Creating HEALTHCARE for the WORLD
An- Najah National University
Faculty of Engineering
Industrial Engineering Department
Developing Maintenance Management
System in Al-Arabi Specialized Hospital
Supervisor
Eng . Tamer Haddad
Students
Reem Asmr
Shayma Smaaneh
Nazmia Mana’a
Sawsan Deek
Ahmad Zaher
Rasha Abu-shanab
Sections :
Introduction
5.Apply the 5S system to arrange the workshop and reduce
the time taken in maintenance.
Maintenance management
Current Status for Maintenance System
Suggested Maintenance Management System
Conclusion and Recommendations.
Al-Arabi Specialized Hospital
History of Al-Arabi Specialized Hospital



Established in 2000 by a group of creative doctors
Located in Nablus
ISO in 2001
Objectives
The main objectives of this project are :
1- Investigate implementing maintenance
management systems in Healthcare Facilities.
2- Developing a new suggest maintenance system
and compare it with the current used one.
3- Developing a new implementation framework
for Healthcare Facilities.
4- Discussing the difficulties in the adoption of
maintenance systems with proper solutions.
Maintenance
 Definition
: to keep the equipment in operational condition
or repair it back into its‟ operational mode
 Objective: increase availability of production systems,
increase safety and optimized cost.
Preventive
maintenance
Corrective
maintenance
Types of
maintenance
Maintenance in Healthcare Facilities
 The
Hospital maintenance department is a crucial element to a
high quality healthcare facility.
 The excellent functioning or, by other words, the maximum
reliability of facilities and equipment is a main rule for this
department.
 The policy that permits such performance must always be
based on planned maintenance including preventive
maintenance.
 To be in advance to failures The other goal persuaded, it is to
maintain costs as lower as possible.
CURRENT SYSTEM
Current system include
The Organizational Structure
Flow charts
The used reports templates
Performance indicator
Analysis of available data
Problems related to the current system
The Organizational Structure
Medical
maintenance
Engineer
Organizational
structure
Flow charts
Reports templates
Head if
Maintenance
Department
Performance
indicator
Analysis of data
Problems
Maintenance
technician (1)
Maintenance
technician (2)
The Maintenance Activities Process
Flow chart :
Organizational
structure
Start
Failure
Inform the maintenance
department for the
failure orally
Filling the request of general
maintenance report
Inform the service
technician internally or extern
ally for the failure orally
Sending request for
maintenance department
No
Filling the request of
the external
maintenance report
Sending the request to
the competent
authorities
Sending the service technician to
the site of failure
Repairing the
failure
The end
Is it possible to
maintain the fault
internally?
Yes
Flow charts
Reports templates
Performance
indicator
Analysis of data
Problems
Report templates
1- Devices and Machines List.
Organizational
structure
Flow charts
Reports templates
Performance
indicator
Analysis of data
Problems
:)‫رئيس قسم الصيانة (التوقيع والتاريخ‬
Report templates
2- Annual Preventive Maintenance Plan.
/
/
:‫تاريخ اإلعداد‬
Organizational
structure
Flow charts
Reports templates
Performance
indicator
Analysis of data
Problems
:)‫رئيس قسم الصيانة (التوقيع والتاريخ‬
Report templates
3- Summary of Preventive Maintenance Works.
________: ‫ _________________ السنة‬:‫ الجهاز_______________ الشهر‬/ ‫الجهاز ______ رقم الماكنة‬/‫اسم الماكنة‬:
Organizational
structure
Flow charts
Reports templates
Performance
indicator
Analysis of data
Problems
Report templates
. 4- Request for General Maintenance report.
Organizational
structure
Flow charts
Reports templates
Performance
indicator
Analysis of data
Problems
Report templates
5- Request for External Maintenance report..
Organizational
structure
Flow charts
Reports templates
Performance
indicator
Analysis of data
Problems
Report templates
6- Record of Maintenance Requests.
Organizational
structure
Flow charts
Reports templates
Performance
indicator
Analysis of data
Problems
Report templates
7- Machine/Device Record.
