A risk-based maintenance approach for critical care medical devices: a case study application for a large hospital in a developing country

The availability of specialized medical equipment plays a critical role in the delivery of healthcare services. This becomes even more critical in developing countries where few medical devices are available in public hospitals, hence do not commensurate with demand, which leads to their overutilization. This often results in frequent failure of the medical devices and as a result, low availability. In turn, this leads to delayed treatment and consequently, access to affordable and quality healthcare by the disadvantaged in the society. This rather high unavailability of critical medical equipment in public hospitals in developing countries motivates this study, hence the necessitating the need to implement optimal maintenance strategies and operational protocols for maximizing equipment availability. However, selecting such optimal maintenance and operation strategies is not straightforward, and for this reason, a risk-based maintenance approach is proposed. The proposed approach addresses the aforementioned challenge through structured steps through which maintenance practitioners identify and prioritize prevalent failure modes. Based on the prioritized failure modes, operation and maintenance protocols may be derived. Moreover, the risk-based maintenance approach is useful for among other decisions, root cause analysis. The proposed risk-based maintenance approach consists of four steps; (1) data collection and standardization process, (2) modified failure mode and effect analysis step for prioritizing critical failure modes, (3) a root cause analysis step for analyzing the causes of recurrent failure modes, and (4) formulation of operation and maintenance strategies for mitigating equipment failure risks. The proposed approach is demonstrated in application in a case of large teaching and referral hospital in Kenya.