3. Hidden failure (HF): a problem that could not be detected by the user unless running a special
test or using specialized test/measurement equipment. The appropriate solution is scheduled
inspection that would attempt to detect the failure and, if found, correct the failure.
Using maintenance monitoring data collected, CE managers can find ways to improve maintenance
services. For example, if the maintenance outcomes (uptime or failure rate) are unsatisfactory even
though the scheduled maintenance completion rates are high, the amount of maintenance oppor-
tunities detected (PPF, PF, and HF) need to be reviewed and their respective causes uncovered. On
the other hand, if PPF, PF, and HF are seldom found during scheduled and corrective maintenance,
the frequency of scheduled services may be unnecessarily high.
Frequent reviews and adjustments of individual maintenance strategies are typically necessary
when CE staff is not familiar with a particular brand or model of equipment. After desired outcomes
are achieved, it is not necessary to revisit every equipment group unless some unforeseen problems
appear. One way to optimize resources would be to share experiences with CE departments in
similar healthcare organizations that deploy the same brands and models of equipment. This kind
of cooperation is common in service outsourcing organizations where they can easily pool data and
experience from dozens or even hundreds of hospitals. Otherwise, one has to rely on the goodwill of
fellow CE professionals.Unfortunately,manufacturers are often reluctant to assist in the optimization
of maintenance efforts. Apparently, some are concerned about their liability exposure if they become
too aggressive in their recommendations, while others see post-sale service as a major source of
The discussions above are limited to improvement of maintenance activities. A broader dis-
cussion of CE Department performance monitor ing and continual improvement will be presented
later in this book.
Like any other type of equipment, medical equipment needs to be replaced when it no longer
provides safe, reliable, and effective services. Due to the rapid introduction of new and better medical
technologies and procedures,medical equipment is increasingly being replaced well before it is unsafe
or unreliable. Nonetheless, the CE Department has the duty to review periodically the status of each
piece or group of equipment to determine whether it is no longer technically feasible or financially
justifiable to continue to maintain it. Once replacement seems needed, the CE Department should
recommend the Capital Equipment Planning Committee to consider it as part of the equipment
incorporation process discussed above. Again, a detailed discussion on how to evaluate the technic al
and financial aspects of equipment replacement is beyond the space allotted for this book but can
be found in a prior one [Wang, 2008].

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