Dr Anjali Hazarika I/c Blood Transfusion Services Cardiothoracic and Neurosciences Centre AIIMS, New Delhi ----------------------- Page 2----------------------- Why Equipment management? Resource involving Heavy capital investment Tedious procurement process Critical to ensure nn interrupted and quality service ----------------------- Page 3----------------------- Equipment management program To : Maintain a high level of performance Lengthen life of instrument Reduce interruption of services due to breakdowns and failures Improve customer satisfaction Improve the technologists confidence and knowledge ----------------------- Page 4----------------------- Equipment management It goes far beyond that of a person simply being able to operate the equipment. It also requires a specific person designated to deal with all aspects of equipment management. ----------------------- Page 5----------------------- Equipment Management Need assessment List of critical equipment i.e. Selection specifications when the result of any of its Procurement functions is essential to achieve a quality outcome Installation Devise a system to uniquely Calibration / Validation identify equipment User Responsibility Prepare labels for Maintenance equipment Troubleshooting Service and repair Retiring equipment / condemnation ----------------------- Page 6----------------------- Need Assessment Utilization Index: Parameter to assess productivity of service of an equipment Use co-efficient Index: N / M x100 N = average number of hours the equipment is used / day M = Maximum number of hours the equipment can be used per day < 50% considered to be under utilized ----------------------- Page 7----------------------- Selection of equipment A Selection Criteria Check List will assist in purchasing the most appropriate piece of equipment to meet the laboratories needs, e.g. Cost Manufacturer Technical Support Availability Model (capacity, volume, warranty) ----------------------- Page 8----------------------- Selection & Validation of Equipment Blood bank/ Blood centre has a policy for selection, procurement and installation New equipment needs to be validated Process should include Design qualification Installation qualification Operational qualification Performance qualification ----------------------- Page 9----------------------- Design Qualification: Documented verification that the design (specifications) of the equipment and its components satisfies the User Requirement Specifications ----------------------- Page 10----------------------- Installation Qualification IQ demonstrates that the instrument is properly installed in environmental conditions that meet the manufacturers specifications IQ testing and documentation typically includes: verification of the manufacturer model no. equipment no. instrument calibration status, equipment SOP verification & verification of critical installation parameters eg equipment location, major components and utilities ----------------------- Page 11----------------------- Operational Qualification: An OQ is a validation protocol that provides documented verification that equipment or a system functions according to written & pre-approved specifications. It demonstrates that the installed equipment operates as intended. It focuses on the capability of the equipment to operate within the established limits and specifications supplied by the manufacturer. ----------------------- Page 12----------------------- Operational Qualification (contd) OQ testing and documentation typically includes verification of the Operator Interface Screen Menus Alarms Inputs and Outputs Print Functions Eventful & Uneventful Functions ----------------------- Page 13----------------------- Performance Qualifications: PQ demonstrates that the equipment performs as expected for its intended use in the processes established by the blood center and that the output meets the centers specifications. It evaluates the adequacy of equipment for use in a specific process that uses the blood centers personnel, procedures, and supplies in a normal working environment. ----------------------- Page 14----------------------- Performance Qualifications (contd) PQ testing and documentation typically includes: verification of the operator training, SOP approval equipment or system process parameters. ----------------------- Page 15----------------------- Procurement and Reception of Equipment At time of delivery the equipment is inspected as per specifications given in the supply order by the user department. On satisfactory receipt, installation certificate to that effect is given by user department. The operational manual is available to the User department ----------------------- Page 16----------------------- Installation Prior to installation: verify physical requirements have been met safety checks, electrical, space, ventilation, water supply, ambient temperature, etc. confirm responsibility for installation ----------------------- Page 17----------------------- Installation (contd) Upon receipt: Verify package contents Do not attempt to use prior to proper installation If required, ensure the equipment is installed by the manufacturer ----------------------- Page 18----------------------- Installation (contd) After installation: Establish inventory record Define conditions Develop and implement protocols for calibration, performance verification, and operating procedures Establish maintenance program Provide training for all operators ----------------------- Page 19----------------------- Labeling of Equipment Blood centre maintains labels on each equipment with the following details: Identification (YY lab code- 0001, 2011-IH-012) Serial number / Model number Date of last calibration Due date of calibration Contact details of the service engineer ----------------------- Page 20----------------------- Equipment Record, Unique Identification Blood centre maintains records for each equipment for life span or for any time period required by regulations and may include: Identification Manufacturers name, type, serial no./ other unique id Manufacturers contact person and telephone number Date of receiving and date of putting into a service Current location, where appropriate Condition when received (new, used or