or out of use.
 A note should be shown when maintenance is in progress like maintenance in progress or
ready to use.
 For better maintenance strategies maintenance team must have effective impact on the
hospital management for full support.
The point which are discussed below will explain the maintenance report.
Management summary:
Management must keep an eye on working condition and proper review of reports. Those have
been produced by maintenance department, to achieve the desired goal and to improve the
maintenance strategy with their full response.
Equipment performance:
A register must be maintained to update the condition of equipment whether equipment is in use
or out of use. There must be notice board place at the reception of maintenance department to
inform the daily routine of maintenance. A brief list must be placed to inform location of
discarded components and about the parts and components which are available to use.
Information distribution:
A detailed list of instruction regarding planned preventive maintenance must be programmed to
give an idea to support the operators and learners in maintenance department. This list must be
distributed to every department and laboratory to avoid the misshape.
Cost-Benefit:
Proper distribution of money in maintenance strategy will profit you a lot the money that you
were spending on substitute equipment and hiring of external technician from companies will be
saved by investing on planned preventive maintenance in your own hospital.
Operating Experience and Continuous Improvement:
Design awareness modules and database for training about the implementation of planned
preventive maintenance tools and techniques to the technicians and operators. In this training
compare your current techniques with other developed hospitals maintenance techniques to

41
create interest in maintenance. By giving examples and other experience improvements can be
made easily by implementing planned preventive maintenance.
4.5. Prediction of Fault
The condition of equipment can only be identified by self observation or by asking from concern
equipment observer and operator. By interviewing all maintenance officials from SMBBMU
conclusion came to this point that the condition of equipment available are not appreciable. Most
of the equipment are out of use due to lack of maintenance awareness. The equipment which are
in working condition are going through a immense load and the maintenance that is being carried
out is not of good level.
It is possible to predict the fault of equipment when technician has full record of equipment
maintenance and the regular maintenance record by the operator. Only by regular maintenance
and weekly technician maintenance can increase the life of equipment and can predict the
upcoming fault. Maintenance record helps a lot in finding the fault and prediciting the fault.
SMBBMU has all kind of equipment easy to use and complex to use but the current maintenance
policy is not that much attractive to take care of all the equipment. But as I analyzed the
interviews the prediction of fault is The prediction of fault can be considered in not attractive.
4.6. Discussion and Decision Making
There should be a point to discuss and to take decision. To make a point maintenance official are
suppose to implement a rule record keeping. For equipment maintenance a conditional report
must be produced and must investigated to understand the issues of equipment. These sort of
activities must be carried out to understand the importance of record keeping. These sort of
awareness regarding record keeping will encourage the technicians and operator to maintain the
record regularly. By saving all data of maintenance will help technician and operator to solve the
unwanted problems of the equipment will give them confidence to take decision regarding
maintenance of the equipment. This will be clear in the maintenance report that this equipment
need to be updated and requires these components to make it in running condition. All planned
preventive maintenance techniques are possible with proper implementation of user guide of the
equipment.
It is the duty of maintenance head to design a program which everyone can easily understand and
follow that rule. A proper utilization of all condition of maintenance data must part of the
properly described. To assess the technology a few points are discussed below:

42
 Scheduling of planned preventive maintenance must be is easy and appropriate defined
quality.
 For Condition baseline reliable and periodic data collection is sufficient.
 The variation in data will help in identifying intolerable misshape.
 A proper system for alarm and alerts should be produced.
 A sensible appraisal of Data and study.
 Integrated data assessment of all technologies.
 A proper and confirm deliverance of decision about medical equipment after analysis of
collected data.
 Information of equipment must paid full concentration before taking any decision.
 The consultation between the operator and technician is must and consultation between
technician and maintenance engineer is must regarding maintenance of equipment.
 Conditions of maintenance should be addressed to maintenance service provider.
 This must be clear that is Responsible for all equipment maintenance analysis.
 The reliable decision takes times to trusted.
Chapter Summery
In this chapter a proposed solution for maintenance are briefly described in light of all tools and
techniques of planned preventive maintenance. Appropriate solutions are given to improve the
maintenance condition of hospital. This chapter briefs the overall efficiency of maintenance tools
and their analysis. The analysis of maintenance strategies and planned preventive maintenance is
done to give an brief idea to understand the maintenance techniques. Training proposal is also
described to understand and analysis of tools and techniques is done to improve the maintenance.
Data analysis, machine analysis, fault prediction and decision making is discussed to fulfil all
maintenance requirement for the equipment and hospital.

