CARE AND MAINTENANCE OF BIOMEDICAL

EQUIPMENTS
for SEARES GENERAL HOSPITAL

Venue: On-site
FEBRUARY 19, 2010 1st Batch
APRIL 12, 2010 2nd Batch
Time: 8:00 am-5:00 pm

CARE AND MAINTENANCE OF BIOMEDICAL

EQUIPMENTS
for SEARES HOSPITAL
Facilitator: BENITO L. MACALINAO
MBA, BSMATH
AM/TM (Assessors Methodology/Teachers Methodology) TESDA
Certification
TESDA, NC II Cert, 090103022845,Biomedical Equipment Servicing II
International Aid Biomed Trainee, RC Manila, US Embassy Biosecurity
Engagement Program (BEP)
Member; AAMI 09, Association for the Advancement of Medical
Instrumentation, Baltimore, Maryland USA , Technology Management
Council
A-PBA, Asia Pacific Biosafety Association, 2009 Singapore
Member, Rotary Club of SFLU City North
Director, CCILU- Chamber of Commerce and Industry La Union
Chapter
PCCI Accredited Trainer on Basic Marketing for SMEs

Biomed Tech/GM-BLM MARKETING

CARE AND MAINTENANCE OF BIOMEDICAL

EQUIPMENTS
for SEARES HOSPITAL

BACKGROUND
INTRODUCTION;
BIOMEDICAL INSTRUMENTATION
AND INTERNATIONAL aid

BACKGROUND
ASSETS AND PROPERTIES OF AN
INSTITUTION
Human Resources
Management
Personnel and Staf

Facilities
o Buildings, Furniture and Equipments

CCIH

Biomed
Capacity
Building for
Mission
hospitals

NEED

What is the condition of the

equipment well meaning
donors have sent to mission
hospitals or that hospitals
have purchased?
Estimates vary from 40 to 90 % of
medical equipment shipped to
hospitals in developing countries is
inoperative at any given time, some
of which has never worked after
arrival.

WHO has documented that 50% of

medical equipment
(in developing countries) is not in
use
Found in:
* Maintenance of Hospital Equipment, 21st Meeting of PAHO
Executive Committee of the Directing Council, Washington D.C., 9-10
December 1993, SPP21/4, 8 November 1993
* Investing in Health, World Development Report 1993, chapter 6
on Health Inputs, p 134-155, World Bank, 1993
* Health Care Equipment: A WHO Perspective, by A. Issakov, in
Medical Devices: International Perspectives on Health and Safety, edited
by C.W.D. van Gruting, p. 3-5, Elsevier, 1994
* Service and Maintenance in Developing Countries, by A. Issakov,
in Medical Devices: International Perspectives on Health and Safety,
edited by C.W.D. van Gruting, p. 21-38, Elsevier, 1994
* Better Health in Africa: Experience and Lessons Learned,
chapter 7 on Infrastructure and Equipment, p. 98-108, World Bank, 1994"

Some of the reasons that at

least 50% of equipment is
inoperative

Lack of maintenance
Lack of spare parts
Equipment is too sophisticated
Medical staf do not know how to use
it
Equipment shipped in as-is
condition and not properly prepared
for use overseas

Lack of Maintenance:
E-mail received April 28, 2008

My name is Andreas Andoko. I'm the superintendent of

the Imanuel Baptist Hospital in Bandar Lampung,
Indonesia.
As a former missionary hospital we have many medical
equipments that weve had since the hospital was
founded.
Many of them discontinued (taken out of service) since:
(1) we couldn't repair
(2) we couldn't find the spare parts
(3) Buying new is too expensive for us.
Because of this our medical services to the public
has to decrease.
In Indonesia more than fifty former missionary of
Christian hospital that have same problem with us.

Mother hand venting her

child

Upstairs is room full of inoperative

ventilators

Lack of Spare Parts:

E-mail received April 28, 2008 (less than one month

ago)
My name is Andreas Andoko. I'm the superintendent of
the Imanuel Baptist Hospital in Bandar Lampung, Indonesia.
As a former missionary hospital we have many medical
equipments that weve had since the hospital was founded.
Many of them discontinued (taken out of service) since:
(1) we couldn't repair or
(2) we couldn't find the spare parts
(3) Buying new is too expensive for us.
Because of (the above) our medical services to the
public has to decrease.
In Indonesia more than fifty former missionary of
Christian hospital that have same problem with us.

Difficulty finding and

purchasing repair parts
Acquiring parts is the number one difficulty
all developing world technicians face
Example:
My name is Carlos Amaral. I am biomedical
engineer from Mercy Ships. We are starting
one project to train and support West
African Hospitals in the biomedical field.
One of the ideas is to help with the
acquisition of parts. Could International Aid
help us to purchase such items?