Organizational
structure
Flow charts
Reports templates
Performance
indicator
Analysis of data
Problems
Report templates
8- The “Under Maintenance” Card
‫قسم الصيانة‬
Organizational
structure
Flow charts
"‫"تحت الصيانة‬
Reports templates
UNDER MAINTENANCE
‫ الجهاز‬/ ‫ال تستخدم هذه الماكنة‬
Performance
indicator
Do Not Use This Equipment / Device
Analysis of data
Problems
Measurement of Maintenance
Activities Performance
The Performance Indicator/ Maintenance Monthly report
Organizational
structure
Flow charts
Reports templates
Performance
indicator
Analysis of data
Problems
Measurement of Maintenance
Activities Performance
The Performance Indicator/ Maintenance Monthly report
Organizational
structure
Flow charts
Reports templates
Performance
indicator
Analysis of data
Problems
Analysis of Malfunctions Data
Department malfunctions frequencies.
Organizational
structure
Flow charts
Reports
templates
Performance
indicator
Analysis of
data
Problems
Analysis of Malfunctions Data
Lab devices malfunctions frequencies.
Organizational
structure
Flow charts
Reports
templates
Performance
indicator
Analysis of
data
Problems
Malfunctions’ Causes Analysis
A. Chemwell-Awarness
Chemwell-Awarness device has the highest number of failures
Environment
Poor Cleaning
Poor
cleaning
of lamp
Dust in the
surrounding
area
Bad
preventive
maintenance
Flow charts
Poor
cleaning of
filter
Failure of Chemwell
Awarness device
Excess load
Organizational
structure
Untrained
staff
Reports
templates
Performance
indicator
Human
Analysis of
data
Cause-Effect diagram for Chemwell-Awarness device.
Problems
Malfunctions’ Causes Analysis
B. Blood Gas Analyzer
It’s the second highest device in number of failures
Poor Cleaning
Flow charts
Poor internal
cleaning
Untrained
staff
Organizational
structure
Failure of Blood
Gas Analyzer Device
Bad
preventive
maintenance
Excess load
Human
Reports
templates
Performance
indicator
Analysis of
data
Cause-Effect diagram for Blood Gas Analyzer device
Problems
Malfunctions’ Causes Analysis
C. Electrolyte
It has the same number of failures as the Blood Gas Analyzer device
Equipment
Flow charts
Poor Cleaning
Poor
cleaning
after
using
Insufficient
self washing
Failure of Electrolyte
device
Wrong
calibration
process
Excess
load
Human
Organizational
structure
Calibration
Reports
templates
Performance
indicator
Analysis of
data
Cause-Effect diagram for Electrolyte device
Problems
Problems related to the existent system
These problems can be summarized as:
1.The general and external reports are written by
hand
2.The reports are stored in a non-professional and
unsafe way
3.All maintenance reports related to all hospital
departments are stored together in one record.
Organizational
structure
Flow charts
Reports templates
Performance
indicator
Analysis of data
Problems
4.Many simple malfunctions could be fixed at the
instant of occurrence instead of taking a long time in
performing the maintenance operation.
Problems related to the existent system
These problems can be summarized as:
5.When there is a need for external maintenance,
then the request for external maintenance report must be
documented and attached with the request for general
maintenance report.
6.Record of Maintenance Request reports are
not filled out.
7.The used performance indicator is not
efficient and is not accurate.
Organizational
structure
Flow charts
Reports templates
Performance
indicator
Analysis of data
Problems
Problems related to the existent system
•The following items are not documented in most request
for general maintenance reports:
1.The name of the department that submitted the request
for maintenance report.
Organizational
structure
Flow charts
Reports templates
2.The name of the person who informed of the malfunction.
Performance
indicator
Analysis of data
Problems
3.The date and time of malfunction occurrence.
Problems related to the existent system
•The following items are not documented in most request
for general maintenance reports:
4.The name of the technician who performed the
maintenance.
Organizational
structure
Flow charts
Reports templates
5.Description of the malfunction and the reasons of its
occurrence
Performance
indicator
Analysis of data
Problems
6.Clarifying the need for local or external maintenance
SUGGESTED MAINTENANCE MANAGEMENT SYSTEM
Suggested Maintenance Management System
Include :
Job description
Suggested Organizational Structure
Suggested Flow charts
Suggested Tracking Serial Number
Suggested Report Templates
Suggested Measurement of
Maintenance Activities Performance
5S Implementation
Computerized Maintenance
Management System (CMMS)
Job Description
a) The Head of the Maintenance Department
Job description
•Job Title: Head of the Maintenance Department:
•The academic qualifications and experiences required:
Organizational
Structure
1. Bachelor degree in Medical, Mechanical, Electrical or Electronic
engineering.
2. Six years of experience in maintenance work of which two
years in experience as head of a department in a hospital.
• Main tasks:
1. Planning, organizing, directing and monitoring all maintenance
activities in the hospital.
