Benchmarking using KPIs help identify good practice – and so the work for 2012/13 includes some KPIs. These are limited in scope but will develop year-on-year with the development of the process of compiling data.
NHS Fife has written policies and procedures to cover the various stages in the life cycle of equipment. Our Good Practice Guide to Managing Equipment is currently being updated to reflect changes in practice. This guide is underpinned by the following up to date written procedures:
Equipment Procurement; Accessing Equipment; Equipment Inventory;
Equipment on Loan or Free Issue; Equipment permanent Location Change; Condemnation of equipment;
Transfer of liability for Written-Off Equipment Equipment Maintenance.
There is also a separate policy for the management of Electro-Medical equipment. This outlines the responsibilities of Medical Physics, Estates, the Department Equipment Controllers and links to the EMG and the other Equipment Policies. It also includes the ‘Code of Practice to Ensure Safety in the Servicing and Maintenance of Anesthetic and Respiratory Equipment’.
Equipment Management Group
There is an established Equipment Management Group (EMG) in NHS Fife which meets on a monthly basis. Until now it has had responsibility for the Acute Hospitals only but as of 2013 will be responsible for equipment management throughout NHS Fife.
There is a formal role and remit for the EMG. Its roles and responsibilities are:
To carry operational responsibility for medical equipment policy development and implementation; Agree policies on standardisation of equipment between units and sites where appropriate;
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Ensure Equipment Asset Register and Maintenance register are appropriately maintained by providing the necessary information;
Oversee the needs assessment process and initial prioritisation for medical equipment;
Prioritise the funding allocated by NHS Fife for procurement of Capital equipment and recommend the same for approval by the Capital Planning Group;
To agree the equipment specification and agree the final business case;
Take into account the impact of the procurement on the wider services within NHS Fife; To review a rolling programme of equipment replacement and to advise on the consequences; To oversee the procurement of medical equipment;
To review incidents involving equipment failure or misuse and recommend, alter, change practice or equipment to reduce the risk of repetition;
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Ensure appropriate policies and procedures are in place for all aspects of equipment procurement, use, maintenance, repair, decontamination, disposal and replacement and that staff are aware of all these policies.
The Group is chaired by NHS Fife’s Equipment Manger and all Directorates are represented on the EMG. There is also representation from Procurement, Estates, Finance, Infection Control, Risk Management and Training.
Department Equipment Controllers
Each ward or department formally nominates a person to carry out the duties of the Department Equipment Controller (DEC). Overall responsibility for Equipment Control lies with the line manager/charge nurse. The duties of the DEC include:
Maintain an up to date list of all equipment in the department; Participate in equipment selection arrangements;
Ensure new equipment is commissioned before use; Be responsible for User equipment servicing;
Record all events and build a history of each item in conjunction with Estates Department; Ensure equipment is maintained in accordance with manufacturer’s recommendations; Record movement of equipment.
A record of all Department Equipment Controllers is held within Estates Department.
Management and Inventories
A comprehensive asset and maintenance register is required to enable us to know what equipment we are looking after and provide its service history. In NHS Fife this information is managed by the Estates Department utilising Apollo: a commercial asset management database.
All new equipment is given an electronic asset tag and is logged by Estates Department in Apollo and also locally by the Department Equipment Controller.
Procurement of Medical Equipment
The process for procuring medical equipment is laid out in the aforementioned Equipment Procurement Policy and the Board’s Financial Operating Procedures.
The capital equipment budget is managed and allocated by the EMG.
EMG maintains a list of requests for new or replacement equipment that has been identified by departments. All requests are scored using the same grading matrix and held on a list to be allocated when funding is available.
EMG monitors the procurement of the equipment and ensures all processes are carried out effectively. National contracts are utilised where these exist. If no national contract exists then appropriate tendering procedures are used dependant on the value of the equipment.
There is also a Condemnation budget. Requests to this budget are managed by Finance.
Imaging Equipment
Due to the high value of all Imaging Equipment a percentage of the equipment budget has been ring fenced annually for the purchase of Imaging Equipment. This has enabled a planned equipment replacement programme to be identified and equipment replaced on a rolling basis. This work has been done in conjunction with the National Imaging Equipment Group of Health facilities Scotland in order to improve the cost effectiveness of purchasing and maintaining this type of equipment. This replacement programme will be ongoing.