Not knowing how to use

it
New x-ray
machine-has
never been
used. Why?
Staf
received no
training on
how to use it

Not knowing how to use

it:
A very nice ultrasound
that has never been
used. Why? Staf
received no training on
how to use it

Equipment shipped Asis

When new or used medical equipment is sent
to a mission hospital without checking it out
to make sure everything works
Equipment shipped without making all
necessary repairs
Equipment shipped without preparing it to
work on the electrical power in that country
Equipment left for the hospital to figure out
installation requirements and other details on
their own.

NEED

TRAINING
TECHNICIANS

Medical Equipment Training

Empowering Nationals to Help Their Own
Communities
Providing
tools, test
equipment
and service
manuals

Providing
instructors to
teach electronics
and medical
equipment repair
to hospital
maintenance
workers
Empowering healthcare
facilities with selfsustainable solutions

Teaching valuable
skills to improve
healthcare

Course Outline Mod 1 &

2
MODULE I

IA Maintenance Management

Maintenance Philosophy
Planned Preventive Maintenance
Inventory Control
Electrical Safety Practices
Standards and Regulations
Networking

IB DC Electricity

Magnetism
Electrical Circuits
Ohms Law
DC Components
Troubleshooting Theory

IC Equipment Troubleshooting I

BP Apparatus
Sterilizers
Microscopes
Suction Pumps
Oxygen Equipment

MODULE II

IIA Shop Practice

Hand Tools, Care and Safe Use
Soldering and Desoldering
Welding
Shop Safety
IIB AC Electricity
AC Waveforms
AC Test Equipment
Voltage Dividers
Power Calculations
AC Components
Transformers
AC Power Production & Delivery
IIC Equipment Troubleshooting II
Eye Equipment
Dental Equipment
Respirators and Ventilators

Course Outline Mod 3 &

4
MODULE III

III A Medical Education

Anatomy & Physiology
Medical Terminology
III B Solid State Devices
Diodes
Transistors
Amplifiers
Vacuum Tubes
Reading/Extracting Circuit Diagrams
III C Equipment Troubleshooting III
Electrosurgical Units
Physical Therapy Equipment

MODULE IV

IV A Radiation Theory & Practices

Radiation Safety
X-Ray Physics
Film Production & Developing
X-Ray Quality Control
IV B Circuit Reading & Troubleshooting
Circuit Reading
Troubleshooting
Build Power Supply
IV C Equipment Troubleshooting IV
Mobile and Stationary X-Ray Machines
Single phase, 3 phase & high frequency
generators
High Voltage Transformers
X-ray Tubes and Collimators
Tables and tube stands
V D Instructor Training
Writing Lesson Objectives
Using Audio Visual Materials
Conducting Evaluations

Course Outline Mod 5 &

6
MODULE V

V A Basic Laboratory Technology

Role of Laboratory in Diagnosis
Blood & Body Fluids
Blood Typing
V B Motors, AC and DC
Common Problems and Solutions
Control Systems
V C Digital Fundamentals
Logic Gates
Microprocessors
Microcontrollers
V E Equipment Troubleshooting V
General Laboratory Equipment
Colorimeters
Spectro and Flame Photometers
Centrifuges
Autoanalyzers

MODULE VI

VI A Biomed Computer Applications

Electronics Workbench Software
Hospital Equip. Management programs
On-line Courses
Internet Search Techniques for technical
information
VI B Advanced Troubleshooting
Electrocardiographs
Cardiac Monitors
DC Defibrillators
Patient Care Equipment
Pulse Oximeters
VI C Equipment Troubleshooting VI
Diagnostic Ultrasound
Monitors
Fetal Monitoring
VI D Supervised Work Experience
Medical Computer Technology
Cardiac equipment

Ghana

How did we get there?

- MET program began in Ghana in 1998

Active areas for IA

What have we accomplished?

- 140 students have participated

- 86 students have graduated
- 11th class will begin June 2 (45 students approved)
- 13 countries benefiting to date (Cameroon, Chad, Dem Rep
of Congo, Ethiopia, Ghana, Kenya, Liberia, Nigeria, Sierra
Leone, Togo, Uganda, United Kingdom and Zimbabwe)
4 graduates have participated as instructors
- Will be certified by Ghana Education Service in July 2008

Honduras

How did we get there?

Active areas for IA

- MET began as a Development Project after

Hurricane Mitch

What have we accomplished?

