Application of Overall Equipment Effectiveness for Optimizing Ventilator Reliability in Intensive Care Units and Emergency Departments

Khelood A. Mkalaf; Rami Hikmat Al-Hadeethi; Peter Gibson

doi:10.51173/jt.v5i2.1419

Authors

Khelood A. Mkalaf Technical Institute for Administration, Middle Technical University, Baghdad, Iraq https://orcid.org/0000-0001-9260-9865
Rami Hikmat Al-Hadeethi University of Jordan, Amman 11942, Jordan
Peter Gibson University of Wollongong, NSW, 2522, Australia

DOI:

https://doi.org/10.51173/jt.v5i2.1419

Keywords:

Reliability-Based Maintenance, Risk-Based Maintenance, Ventilator Machines, Intensive Care Units, Emergency Departments

Abstract

Healthcare organizations seek to offer a comprehensive medical services system framework with safety and high quality. This needs continuously developing integrated governance systems that provide safe, reliable, and maintaining high-quality care and value-based care for patients. In addition to improving access to health services in time, increasing efficiencies in providing medical services, reducing the risk-based medical services, and selecting a suitable maintenance policy for maintaining the medical devices. This paper adopted a quantitative analysis method based on Reliability-Based Maintenance (RCM) to comprehensively evaluate the overall medical equipment's effectiveness. RCM is an integrated approach to continuous improvement of the maintenance programs because it can predict early medical equipment failure and determine the mean time between failures. It also assesses the risk level to the patient's life in case of a medical equipment breakdown while provisioning medical services. This study targeted biomedical engineering, intensive care units, and emergency departments at 24 public hospitals in a top 20 OECD country. It selected these departments due to the rise in the rate of patients needing ventilator equipment availability during COVID-19, risk based on the sudden breakdown of the ventilator machines, and increasing the annual budget percentage required to provide medical services, where 239 of the ventilator equipment were investigated. Staff Experience-based Evidence was adopted to collect data by interviewing staff and distributing the survey. The study found that the average OEE for ventilator devices in Intensive Care Units and Emergency Departments was 63%. The device's performance was rated at 65%, while its availability and quality rate were both rated at 100%. These findings suggest that the use of the OEE metric has improved ventilator device reliability and performance in selected hospitals. The OEE metric may have potential benefits for improving the performance of other medical devices as well.

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Author Biographies

Khelood A. Mkalaf, Technical Institute for Administration, Middle Technical University, Baghdad, Iraq

Dr. Khelood A. Mkalaf works with Middle Technical University. Iraq since 1989.
1. Head of Department of Materials Management Techniques. Technical Institute For Administration: Baghdad, Baghdad, IQ.
2. Member of the editorial board of the journal Technical. Middle Technical University. Iraq.
3. A Reviewer in the Journal "Materials Science Forum", 2020.
4. Member of the Technical Program Committee member of ICITM 2020. University of Oxford, United Kingdom.
5. Member of the Technical Program Committee member of ICEIT2020 and 2022. University of Oxford, United Kingdom.
6. Members of the Technical Committee and reviewers in the ICITM 2019 and ICITM 2021. University of Cambridge, United Kingdom.
7. Reviewer in the 2nd international conference on materials, Engineering, and science (IConMEAS 2019).

8. Reviewer in the 3rd international conference on materials, Engineering, and science (IConMEAS 2021).

Rami Hikmat Al-Hadeethi, University of Jordan, Amman 11942, Jordan

Industrial Engineering Department

Peter Gibson, University of Wollongong, NSW, 2522, Australia

Faculty of Engineering and Information Science

References

Gabriel, Laís Pellizzer, and Éder Sócrates Najar Lopes, "Simplification of regulatory practices for approving personal protective equipment and medical devices during the early stages of COVID-19 pandemic in Brazil." Research on Biomedical Engineering, vol.37, no. 4, 2021, pp.765-772. https://doi.org/10.1007/s42600-021-00183-y.

Sukma DI, Prabowo HA, Setiawan I, Kurnia H, Fahturizal IM., “Implementation of Total Productive Maintenance to Improve Overall Equipment Effectiveness of Linear Accelerator Synergy Platform Cancer Therapy.” International Journal of Engineering, vol. 35, no. 7, 2022, pp.1246-56. DOI:10.5829/IJE.2022.35.07A.04.

Suzumura EA, Zazula AD, Moriya HT, Fais CQ, Alvarado AL, Cavalcanti AB, Rodrigues RG., “Challenges for the development of alternative low-cost ventilators during COVID-19 pandemic in Brazil”. Revista Brasileira de Terapia Intensiva, vol. 12, no. 32, 2020, pp. 444-57. https://doi.org/10.5935/0103-507X.20200075.