reconditioned) Manufacturers instructions, Equipment performance records that confirm the equipment suitability for use Maintenance carried out and that planned for the future Damage to or malfunction/modification/repair of equipment ----------------------- Page 21----------------------- Proforma for History Sheet of the Equipment Name of the equipment Model No. Manufacturer Name of supplier with contact No. Mode of purchase Hospital supply/NACO/UPSACS/Other Cost of equipment User manual List of accessories List of repairs Warranty AMC Date of installation & demo Calibration Validation Operational qualification Performance qualification Status of the equipment ----------------------- Page 22----------------------- Use of equipment Only authorized person should operate the equipment. Equipment used in the collection, processing, testing, storage and distribution of blood and its components should be maintained in a clean and proper manner and so placed as to facilitate cleaning and maintenance. Instructions for use and daily maintenance of all equipment should be available to personnel. ----------------------- Page 23----------------------- User Responsibilities The user has the major responsibility to ensure the equipment is used properly and services regularly Need well trained staff Understand how equipment works Have been trained to maintain equipment Understand possible problems and their prevention ----------------------- Page 24----------------------- Training of User Staff All relevant staff are trained on the use of equipment. Training should include the following modules: Use & practice of equipment including proper handling of equipment Preventive maintenance and trouble shooting Following instruction manual in day-to-day use of equipment Common and recurrent causes of break-down Common spare parts responsible for frequent break-downs Inspection and routine maintenance Calibration Testing and safety guidelines Basic concepts of physics and electronics as relevant to equipment Documentation of procedures (SOPs) Refresher training when new equipment is procured, is provided. ----------------------- Page 25----------------------- Programme for calibration and maintenance of equipment It includes establishing a programme that regularly monitors and demonstrates proper calibration and function of instruments, reagents and analytical system Established or implemented procedure for calibration and regular monitoring Program of preventive maintenance which contains recommendations of manufacturers / service report. Frequency of calibration of equipments as per recommendation of manufacturer, or as per prevalent standards. ----------------------- Page 26----------------------- Calibration & Validation Blood centre should have a policy and procedure for calibration and validation of equipment to achieve the required performance that complies with standards What is calibration? What is validation? ----------------------- Page 27----------------------- Calibration Definition Comparison of measurements performed by an instrument to those made by a more accurate instrument (traceable to national or international standard) for the purpose of detecting, reporting & eliminating errors in measurement ----------------------- Page 28----------------------- Equipment Calibration Perform initial calibration Calibrators or standards Follow manufacturers instructions Determine frequency of routine calibrations Calibration certificate / due date for next calibration ----------------------- Page 29----------------------- Calibration When to calibrate? At regular intervals based on usage When equipment is new and no calibration certificate provided When equipment undergoes traumatic events e.g. moving over long distance When routine maintaining shows functioning outside specifications ----------------------- Page 30----------------------- Validation Confirmation and provision of objective evidence that requirements for a specific intended use or application have been fulfilled Assurance that a specific process will consistently produce an outcome that meets its pre- established quality and performance specifications ----------------------- Page 31----------------------- Validation: General Principle It is a key part of quality system It needs to be carefully & clearly thought out or planned You validate something before you use it You can validate something while you are using it Prevention is better than cure Failing to plan is planning to fail ----------------------- Page 32----------------------- What can be validated? Any process, piece of equipment or software Processes Is the output correct? Does it meet specification? Is it documented? Does it affect another process? Is it safe to use? Is there defined maintenance/ repair? ----------------------- Page 33----------------------- Validation of equipment When to do? On commissioning of the equipment, based on full validation data supplied by the manufacturer After any repair or adjustments which may potentially alter the function of equipment If ever a doubt arises that the machine is not functioning properly ----------------------- Page 34----------------------- Performance Validation Validate the performance of new equipment prior to use Test known samples, analyze data Establish stability/uniformity of temperature controlled equipment Check accuracy/precision for pipettes Check centrifuge rpms/ rcf ----------------------- Page 35----------------------- Implementing a Maintenance Program Assign responsibility Oversight of all laboratory equipment Individual responsibilities Develop written policies and procedures Train staff Keep records ----------------------- Page 36----------------------- Implementing a Maintenance Program: Types of maintenance contracts: Annual maintenance contract (AMC) Comprehensive maintenance contract (CMC). ----------------------- Page 37----------------------- Annual maintenance contract A manufacturer company provides the service through AMC by themselves or with the help of service providers. The contract is usually for the period of 1 year after the warranty period is over and can be extended up to three years or five years as per the mutual understanding of both the parties. Usually the service providers give only service support