- All lectures and training materials are in
Spanish
- 111 students have participated
- 72 students have graduated
- New class of 23 students began May 5

India

How did we get there?

Active areas for IA

- Rotary International Matching Grant

What have we accomplished?

-

Program ran from 1999 to 2000

19 students enrolled
10 hospitals benefited in India
21 hospitals benefited in Nepal

Indonesia

How did we get there?

Active areas for IA

- In response to Dec 2004 Earthquake and Tsunami

What have we accomplished?

- Medical Equipment Service Center opened Nov 2005
- MET training began September 2006
- All lectures and training materials in Indonesian
Bahasa
- 57 students participated

Kosovo

How did we get there?

Active areas for IA

- MET began in 2001 after NATO bombing

What have we accomplished?

-

New training facility set up and equipped

All materials translated into Albanian
45 students participated
43 students graduated
6 hospitals received new biomed workshops

Philippine
s
How did we get there

- 2001 Rotary Foundation 3-H grant

Active areas for IA
What have we accomplished?

- 192 students participated

- 47 students graduated
- 26 students enrolled in MET Extension
3 colleges now use MET curriculum for trainin
programs

- Certified by Technical Education & Skills Developmen

Correspondence Courses
- 7 students enrolled
- 4 countries benefiting

Chile
Guatemala
Haiti
India

-Conducted via e-mail and ftp file transfer

MET Global Impact

Honduras

Haiti

Ghana

Kosovo
Philippines

Guatemala
Chili
India

Indonesia

540 Students have participated

248 Technicians graduated from MET course
312 Hospitals have in-house biomed
technicians
26 Countries have benefited

NEED

TRAINING
TECHNICIANS

TRAINING ADMINISTRATORS

Advanced Medical
Equipment Management
A Program for Health Reform
A Presentation to CCIH
May 25, 2008

Health Expenditures

Population to be Served

1% of population

Tertiary Hospital
Care
(specialized
services)

40% of Expenses

9% of population
Secondary
Hospital Care
(hospital
services)
90% of
population

Primary Health
Care
(promotion,
preventive, &
basic curative
services)

Health Pyramid Showing

Proportion of Expenses
with People Served

45% of
Expenses

10-15% of Expenses

The Need
Hospital operations not working
at peak efficiency levels
Dependence on foreign
consultants & repair services
Drain on foreign currencies
Compromises quality &
efectiveness of healthcare

A Proposed Solution to
Improve Hospital
Productivity & Cost
Efficiencies
International Aids Advanced Medical
Equipment Management Program
To improve health care delivery
through professional equipment
management for medical equipment

Hospital Equipment
Management Training
One Year Learn & Do
Quarterly 1 week learning
events
4 Modules (one per quarter)
In partnership with World Health
Organization and Pan American
Health Organization

Support Systems
Equipment Inventory System
Preventive Maintenance System
Equipment Management Info
System
Equipment & Technology
Acquisition System

Process

2-3 year process

Assessment & Inventory
Baselines
Training Events (MET & AMEM)
Systems Development /Installation
Establish Repair Centers
Evaluation (Measurable Results)

Benefits
1. Increased saved lives from proper
equipment operations
2. Cost Savings from more efficient
equipment operations for
allocation to Primary Health Care
3. Sustainable Operations
4. Professionalized hospital
equipment management

NEED

TRAINING
TECHNICIANS

FUTURE DIRECTION

TRAINING ADMINISTRATORS

How is International Aid planning

to build Biomed capacity
worldwide?
Spread Biomed training faster and farther
Institutionalization Partner with public
universities and technical schools
Such instructors are already trained in pedagogy
and electronics
Focus training on teaching biomed applications
Curriculum-In-A-Box (for trained instructors)
Sustainability Tuition funded: Partner schools will
ofer the course as a part of their regular
curriculum

2009-11 Plans
Honduras

South
America

Ghana

East Africa Philippines

Indonesia

Advanced Medical Equipment Management (AMEM)

training planned for Ghana, Honduras and the
Philippines
New MET program planned for East Africa (Uganda

Other Possibilities
Haiti

Iraq

China

Indonesia
PCUSA & MBF Interested in Haiti MET
80 Catholic hospitals and 60 Protestant
hospitals want Indonesia MET
China Medical Foundation interested in MET
Iraq MET - on hold until security improves

QUESTIONS

CARE AND MAINTENANCE OF BIOMEDICAL

EQUIPMENTS
for SEARES HOSPITAL

Training and orientation sessions

on the right handling of first-line
basic diagnostic instruments and
measuring devices in diagnosing
the physical state conditions of
human being. (On-site training)