2.Determining the departments annual needs of devices, equipment
and spare parts.
3.Supervision of preventive maintenance programs and
Documentation and archiving the maintenance reports.
4. Assess the level of performance of the department
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Job Description
b) Medical Maintenance Engineer
Job description
•Job Title: Medical Maintenance Engineer.
•The academic qualifications and experiences required:
Organizational
Structure
1. Bachelor degree in Medical or Electronic devices engineering.
2. Five years of experience in maintenance of medical devices.
• Main tasks:
1. Developing a work program and distributing duties on
medical devices technicians.
2. Following-up on medical devices that are sent to outer repair
shops.
3. Provide the tools, inspection equipment and spare parts
required for maintenance.
4. Submitting the periodic reports to the head of maintenance
department.
5.Developing preventive maintenance programs associated
with the medical maintenance department.
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Job Description
c) Medical Devices Technician
Job description
•Job Title: Medical Devices Technician
•The academic qualifications and experiences required:
Organizational
Structure
1. A two years diploma in medical devices.
2. Five years of experience in maintenance medical devices.
• Main tasks:
1. Preparing tools and inspection equipment that are necessary
to inspect and maintain the medical devices.
2. Dismantling and cleaning of medical devices for testing,
calibration or maintenance and their re-installment according to
the established maintenance procedures and manufacturer’s
instructions.
3. Making sure that the backup parts of a device are available
before starting to repair it.
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Organizational Structure
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Flow Charts
1.Preventive Maintenance process
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Flow Charts
2.Corrective Maintenance Process
Internal Maintenance Process
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Flow Charts
2.Corrective Maintenance Process
External Maintenance Process
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Tracking Serial Number
serial number is a unique number assigned to facilitate
Job description
identification the devices locations.
Organizational
Structure
( EM 04 11 1011)
Flow charts
Serial Number
emergency
department,
fourth floor
room number
Machine
code #
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Report Templates
1. Device list.
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Report Templates
2. Annual Preventive Maintenance Plan.
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Report Templates
3. Preventive Maintenance card “PMC”.
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Report Templates
4. Preventive Maintenance Checklist.
Daily preventive maintenance checklist.
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Report Templates
5. Request for General Maintenance report.
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Report Templates
6. Request for Outside Maintenance report..
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Report Templates
7. Records of Maintenance Requests
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Report Templates
8- Device Record
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Measurement of
Maintenance Activities Performance
• Data Sheets
1- Preventive maintenance data sheet.
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Measurement of
Maintenance Activities Performance
• Data Sheets
2- Corrective maintenance data sheet for devices..
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Measurement of
Maintenance Activities Performance
• Data Sheets
2- Corrective maintenance data sheet for devices..
This chart helps in recognizing the most causes of failures
and their frequencies. As shown it is obvious that the
human causes have the highest frequency.
Job description
Organizational
Structure
Flow charts
Serial Number
fauiler casues-freq(for each device)
Report Templates
Frequency
14
12
10
8
6
4
2
0
Activities
Performance
Human
Environment P .cleaning
Failure causes
5S
(CMMS)
Suggested Measurement of
Maintenance Activities Performance
• Data Sheets
3- Corrective maintenance data sheet for departments.
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Measurement of
Maintenance Activities Performance
• Data Sheets
3- Corrective maintenance data sheet for departments.
The following chart represents the frequency of failures of the labs’
devices as an example.
Devices vs Failure freq
Job description
Organizational
Structure
Flow charts
Serial Number
6
Report Templates
5
4
Failure
3
Frequency
Activities
Performance
2
1
0
Blood gas Chemwell Electrolyte Modonic Microscope easylyte
Hettich
analyzer awarness analyzer
centrifuge
Device name
5S
(CMMS)
Suggested Measurement of
Maintenance Activities Performance
• Data Sheets
4-Corrective maintenance data sheet for the maintenance department
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Suggested Measurement of
Maintenance Activities Performance
• Data Sheets
4-Corrective maintenance data sheet for the maintenance department
The following chart is used to facilitate identifying and the
number of failures in each department in addition to
notifying the maintenance type performed for each failure
whether if it is internal or external.
Internal&External maintenance Vs failures frequency
4
3
3
2
Failure frequency
2
1
1
0
Organizational
Structure
Flow charts
Serial Number
Report Templates
Internal
External
Departments
Job description
Activities
Performance
5S
(CMMS)
5S Implementation
 Definition
: It is an approach to keep the
work place in the different departments and
in the maintenance workshop in a suitable
condition to perform the required work
efficiently.