Motta, Daniel, Luiz Fernando Taboada Gomes Amaral, Bruno Caetano dos Santos Silva, Lucas de Freitas Gomes, Willams Teles Barbosa, Rodrigo Santiago Coelho, and Bruna Aparecida Souza Machado, "Collaborative and Structured Network for Maintenance of Mechanical Ventilators during the SARS-CoV-2 Pandemic." In Healthcare, vol. 9, no. 6, p. 754, MDPI, 2021. https://doi.org/10.3390/healthcare9060754.

Dar, Mohammad, Lakshmana Swamy, Daniel Gavin, and Arthur Theodore, "Mechanical-ventilation supply and options for the COVID-19 pandemic, Leveraging all available resources for a limited resource in a crisis." Annals of the American Thoracic Society, vol. 18, no. 3, 2021, pp. 408-416. . https://DOI: 10.1513/AnnalsATS.202004-317CME.

Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y, Zhang L, Yu Z, Fang M, Yu T, Wang Y., “Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study”. The Lancet Respiratory Medicine, vol. 8, no.5, 2020, pp.475-8. https://doi.org/10.1016/S2213-2600(20)30079-5

Garner, Daniel J., David J. Berlowitz, James Douglas, Nick Harkness, Mark Howard, Nigel McArdle, Matthew T. Naughton et al. "Home mechanical ventilation in Australia and New Zealand." European Respiratory Journal 41, no. 1, 2013, pp. 39-45. https://DOI: 10.1183/09031936.00206311.

Khan, Faisal I., and Mahmoud M. Haddara, "Risk-based maintenance (RBM): a quantitative approach for maintenance/inspection scheduling and planning." Journal of Loss Prevention in the Process Industries, vol.16, no. 6, 2003, pp. 561-573. https://doi.org/10.1016/j.jlp.2003.08.011.

Mkalaf, Khelood A., "Total Productive Maintenance: A Safety Approach to Optimize the Anesthesia Device Outcomes." In 2020 9th International Conference on Industrial Technology and Management. IEEE, pp. 122-126, Feb 2020. DOI: 10.1109/ICITM48982.2020.9080374

MacIntyre, Neil R., "Current issues in mechanical ventilation for respiratory failure." Chest, vol.128, no. 5, 2005, pp. 561S-567S. https://doi.org/10.1378/chest.128.5_suppl_2.561S.

Guérin, Claude, and Patrick Lévy, "Easier access to mechanical ventilation worldwide: an urgent need for low income countries, especially in face of the growing COVID-19 crisis." European Respiratory Journal, vol. 55, no. 6, 2020. DOI: 10.1183/13993003.01271-2020.

Ferreira, J.C., Medeiros Jr, P., Rego, F.M. and Caruso, P., “Risk factors for noninvasive ventilation failure in cancer patients in the intensive care unit: a retrospective cohort study”. Journal of critical care, vol. 30, no.5, 2015, pp.1003-1007. https://doi.org/10.1016/j.jcrc.2015.04.121.

Riviere, Sven, Julien Monconduit, Véronique Zarka, Patrice Massabie, Stéphane Boulet, Philippe Dartevelle, and François Stéphan. "Failure of noninvasive ventilation after lung surgery: a comprehensive analysis of incidence and possible risk factors." European Journal of Cardio-Thoracic Surgery 39, no. 5, 2011, pp.769-776. https://doi.org/10.1016/j.ejcts.2010.08.016

Garcés, H.H., Lacalle, A.N., López, L.L. and Crespo, R.Z., “Risk factors associated to noninvasive ventilation failure in primary influenza pneumonia in the critical care setting”. Medicina Intensiva (English Edition), vol.45, no.6, 2021, pp.347-353. https://doi.org/10.1016/j.medine.2019.11.007.

Sosa-Hernández, O., Matías-Téllez, B., Estrada-Hernández, A., Cureño-Díaz, M.A. and Bello-López, J.M.. Incidence and costs of ventilator-associated pneumonia in the adult intensive care unit of a tertiary referral hospital in Mexico. American Journal of Infection Control, Vol. 47, no. 9, 2019, pp.e21-e25. https://doi.org/10.1016/j.ajic.2019.02.031

Alkhazraji, Huthaifa, Sohaib Khlil, and Zina Alabacy. "Evaluation of overall equipment effectiveness in concrete block manufacturing." Journal of Techniques, vol. 1, no. 1, 2019. pp. 6-17. https://doi.org/10.51173/jt.v1i1.85.

