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Clinical engineering professionals need to continually review and improve their management strategies in order to keep up with improvements in equipment technology, as mil as with increasing expectations of health cure organizations. In the lust 20 years, management strategies have evolved from the initial obsession with electrical safety to flexible criteria that fit the individual institution's needs. Few hospitals, however, are taking full advantage of the paradigm shift offered by the evolution of Joint Commismsion standards. The focus should be on risks caused by equipment failure, rather than on equipment with highest maintenance demands. Furthermore, it is not enough to consider risks posed by individual pieces of equipment to individual patients, it is critical to anticipate the impact of an equipment failure on larger groups of patients, especially when dealing with one of a kind, sophisticated pieces of equipment that are required to provide timely and accurate diagnoses for immediate therapeutic decisions or surgical interventions. A strategy for incorporating multiple criteria to formulate appropriate management strategies is provided in this article.
(Biomedical Instrumentation & Technology 2006; 40:233-237).
The medical equipment management standards published by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) have been a major driving force for the practice of clinical engineering (CE) in the United States over the last 20 years. During that time, JCAHO has continually revised and improved these standards as health care and technology have evolved. We review here some of those changes that allow us to refocus our resources on areas with the greatest potential for improving patient care and enhancing organizational success.
When JCAHO introduced the Shared Vesions-New Pathways accreditation process in 2004, standard EC.6.10, Element of Performance-EP4 stated, "[t]he organization identifies appropriate inspection and maintenance strategies for all equipment on the inventory for achieving effective, safe, and reliable operation of all equipment in the inventory." JCAHO also clarified in a footnote that "[h]ospitals may use different strategies for different items as appropriate..." Therefore, hospitals are allowed to not schedule inspection or maintenance tasks for certain pieces or types of medical equipment, if they determine that these tasks are not needed for safe and reliable operation. Furthermore, it is acceptable to establish different maintenance and/or inspection procedures or schedules for identical devices used in different...