Implementation of a Multicomponent Program to Improve Effective Use and Maintenance of Medical Equipment in Sri Lankan Hospitals.

BACKGROUND

Medical equipment (ME) maintenance retains an asset's original anticipated useful life and preserves its reliability and cost-effectiveness. This study developed and implemented a multicomponent program to improve ME use and maintenance in nine Sri Lankan hospitals from May 2020 to May 2021.

METHODS

This pre-post implementation study involved an initial baseline assessment of existing ME maintenance systems, the development and implementation of a multicomponent improvement program, and a 3-month postevaluation. Five targets ME were selected for the study: oxygen regulator, electrocardiogram (ECG) machine, suction apparatus, blood pressure apparatus, and mini autoclave. A pretested questionnaire was administered to randomly selected nursing officers (n = 101) and health-care assistants (n = 120) to obtain baseline ME maintenance data. Six focus group discussions and 24 key informant interviews were conducted with key stakeholders to codesign the multicomponent interventions, which included: developing a standard operating procedure targeting preventive maintenance activities; establishing focal points to provide technical and logistic support; staff training; and the introduction of institutional ME maintenance documents. Program effectiveness was assessed at 3 months postimplementation using the seven predefined outcome variables.

RESULTS

Baseline assessment identified no ME maintenance programs implemented in any of the hospitals. The highest availability was observed for oxygen regulator (62% to 82.3%) and ECG machine (66.1% to 84.7%). The highest functionality improvement was observed for ECG machine (40.4% to 79.7%). The positive perception of maintenance process of ME achieved the highest (33% to 80%) improvement. Following program implementation, improvements were noted in: the availability (P = 0.00) and functionality (P = 0.00 to P = 0.02) of all selected ME; equipment maintenance processes (P = 0.000); as well as staff knowledge, skills, perceptions, and satisfaction.

CONCLUSIONS

The program improved the use and maintenance of ME and was widely supported by the key stakeholders. The approach is relevant to other resource-poor hospital settings, as inadequate ME maintenance causes health system inefficiencies.