CHALLENGES FACING MEDICAL ENGINEERING SERVICES IN KENYA

BY

MS SALOME MWAURAMINISTRY OF HEALTH, KENYA

Second WHO Global Forum on Medical Devices

22-24 NOV 2013

Introduction

� Medical Engineers in Kenya deal with maintenance and management of all medical and hospital equipment which includes Electrical, Civil, mechanical works and plants.

� Thus medical equipment are not given enough attention.

� This arises from lack of understanding and awareness of complexity of the Medical Equipment.

� Different staff are involved in making decision which at times affects the viability of equipment.

Introduction cont’d

� Most users work in isolation and therefore don’t think about other service providers.

� Therefore power and responsibility in decision making is disconnected from the end result.

� No one is made accountable for the result of their action as it is someone else who has to work with consequences.

Challenges

� Management of equipment life cycle� Budgetary allocations� Technical competency� Poor health facility management� Lack of technical documentation� Inadequate testing and measuring equipment� Sabotage� Donated equipment.� Poor management of resources.� Lack of equipment regulations

How do we overcome these challenges� This will be done through identification of the various component of technology package and our role as Medical Equipment Maintenance Managers (MEMM)

� These include:

◦ Selection

◦ Procurement

◦ Operation

◦ Maintenance.

Selection

� Choose equipment which is appropriate.

� Level of health service provision

� Clinical skills available

� Availability of sources of consumables

� Existing equipment and utilities

� Physical facilities

� Financial commitment

Procurement

We must be able to procure:

◦ The RIGHT ITEM,

◦ The RIGHT QUALITY

◦ The RIGHT QUANTITY

◦ At the RIGHT TIME,

◦ To the RIGHT PLACE

◦ And for the RIGHT PRICE

If you don’t procure the right item

A 30kg washing machine for a 300 bed capacity hospital

If you don’t procure the right quality

If you don’t procure the right quantity

If you don’t procure in the right place

Procurement cont’d

The purchaser must ask for:� Accessories� Start up consumables� Stock for spare parts� Operation and service manuals� A warranty� Training for users and technicians� A maintenance contract (if necessary)� Need for installation and commissioning(if necessary)

Operation

� Supervise installation and commissioning.

� There should be availability of consumables.

� Set up safety procedures.

� Set up standard operating procedures (SOPs).

� Train users

Maintenance

� Set up inventory of equipment , spares, and tools.

� Organize a PPM system. � Supervise maintenance contract.� Set replacement policy.� Oversee the stock control for spares and consumables.

� Initiate safety procedures.� Supervise capabilities for fault finding and modification.

� Provide feedback to manufacturers.

There is need for Medical Equipment Management which includes:

� Equipment Control and asset management

� Work order management

� Data quality management

� Personnel management

� Quality assurance

� Patient safety

� Risk management

� Risk management

� Hospital safety programs

Conclusion

� For effective equipment management the following officers must be involved in every step of METP:

� Clinicians

� Procurement officer

� Medical Engineers

� Administration

Way Forward

� Need for Policy guidelines

� Continuous professional development

� Improved curriculum in our training institutions

� Encourage Innovations

� Monitoring and evaluation