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
 There
are five primary phases of 5S: sorting,
straightening, systematic cleaning,
standardizing and sustaining.
Activities
Performance
5S
(CMMS)
5S Implementation
1. Sorting
Eliminate all unnecessary tools, parts, and instructions. Go through
all tools, materials, and so forth in the plant and work area.
Job description
Organizational
Structure
Flow charts
2. Straightening or Setting in order
There should be a place for everything and everything should be in its
place
3. Systematic cleaning or shining
Clean the workspace and all equipment, and keep it clean, tidy
and organized.
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
5S Implementation
Job description
4. Standardizing (Seiketsu)
Work practices should be consistent and standardized. All
work stations for a particular job should be identical.
Organizational
Structure
Flow charts
5. Sustaining the discipline or selfdiscipline
Maintain and review standards. Once the previous 4 S's have
been established, they become the new way to operate.
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
5S Implementation
To assess the level of the maintenance workshop in the
hospital based on the 5S modeling, the following checklist
form should be followed.
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
5S Implementation
Job description
Organizational
Structure
Flow charts
Serial Number
Report Templates
Activities
Performance
The workshop table.
As shown, the table is dirty and
untidy.
The workshop shelves
As shown the shelves are
in a very bad
5S
(CMMS)
CMMS
Computerized Maintenance
Management System (CMMS)
Definition
Job description
(CMMS) is a type of management software that performs functions in Organizational
Structure
support of management and tracking of maintenance activities.
Flow charts
A suggested CMMS interfaces has been developed for the maintenance
department in the hospital to facilitate managing and documenting the
operation since there are huge amounts of information should be extracted
and documented.
Example:
Serial Number
Report Templates
Activities
Performance
5S
(CMMS)
Maintenance Department
ADD A NEW MAINTENANCE REQUEST
VIEW THE RECORD OF MAINTENANCE REQUESTS
EDIT REQUEST
PREVINTIVE MAINTENANCE CHECK LIST
DEVICE RECORD
RECORD OF MAINTENANCE REQUESTS
PERFORMANCE INDICATORS
MAINTENANCE DEPARTEMENT
GENERAL MAINTENANCE REQUEST FORM
-INQUIRY FORM -
Date of reporting:
Time :
Department:
Floor number :
Employee name:
Failed
device
information
Device
information
Device number :
Device code :
Time :
Date of fauiler :
Failure
Failureclassification:
classification
save
Mechanical
civil
medica
electrical
clear
proceed
MEDICAL MAINTENANCE DEPARTEMENT
-MEDICAL MAINTENANCE ENGINEER Request number :
Failure description :
……………………………………………………………………
…………………………...
Failure causes:
Poor cleaning
Human
Environment
calibrration
Otherwise
Type of needed maintenance
Fill the maintenance
activity form
Internal
fill the external
maintenance request
form
External
next
Next
back
Exit
MEDICAL MAINTENANCE DEPARTEMENT
EXTERNAL MAINTENANCE REQUEST FORM
Request number :
Date :
Device name :
Device code
:
supplier name:
Notifications:
………………………………………………
…………………………………...
save
back
proceed
MEDICAL MAINTENANCE DEPARTEMENT
EXTERNAL MAINTENANCE ACTIVITY FORM
supplier name:
…………………………………………
………………………...
The executed maintenance description :
The used parts -if exists
number
type
quantity
Maintenance action date :
spent Time :
Delivered date :
Delivered to:
save
next
Back to menu
MEDICAL MAINTENANCE DEPARTEMENT
PREVENTIVE MAINTENANCE CHECK LIST
Department name
Failure frequency VS
Type of
maintenance
minth
check list
Daily
Weekly
Monthly
Annual
Semi-annual
Date
Back
Backto
tomenu
menu
Proceed
MEDICAL MAINTENANCE DEPARTEMENT
PREVENTIVE MAINTENANCE CHECK LIST
Failure frequency VS minth
Daily preventive maintenance check list
Department name
Date
Device name
PM code
Maintenance status
Result
NO . Of incomplete
maintenance activity
Back
Backto
tomenu
menu
Print
MEDICAL MAINTENANCE DEPARTEMENT
RECORD OF MAINTENANCE REQUESTS
Choose a year :
2008
2009
2010
2011
jan
Choose a month :
Feb
March
April .
….