Singh, Ranteshwar, Ashish M. Gohil, Dhaval B. Shah, and Sanjay Desai. "Total productive maintenance (TPM) implementation in a machine shop: A case study." Procedia Engineering 51, 2013, pp. 592-599. https://doi.org/10.1016/j.proeng.2013.01.084

Sunadi, Sunadi, Humiras Hardi Purba, and Else Paulina. "Overall Equipment Effectiveness to Increase Productivity of Injection Molding Machine: A Case Study in Plastic Manufacturing Industry." ComTech: Computer, Mathematics and Engineering Applications, vol. 12, no. 1, 2021, pp.53-64.

Mkalaf KA, Al-Sabbagh AA, “Failure modes and effects analysis: An integrated approach for optimizing maintainability and redesign for the concrete pump”, In 2019 8th International Conference on Industrial Technology and Management. IEEE, pp. 157-164, Mar 2019. DOI: 10.1109/ICITM.2019.8710662

Ardeshir, A., Pedram Farnood Ahmadi, and H. Bayat, "A prioritization model for hse risk assessment using combined failure mode, effect analysis, and fuzzy inference system: A case study in Iranian construction industry," International Journal of Engineering, vol. 31, no. 9, 2018, pp. 1487-1497. https://doi:10.5829/ije.2018.31.09c.03.

Shamayleh, A., Awad, M., & Abdulla, A. O. Criticality-based reliability-centered maintenance for healthcare. Journal of Quality in Maintenance Engineering, vol. 26, no. 2, 2020, pp. 311-334.

Pinto CA, Farinha JT, Singh SA. “Contributions of Petri Nets to the Reliability and Availability of an Electrical Power System in a Big European Hospital-A Case Study”. WSEAS Trans. Syst. Control. 2021, vol. 16, pp. 21-42, DOI: 10.37394/23203.2021.16.2.

Jamshidi A, Rahimi SA, Ait-Kadi D, Ruiz A. “A comprehensive fuzzy risk-based maintenance framework for prioritization of medical devices”. Applied Soft Computing, 2015, vol. 32, pp.322-334, https://doi.org/10.1016/j.asoc.2015.03.054.

Hameed A, Khan F, Ahmed S. “A risk-based shutdown inspection and maintenance interval estimation considering human error”. Process Safety and Environmental Protection, 2016, vol. 100, pp. 9-21, https://doi.org/10.1016/j.psep.2015.11.011.

Rahman F, Sugiono S, Sonief AA, Novareza O. “Optimization maintenance performance level through collaboration of overall equipment effectiveness and machine reliability”. Journal of Applied Engineering Science, 2022, vol., 20 (3), pp. 917-36, https://doi.org/10.5937/jaes0-35189.

Mahfoud H, Barkany AE, Biyaali AE. “Medical maintenance performance monitoring: a roadmap to efficient improvement”. International Journal of Productivity and Quality Management, 2017, vol. 22 (1), pp. 117-40. https://doi.org/10.1504/IJPQM.2017.085850.

Mkalaf, Khelood A., “A study of current maintenance strategies and the reliability of critical medical device in hospitals in relation to patient outcomes”, 2015. https://ro.uow.edu.au/theses/4676.

Poppe J, Boute RN, Lambrecht MR. A hybrid condition-based maintenance policy for continuously monitored components with two degradation thresholds. European Journal of Operational Research. 2018 Jul 16;268(2):515-32, https://doi.org/10.1016/j.ejor.2018.01.039.

Mkalaf, Khelood A., and Peter Gibson. "Application the Risk-Based Maintenance for Optimizing the Overall Medical Devices Safety." Journal of Techniques 4, no. 4, 2022, pp. 111-118. https://doi.org/10.51173/jt.v4i4.615.

Slack N, Chambers S, Johnston R., Operations Management, Pearson Education, 2010.

Wang, B., E. Furst, T. Cohen, O.R. Keil, M. Ridgway, and R. Stiefel, “Medical equipment management strategies”. Biomedical Instrumentation & Technology, vol.40, no.3, 2006, pp. 233-237. https://doi.org/10.2345/i0899-8205-40-3-233.1.

Vasan, A., Weekes, R., Connacher, W., Sieker, J., Stambaugh, M., Suresh, P., Lee, D.E., Mazzei, W., Schlaepfer, E., Vallejos, T. and Petersen, J., “MADVent: A low‐cost ventilator for patients with COVID‐19”. Medical devices & sensors, 2020, vol. 3(4), p.e10106. https://doi.org/10.1002/mds3.10106.

Rabec, Claudio, Daniel Rodenstein, Patrick Leger, Sylvie Rouault, Christophe Perrin, and Jésus Gonzalez-Bermejo. "Ventilator modes and settings during non-invasive ventilation: effects on respiratory events and implications for their identification." Thorax 2011, vol. 66, no. 2 2011, pp. 170-178. http://dx.doi.org/10.1136/thx.2010.142661.