EQUIPMENT PLANNING Mr Mahboob Ali Khan MHA CPHQ

EQUIPMENT PLANNING Mr. Mahboob Ali Khan MHA CPHQ USA HARVARD UNIVERSITY

EQUIPMENT PLANNING A Good equipment planning includes careful Attention to fixed and movable equipments that will be needed in operations The lack of planning will result Wastage of millions of rupees Reduced Operational efficiency Lower standards of patient care

WHOM RESPONSIBILITY? (a) It is the responsibility of Hospital consultant (OR Hospital Administrator in case H. consultant not engaged) to determine all the items of equipments necessary, & then write their specification, recommended bids (tender) & purchase according to hospitals policy. (Expendable, non-expendable & capitals equipments) (b) The Architect is responsible for the Built in equipments.

WHEN & IN WHICH STAGE EQUIPMENTS PLANNING IS DONE ? (i) Equipments planning is done Early in design dev. Stage. This planning involves. (a) A series of Meetings of Medical staff HODs & Other Staffs to discuss the needed equipments

(b) Preparing Equipment List Room by Room (c) Review of this list by Administrator Medical staff Departmental heads Another detailed Equipments planning is necessary at final FURNISING & while actually EQUIPPING the hospitals

DESIGNING OF EQUIPMENTS A set of black line points of working Drawing (Floor Plans only) should be secured from Architect and marked up in advance all Gross equipments shown to scale & identified It is done in designing phase

NATURE OF EQUIPPING THE HOSPITALS It is an extensive and exhaustive work because it involves not only the degree but a variety of technical knowledge. There are innumerable expandable items, which should be procured and stoked in sufficient quantities.

There is no preformed procuring system in the new hospitals (if compared with an old existing running hospital) The problem is compounded by installing equipments apart from purchasing them. Important considerations are Timing of delivery Warehousing Unpacking Assembling

IMPORTED EQUIPMENTS creates more complex problems like (a) Needs, approvals and licenses. (b) Bureaucratic hurdles needed to be crossed (c) costly items (d) Lead time is longer. (e) Delay can cause losses in millions.

COSTING In a Modern General Hospital the equipping cost is around 40% of total project cost. (a) 20% is invested on mechanical and electrical installations (b) 20% is invested on medical equipments

TYPES OF EQUIPMENTS (a) Built- in Equipments (b) Depreciable equipments (Nonexpandable) (c)Non-depreciable (Expandable) (d) Capital Equipments equipments

BUILT IN EQUIPMENTS It’s the Architect’s Responsibility Included in construction contracts List includes Cabinets & counters in Pharmacy Laboratory Other parts of hospitals

Fixed kitchen Equipments. (lines) & (Channels) Elevators Dumb waiters Sterilizers, Boilers Incinerators. Air Conditioning/Deep freezers Surgical lighting etc

(B) NON-EXPENDABLE EQUIPMENTS OR Depreciable Equipments Def: The Equipments that have a life of 5 yrs of > 5 yrs are k/a Non-Expendable equipments These equipments are not purchased through construction contracts These large items of furniture and Equipments have a reasonable fixed location in the hospital building but are capable of being moved

EXAMPLES OF DEPRECIABLE EQUIPMENTS (i) Surgical Apparatuses (ii) Diagnostic & Therapeutic Equipment (iii) Lab & pharmacy Equipment. (iv) Office Equipment Typewriter, Intercoms Computers/Electronic exchanges (v) General use surgicals Refrigerator Physiotherapy equipments Suction machines

(vi) Diagnostic and Therapeutic Eqpts. Like Sw diathermy, X-Ray machine Cutlery, ECG machine Respirators, Incubators Monitoring Eqpts Ultra sound machine Respirators

(C) EXPENDABLE (NONDEPRECIABLE) EQUIPMENTS These Equipments have life span < 5 yrs Recurring in use & low cost equipments. These equipments are purchased through other than construction contracts. Examples are Kitchen utensils Chinaware Table ware Surgical instruments Catheters Linen, sheets, Blankets Lamps, Wastebins etc.

PREPARING THE EQUIPMENT LIST The list of expandable and non-expandable items is prepared by H. consultant & H. Administrator Steps in preparing the list are (i) consider each Room as a separate Eutily in the plane (ii) Make a compressive Room by Room eqpments

LIST WITH ADDITIONAL ITEMS REQUIRED Detailed specifications must be given During design stage Should test the space needed for each item of the eqpts on the list in drawings

IMPORTANT CONSIDERATION Hospital interest lies in purchasing minimum needed Equpts & Hospital consultant can help in it.

SELECTING THE EQUIPMENTS Selection of Technical, Scientific and Medical Eqpts requires careful Analysis of the needs of each department and conscientions study that will result in selection of needed equpts. The present day High-tech medical eqpt. is mind-boggling to even medical experts that the H. consultant and H. Admi. may be easily stumped out

Departmental heads satisfied with the Type & should be fully satisfied with the Type & Quality of eqpt. So they should consulting before selections of equpts. Indiscrimnatory procurements of eqpts. may be a wastage and liability to the hospital.

TIMING OF PURCHASE, ORDER & DELIVERY Are exceedingly important (i) Delivery Instructions should be keyed to the building completion schedules (ii) H. Adm may ask a central General store space & adjoining room form temporary storage of eqpts from contractor 6 months before opening & 3 months before completion schedule

(iii) These spaces can be used as work center for equipping operation. Time schedule and Performance Agreements will be helpful in their concern If there is Delay in construction, the supplier should be notified to delay supplies. The storage places should be protected from weather, Theft and damage but should not obstruct the construction

SYLLABUS Preparing hospitals (a) eqpts list for the new Building equipment (In built eqpts) (b) Non expendable (Depreciable) Locally available Imported Expendable equpt (no depreciable) Capital equipments – CT scan/MRI

EQUIPMENT PLANNING Hospitals planning include careful Attention to Fixed and immovable eqpts that will be needed in operation Lack of planning's can involve Wastage of lakhs of rupees Reduced operative efficiency & Low standards of pt. care

RESPONSIBILITY OF It is the Responsibility of Hospital consultant (OR H. Administrator in case H. Consultant not engaged) to determine all the items of eqpts necessary, write their speciation, recommend bids & the purchase accerding to hospital policy. The domains of hospitals consultant/Adm. Is expendable, non expandable & capital eqpts. The Architect is responsible for the Built in equipments

WHEN THE PLANNING IS DONE First Equipment planning is dore early in the design development stage. The planning involves (i) A series of meetings medical staff, HODs & other staff to discuss the needed equpts (ii) Preparing Room by Room eqpt list (iii) Review of this list by Administrator medical & departmental staff. Another detailed equipment planning in necessary at Actual Furnishing & equipping the hospital

DESIGNING THE EQUIPMENT A set of black line points of working drawings (floor plans only) should be secured from Architect & market up in advance, All Gross shown to seale & identified Done in Designing phase

NATURE OF EQUIPPING WORK It is an exhaustive work because it involves not only degree but a variety of technical knowledge. There are innumerable expendable items which should be procured & stocked in sufficient Quantities No well procuring system in a new hospital (c/f purchasing in an running hospital) This problem is compounded by timing of delivery, ware housing, unpacking Assembling & installing eqpt apart from purchasing

IMPORTED EQPTS Poses more complex problem (a) Needs Approvals & license (b) Burecratie hurdles needed to be crossed (c) Costly items (d) lead time will be longer (e) Delay can cause loss in lakhs

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