COURSE OBJECTIVES
Participants are able to;
understand and perform the roles and
responsibilities of Biomed Manager/
Technician in their Healthcare Institution
write forms, maintain records and
inventories of medical equipments in their
own Healthcare Institution
test-run, assess and refer faulty
equipments under warranty from
manufacturer

COURSE OBJECTIVES

install, assess and perform preventative and

corrective maintenance of hospital equipments
that are beyond warranty from the manufacturer

prepares purchase request for spare parts and

replacements

conduct routine maintenance and schedules for

life support equipments

Train and demonstrate how to operate the

medical device/equipment to users (health
workers)

COURSE OUTLINE
PART 1 (Day1- AM)
Role and responsibilities of a Biomed
Manager/Technician in a Healthcare
Facility
PART 2 (Day1- AM)
Biomedical Equipments Management
System

COURSE OUTLINE
PART 3 (Day 1, PM)
Guidelines for safety handling and usage
of Medical Equipments
Medical Term, Anatomy & Physiology
Pre-operative, operative and post operative
procedures on medical equipments and
devices

PART 4 (PM)
Bench work/Trouble shooting and
Workshop of selected medical equipments

Roles and responsibilities of a Biomed

Manager/Technician
(PART 1)

Maintenance Officer
Maintenance Staf
Participate in Workplace Communication
Work in a Team Environment
Practice Career Professionalism
Practice Occupational Health and Safety
Procedures

Roles and responsibilities of a Biomed

Manager/Technician
(PART 1)

Maintenance Officer/Manager
Formulates and review the current
maintenance system in the Organization
Recommends, suggest potential development
of the maintenance system to the concerned
departments in the Organization
Train and motivate maintenance staf members
and equipment users (health workers)
Monitor and control records on routine
maintenance schedules of medical equipments
Plan and organize meetings with the
maintenance team for any developments of
the maintenance systems and procedures

Roles and responsibilities of a

Biomed Manager/Technician
(PART 1)

Maintenance Staf

o coordinate and respond to faulty equipments

requested by the users (concerned department).
o Submit reports on the status of the assessed
faulty equipments with recommendations to the
Maintenance manager
o Performs corrective maintenance on the faulty
medical equipment
o Conduct and implements routine schedule of
preventive maintenance of all medical
equipments

Roles and responsibilities of a

Biomed Manager/Technician
(PART 1)
Participate in Workplace Communication
Join the committee on acquisition of medical
equipments (new, refurbished and for
donation)
Obtain and convey workplace meetings and
discussions pertaining to medical
equipments and work related issues.
Cooperate, complete and coordinate
relevant work related documents (3 Cs)

Roles and responsibilities of a

Biomed Manager/Technician
(PART 1)

Work in a Team Environment

o Demonstrate team role and scope
o Performs own role and
responsibility within the team
o Working as a team member

Roles and responsibilities of a

Biomed Manager/Technician
(PART 1)
Practice Career Professionalism
Integrating personal objectives with the
Organizational goals
Setting and meeting work priorities
Maintaining professional growth and
development

Roles and responsibilities of a

Biomed Manager/Technician
(PART 1)

Practice Occupational Health and

Safety
Identifying hazards and risks
Evaluating hazards and risk
Controlling hazard and risk

Maintaining occupational health and safety

awareness (OHS)

PART 2
Biomedical Equipments
Management System
The importance of record keeping

Data base Inventory of Equipments

Equipments I.D. /Manufacturer/Vendor
Functions/usage
Status and Performance
Locations and users

PART 2
Biomedical Equipments
Management System
Users /Department
Nursing Dept, OR, Laboratory, Clinical
Therapist & etc (Member, Maintenance Team)

Service and Operation Manuals

All delivered/acquired medical equipments
must be accompanied with SOMs

Routine Maintenance Schedules

Daily, weekly, monthly, quarterly and
annually

PART 2
Biomedical Equipments
Management System
Records on equipments performance history
Replaced parts, sources and vendors
Time spent and cost value of repaired
equipment
ROI in keeping the maintenance of the
equipment (recommendation)
Incident reports on faulty medical
equipments
Safe to all users anytime and anywhere
(calibrated & well maintained)

PART 2
Biomedical Equipments
Management System
Buying refurbished or brand new. (cost analysis)
Specifications, National Electrical Code Standard
Cost efficiency vs. budget constraints

Upkeep on the equipment, base on

urgency/necessity or either required by government
regulating agency
Potential risk , efect and impact of less maintained
equipment currently being used
(Institution as a Healthcare service provider, Image &
status and legal obligations)