Back
Backto
tomenu
menu
Proceed
RECORD OF MAINTENANCE REQUESTS
Request
number
Device
Department
name /Serial
name
number
Failure
Maintenance
occurrence
type
Executer name
(ext \ int)
Date
Time
Failure
reporting
Date
Time
Failure maintenance
Date
Ts
Frequency for internal maintenance request :
NO. of external maintenance
requests in all departments t :
NO. of failures :
NO .of internal maintenance
request in all departments t :
Departments :
emergency
Data for department
Select department:
lab
Men
outoscope
Back
Backto
tomenu
menu
Print
Tf
Tspent
DEPARTEMNT MAINTAINANCE REQUESTS
Number of failure :
Number of external
maintenance request :
Number of internal
maintenance request :
Back to
menu
Save
Exit
DEVICE RECORD
Choose a device :
·
·
·
·
·
·
Chemwell- awarness
Modonic
Pressure device
ECG
Electrolyte
…….
Serial number :
Start using date:
Back
Backtotomenu
menu
proceed
DEVICE RECORD
Device name:
Request #
Failure
causes
Device number :
Maintenanceused
type
parts
Cost
Executer
name
Failure
occurrence
Date
Time
Failure
reporting
Date
Failure maintenance
Time
Date
Ts
Tf
NO. of internal maintenance:
NO. of failure:
Frequency of failure causes:
Mean time between
failures
Mean Down
Time
NO. of internal
maintenance:
causes
.human
.Environment
. Cleaning
…….
Mean spent time
Mean inactive time
NO. of external
maintenance:
Back
Backto
tomenu
menu
Print
Print
frequency
Tspent
PERFORMANCE INDICATORS
Choose indicator :
·
Performance
indicators :
·
·
·
Preventive Maintenance
indicators.
Corrective Maintenance
indicators for
departments
Corrective Maintenance
Select department
Lab
Emergency
Maternity
Nursing
Men
…..
Select department
indicators for devices.
Lab
Select device
Emergency
:
Show graph : MonthYes
No
Year:
·
Maternity
Nursing
Men
…..
·
·
·
Corrective Maintenance
indicators of the Medical
maintenance department.
Starting date
End date
Back
Backto
tomenu
menu
proceed
Pressure device
Outoscope
…..
PERFORMANCE INDICATOR
CORRECTIVE MAINTENANCE SHEET FOR DEPARTEMENT
Month :
Year :
Department name
Year
Month
No. of devices
NO. of incomplete daily preventive
maintenance:
NO. of incomplete weekly preventive
maintenance:
Total No. of failures
For the department
NO. of incomplete monthly preventive
maintenance:
No . Of total maintenance
operation
NO. of incomplete semi-annual preventive
maintenance:
No . Of internal maintenance
-if exist in this month operation
No . Of external
NO. of incomplete annual preventive
maintenance operation
maintenance:
-if exist in this month Frequency of failure for each device in
the department
Device
proceed
back
Frequency
Of failure
NO.
External
Back
NO.
Internal
CORRICTIVE MAINTENANCE ACTIVITY
PERFORMANCE INDICATOR FOR DEPARTMENT
·
Department failure
frequency VS
month
Select type of operation
Select indicator
·
operation
frequency VS
month
Internal maintenance operation
External maintenance operation
All maintenance operation
·
Print
Graph
Devices in the dep
VS failure
frequency
Back to menu
PERFORMANCE INDICATOR
CORRICTIVE MAINTENANCE ACTIVITY
Failure frequency VS
Department
failure
minth
frequency VS month
Department name
Month
Frequency of failure
jan
feb
march
April
May
month - frequency of failure for the
departement
8
6
4
month
2
freq of fauilers
0
jan
Print
Print
feb
march
april
back
may
End
PERFORMANCE INDICATOR
CORRICTIVE MAINTENANCE ACTIVITY
Failure
frequency
minth
Devices
Vs failureVS
frequency
in
the department
Department name
Table of values :
Device name
Frequency
of failure
Modonic
3
Microscope
5
Easylyte
2
electrolyte
Print
Print
1
back
End
RECOMMENDATIONS
Recommendation
1.Creating a computerized system to deal with the data and
to ensure the documentation of information to save time.
2.Review the approved coding system and replace it with a
new system to facilitate dealing with the hardware.
3.Hold training sessions for the maintenance crew every
now and then.
4.Change the (organizational structure) used previously and
apply the new organizational structure which regulates and
determines the crews’ responsibilities
5.Apply the 5S system to arrange the workshop and reduce
the time taken in maintenance.