43
Chapter 5: Project Evaluation and Conclusion
This chapter is the whole summary of the project. This chapter give a collective viewpoint on the
research objectives with limitations and describes all skills like learning and technical skills. It
covers all sort of collective issues that has been discussed above to give them an appropriate end.
The assessment and evaluation of the project are briefly described as under:
Project Results evaluation according to Client Need
Project Results evaluation V/s TOR objectives
Project Results evaluation V/s Customer’s Feedback and approval.
Project evaluation
Complications Encountered/Limitations.
Lessons Learnt
Data analysis and Maintenance recommendations
Conclusion
Further Research recommendations.
5.1. Project Results evaluation according to Client Need.
This part outlines the results achieved with the demands of the client requirements which are
given as under:
Client requirement 1: A comprehensive ‘Literature review’ on all maintenance strategies,
their all Tools and Techniques and tools and techniques of planned preventive maintenance.
Level of Success: in chapter two the literature review a brief description of all maintenance
strategies and their tools and techniques is briefly described and use of all tools and
techniques in planned preventive maintenance to achieve a desired goal to avoid any

44
breakdown.
Client requirement 2: Identification of current maintenance strategy in SMBBMU.
Level of Success: all data gathered with help of SMBBMU maintenance staff through
telephonic interviews. A brief data about all equipment was provided to understand the
condition of equipments and the maintenance strategy in SMBBMU. Two types of
equipments are used one is basic diagnostic equipment and other are sophisticated
equipments.
Client requirement 3:Preparation of a report which contains suggestions and
recommendations for SMBBMU after gathering of data.
Level of Success: A brief analysis of all suggested maintenance strategies is described to
improve the current maintenance techniques to achieve desired goal.
Table 5.1. Project Results evaluation according to Client Need
5.2. Project Results evaluation V/s TOR objectives.
The objectives success achieved in accordance to discussed objective in TOR.
Objective 1: Comparison of the different maintenance approaches to find appropriate for
hospital
Level of Success: a brief description of maintenance strategies is given in literature review by
sited with references from different maintenance journals, conferences, websites and other
published paper to support the literature. In this literature review an appropriate maintenance
strategy is suggested for hospitals. To encounter their medical equipment problems.

45
Objective 2: Focused study on equipment maintenance requirement.
Level of Success: in literature review a brief description is given in planned preventive based
maintenance.
Objective 3: Recommendation for risk management in hospitals.
Level of Success: to avoid any misshape recommendation are described in maintenance to
avoid any misshape and any horrible situation.
Objective 4: Collect data from concern officials of the client.
Level of Success: this is discussed in chapter three and data was collected from officials in
accordance to need.
Objective 5: assessment of the collected data to propose a maintenance schedule.
Level of Success: The assessment of collected id briefly described in chapter four.
Objective 6: Make recommendations on maintenance.
Level of Success: all recommendations and proposal are presented in chapter four.
Objective 7: project evaluation.
Level of Success: The evaluation of overall project id done chapter four and five.
Table 5.2. Project Results evaluation V/s TOR objectives.
5.3. Project Results evaluation V/s Customer’s Feedback and approval.
This project has two important phases to cover according to client. For most concern of project is
the client demand, proposed solution of maintenance in projects are rated in client response were
+4 on both and this confirms that the proposed solution is slightly lacking to get full response +5.
This could have been achieved if I would not have this limited time and time difference in
between Pakistan and UK. The other reason could be the lack of the understanding to the
proposed solutions of maintenance and techniques. Otherwise the score would have been +5
instead of +4. The delivered product has fully satisfied the sponsor.

46
5.4. Project Evaluation
This project is of limited time and has gone through different phases and activities which are
described as under:
It was hard to select an effective topic for project and to produce a term of reference (TOR) to get
it approved by the client and supervisor. Finally I got TOR approved of from client and
supervisor. A further project plan was prepared to schedule my activities regarding project
proceedings, Gantt chart, risk assessment sheet and discussion of objective. In Gantt chart
milestones were set to accomplish them in time and need to be aware of all unwanted
happenings. To achieve a the desired goal need to turn my planning in real. During all these
planning meetings with supervisor to discuss my progress and issues were on and good
communication relation was established with the client with client. In chapter three and four an
assessment of collected data from client was done with proposed solution for maintenance and it
techniques. In chapter five overall evaluation TOR objectives and client requirement were done
successfully.
The motivation to this project was my study that encouraged me to apply all my educational
experiences to produce a meaning full project with a lot of research work. This project will fulfil
my masters degree requirement. The courses that i have learnt in MSc Engineering Management
were useful in this research project.
This degree enriched with a lot of knowledge and gave me confidence to take initiates or give
suggest the best for the betterment of any organization. This research project is a brilliant
experience of educational experience and gave me confidence to achieve and explore. This
research project will help me in my practical field to analyse the issues. The project is done with
success with help of client and supervisor. The evaluation of project is done in accordance to
client requirement and the in accordance to project need.
5.5. Complications Encountered/Limitations.
The deliverance of the full maintenance information is the prime objective of the project. All
described tools and techniques of planned preventive maintenance in literature review are not
those much sufficient to deliver full techniques of maintenance. This is due to lack of time i
could not paid full efforts to gather data from other limited journals but I did my best to present a
meaningful and useful data to cover all maintenance techniques.

Bio medical equipment maintenance & management

Bio medical equipment maintenance & management

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (20)

Similar to Bio medical equipment maintenance & management

Similar to Bio medical equipment maintenance & management (20)

Recently uploaded

Recently uploaded (20)

Bio medical equipment maintenance & management