PART 2
Biomedical Equipments
Management System

Work Shop/Simulation Activity

Draw your organizational chart (Dept involve)
Draw a flow chart on how to assess a faulty
medical devices
Make a form for purchase request (PR) for
spare parts and replacements with the
correct specifications (make, brand, size &
material, qty)
Make a form and fill out the necessary
information (machines I.D. ,users, location)
Make a form for maintenance schedules on
medical equipments

PART 3
Guidelines for safety handling and
usage of Medical Equipments
Anatomy & Physiology
Knowledgeable with the functions and
operations of the medical equipment.
(training is a must for newly installed
equipment)
Refer to Users Manual, Service Manual
and Manufacturers Standard Operating
Procedures
General Principles of Maintaining Electrical
Equipment

PART 3
Guidelines for safety
handling and usage of
Medical Equipments

Checking Power Supplies, Sockets, Plugs,

Spares and accessories
Test run the unit, observe, investigate and
make recommendation and endorsement.
Orient the users and the machines
operations protocol (pre-op up to post-op)
Commission the unit, endorsement record
and maintenance sheet.

PART 3
Guidelines for safety handling
and usage of Medical
Equipments
Occupational
Health and Safety Working
Environment
PPE/PPD- Personal Protective Equipment/Device
Ex. Gloves, face mask, gown/apron, goggles, ear plug
and etc.

Working Environment
Good Ventilation, Light and Fire protective devices
Practice 5-S, (sanitize, segregate, sort, sweep,
systematize)

PART 3
Guidelines for safety handling
and usage of Medical
Equipments

Biosafety and Biosecurity

Personnels safety
Equipments safety
Environments safety

First line tool kit

Testing Instruments, hand-pieces instruments,
mechanical and improvised tools.

Guidelines for safety handling

and usage of Medical
Equipments

Identifying the types, functions and

operations of various medical equipments.
Manually operated/Mechanical
Automatic functions and operations
Electrically powered machine
Hydraulics (low/High pressure)
Pneumatics (low/high pressure)
Combinations of both or more

END OF SESSION 1
Assignment for the 2nd Session
ORGANIZATIONAL CHART
CURRENT FORMS USED IN THE OFFICE FOR
EQUIPMENTS MAINTENANCE
SHORT QUIZ (tomorrow)

PART 4
BENCHWORK/LAB
ACTIVITY/WORKSHOP
SHORT QUIZ

Trouble shooting protocols

Hands on trouble shooting
BP apparatus, Suction Pump/Vacuum,
Oxygen regulator, Infant (Baby)Incubator,
nebulizer, sterilizers and etc.

PART 4
BENCHWORK/LAB
ACTIVITY/WORKSHOP

Equipments assessments
External Environment

Power cable
Switches
Controls
Connectors and accessories
Casing

Internal Environment
Fuses
Electrical & Electronic components
PCB
soldering leads
Point to point testing

PART 4
BENCHWORK/LAB
ACTIVITY/WORKSHOP
Recommendations

For repair ( in-house service, service comp)

Unserviceable (safe keep, parts source)
For condemn
Buy new equipment

Record Keeping/Documentation
Provides sufficient copies to all concerned
Submit the report copies to all concerned
Maintain a copy on file for future reference

END SESSION

CONGRATULATIONS!!!
!
CONGRATULATIONS!!!
!

REMINDER
Biomedical Equipments are
especial machines and
instruments that if well taken
cared of and used correctly can
prolong its performance and will
help to improve the quality of
life.(QOL)

REMINDER
USERS

U- Users
S- Should be the
E- Experts in
R- Running the
S- System
Medical Equipments, PCs, Electrical
Devices & Appliances, and others

REMINDER
BENITO
B- Biomedical
E- Equipments
N- Need your
I - Involvement and Infinite
T- TLC (tender loving care) like
O Ourselves and our love ones

REMINDER
BLM
B- Biomedical Equipments
L- Love to serve
M- Medical Workers and Healthcare
Providers

CARES

C- correct
A- attitude and
R- right conduct even in
E- emergency
S- situations

A filipino CARESs

C- concerned
A- always affectionate
R- responsible and reliable
E- empathetic to every one
S- sharing time and
S- service above self

Maintenance

M- management
A- always
I - invest in
N- nurturing
T- trust amongst
E- employees
N- noteworthy of their
A- attitude and loyalty
N- never complain to
C- cost incurred towards
E- employees professional development

REMINDER
Biomedical Equipments were invented to
improve the quality of medical services
by the healthcare providers and medical
practitioners where it aims to deliver
precise, accurate measurement, fast and
safety technical operations from
diagnostic tests, prognosis results and
life support devices for human being in
some certain situations.