and would charge separately for every part under AMC. However, in some cases, few parts are replaced during the visit by service engineer when it is mentioned in AMC contract that limited parts will be replaced. ----------------------- Page 38----------------------- Annual Maintenance Contract The Annual Maintenance Contract should include: Regular service and maintenance after the warranty period Warranty with spares Continuous supply of consumables Training of staff to handle the equipment Reliable and prompt after-sale service Suppliers contact details and emergency telephone number is available in Blood Bank. Breakdown time / Uptime / Penalty clause ----------------------- Page 39----------------------- Comprehensive maintenance contract. It includes prompt service from the company or service providers. The contract is usually for the period of 1 year and can be extended up to three years or five years as per the mutual understanding of both the parties. It includes repairs and replacements of faulty parts. Having the contracts gives the benefits such as consumables (which are not part of contract) being available at reduced costs. CMC is costlier than AMC because it includes the costs of spares as well. ----------------------- Page 40----------------------- Essential components of AMC & CMC: Name and address of both the parties Details of the equipment under contract Duration of contract Nature of AMC (comprehensive or non comprehensive) Cost of the contract Number of visits and breakdown calls by the service engineer Payment terms Penalty clause ----------------------- Page 41----------------------- Maintenance Types of maintenance Routine Preventive Corrective ----------------------- Page 42----------------------- Routine Maintenance To ensure their long life and reliability of performance. Routine maintenance includes both preventive as well as corrective maintenance. Any electronic product requires timely service to function properly. In a blood bank, there is always a danger of undesirable machine breakdown. Preventive maintenance can save a lot of time and money. With PMS, it is possible to predict and identify parts which are at verge of collapse. ----------------------- Page 43----------------------- Preventive Equipment Maintenance Definition Measures to ensure proper equipment functioning and to minimize risk or equipment or breakdown Written procedures must exist for planned maintenance of blood bank equipment. Documents Develop written procedures for all equipment Step-by-step instructions for performing maintenance and function checks Include guide for troubleshooting ----------------------- Page 44----------------------- Preventive/planned maintenance (contd) Develop a Problem Log Record for each piece of equipment Date problem occurred, removed from service Reason for breakdown or failure Corrective action taken Date returned to use Change in maintenance or function checks ----------------------- Page 45----------------------- Other safeguards Warranty of new equipment for a sufficient time period to test performance of equipment. Safeguards for electronic equipment e.g. voltage stabilizer automatic switch over for emergency (generator) are ensured Periodic checks and repairs according to guidelines provided in the operational manual A logbook for all critical equipment ----------------------- Page 46----------------------- Preventive Maintenance Schedule of Equipment Name of the equipment Manufacturer & Model No. Name of supplier with contact No. Name of company to whom AMC given Contact person with phone no. Visit for Status of Any Equipment checked Next AM C due AMC on equipment on visit recommendation by on
Breakdown of the Equipment Blood centre has SOP for replacement/ repairing of defective equipment. The defective equipment is labeled and taken out of service. Once repaired it should be calibrated before put in use and the procedure is specified in a laid down SOP . For equipment which are non-functional a prominent label stating OUT OF ORDER is affixed. For equipment not in use a prominent label stating CURRENTLY NOT IN USE is affixed. Blood bank has a back up policy for shifting and storage of blood components in the event of breakdown of equipment. ----------------------- Page 48----------------------- Corrective Maintenance There is a system for communicating defects in equipment which is known to all staff. Written procedures exist for corrective maintenance of all essential blood bank equipment Procedures are described for repair of equipment by outside agencies and in house Records of external repair workshops are kept. Response time of the supplier in case of repairs necessary is recorded. ----------------------- Page 49----------------------- Proforma for repairing of an equipment Name of the equipment Model No. Manufacturer Date of fault reported Description of fault/malfunction Date of information to the vendor Date of visit by service engineer Details of repairs to be done Estimate of repairs Date of reporting to TEMD Repairs done on Duration of breakdown of the equipment Status of equipment after repairs Calibration & Validation Remarks ----------------------- Page 50----------------------- Retiring Equipment / Condemnation When? When service engineer indicate not repairable Outmoded, will replace with new equipment Why? Prevent inaccurate test results Free up valuable space Hazardous How? Condemnation Salvage any useable parts Consider biohazard, follow safety disposal procedures (example: blood irradiator) ----------------------- Page 51----------------------- Condemnation of Equipment Procedures for condemnation and disposal of obsolete equipment are laid down. Criteria for condemnation and disposal of equipment should be defined, such as: Non-functional and beyond economical repair Non-functional and obsolete Functional but obsolete Functional but hazardous Functional but no-longer required ----------------------- Page 52----------------------- To Summarize Importance of Equipment Management Program : Ensures a high level of performance Reduces interruption of services due to breakdowns and failures Lowers repair costs Lengthens life of instrument Provides greater reliability of results ----------------------- Page 53-----------------------