Purpose: Recently, the availability and utilization of healthcare equipment has been emphasized for effective and efficient service delivery. Nevertheless, in common practices, there is a general lack of measurement systems, indicators, and methodologies to support the effective management of the equipment in hospital so that they are operated to their full operational potential and maintained at that level. The purpose of this thesis is to understand indicators and measurements used in healthcare sector, develop an indicator to support healthcare equipment management and finally validate empirically the indicator in a leading hospital in Lombardy. Design/Methodology/Approach: The research process followed in this thesis was carried out implementing three main phases. Firstly, a literature review was performed in order to define the state of the art of maintenance performance measurement systems in healthcare sector. Then, based on the findings from the literature and by comparing it with existing industrial practices and indicators, an adapted overall equipment effectiveness (OEE) indicator was developed for medical equipment. Finally, to adjust the theoretical indicator, an empirical case study was conducted, implementing the developed adapted indicator on three typologies of equipment at the Varese Hospital Company, Sette Laghi, in collaboration with the clinical engineers. Main Findings: The literature search confirms the growing interest of industrial practices on healthcare process but, several gaps come out: the literature on asset management in healthcare organizations is limited and not well suited with the real environment. Although healthcare organizations have great maintenance needs for their medical equipment there is an overall lack of measurement systems, metrics and indicators that take into account time wastes leading to inefficiencies in the use of medical equipment. In this thesis, an adapted Overall Equipment Effectiveness (OEE) for medical equipment was developed and applied. Overall, the indicator proved to be useful for assessing the use of medical equipment in the hospital, nevertheless, several limitations have been identified, for its full adoption in practice. Research Limitations and Implications: The analysis is limited by the number of equipment under study in Varese Hospital and by the scant number of reliable data. The data actually available in the hospital database weren’t immediately suitable to apply the OEE indicator. Moreover, given by the recognition on the adapted indicator by the clinical engineers in the Hospital, there is a large space for further research. Practical Implications: The literature analysis findings and the empirical case let emerge evident existing limitations between practice and theory: nowadays the hospitals don’t have reliable data suitable to support the needs of academic solutions, the possible losses affecting the medical equipment utilization aren’t entirely understood, and it is difficult to group them in categories, and finally, there is a difficulty to standardize the time given that is highly depend to the interrelation between patient, equipment and medical staff. In conclusion, the contribution of the OEE indicator have been recognized by the practitioners, nevertheless the identified limitations open for further research endeavours.
Scopo: Di recente, è stata enfatizzata l’esigenza di migliorare la disponibilità e l'utilizzo delle attrezzature sanitarie, al fine di garantire un'erogazione del servizio più efficace ed efficiente. Tuttavia, nelle pratiche comuni, vi è una generale mancanza di sistemi di misurazione, indicatori e metodologie per supportare la gestione efficace delle attrezzature in ospedale, per mantenerle e gestirle nel loro pieno potenziale operativo. Lo scopo di questa tesi è comprendere gli indicatori e le misurazioni utilizzate nel settore sanitario per gli apparecchi medici, sviluppare un indicatore a supporto della gestione delle attrezzature sanitarie e, infine, validarlo empiricamente in un importante ospedale in Lombardia. Design/Metodologia/Approccio: Il processo di ricerca, adottato in questa tesi, può essere suddiviso in tre fasi principali. In primo luogo, è stata eseguita una revisione della letteratura al fine di definire lo stato dell'arte. Quindi, sulla base dei risultati della letteratura e confrontando le pratiche e gli indicatori industriali esistenti, è stato sviluppato un indicatore OEE (Overall equipment effectivenss) adattato per le apparecchiature mediche. Infine, per convalidare l'indicatore teorico, con il supporto di ingegneri clinici, è stato condotto uno studio empirico su tre tipologie di apparecchiature presso la società ospedaliera ASST Sette Laghi di Varese. Risultati Principali: La ricerca bibliografica conferma il crescente interesse delle pratiche industriali nei processi sanitari, ma emergono diverse lacune: la letteratura sulla gestione delle apparecchiature mediche nelle organizzazioni sanitarie è limitata e non si adatta bene all’esigenze dell'ambiente reale. Sebbene le organizzazioni sanitarie abbiano grandi esigenze di manutenzione per le loro apparecchiature mediche, vi è una generale carenza di sistemi di misurazione, metriche e indicatori che tengono conto degli sprechi di tempo, che portano ad un inefficiente uso delle apparecchiature mediche. In questa tesi, è stato sviluppato e applicato un indicatore OEE (Overall equipment effectiveness) adattato alle apparecchiature mediche. Nel complesso, l'indicatore si è rivelato utile per valutare l'uso delle attrezzature mediche in ospedale, tuttavia sono state identificate diverse limitazioni per la sua piena adozione nella pratica reale. Limitazioni e implicazioni della ricerca: L'analisi effettuata nel lavoro di tesi è limitata a tre apparecchiature studiate in un solo ospedale e la qualità dei dati disponibili in ospedale non è totalmente affidabile per applicare nell’immediato l’indicatore sviluppato. Nonostante ciò, l’utilità e l’unicità dell’indicatore per il monitoraggio delle apparecchiature mediche è stata positivamente riconosciuta dagli ingegneri clinici. Questo sottolinea l’aspetto positivo dello studio: l’aver sviluppato un indicatore non al momento impiegato nel monitoraggio degli apparecchi medici, dando quindi il possibile inizio a future ricerche orientate in questa direzione. Implicazioni pratiche: I risultati dell'analisi della letteratura e il caso empirico hanno fatto emergere evidenti limiti esistenti tra pratica e teoria: oggigiorno gli ospedali non dispongono di dati affidabili adatti a supportare le esigenze delle soluzioni accademiche, le possibili perdite che incidono sull'utilizzo delle apparecchiature mediche non sono del tutto comprese, ed è difficile raggrupparli in categorie e, infine, c'è una difficoltà a standardizzare il tempo, dal momento che dipende fortemente dall'interrelazione tra paziente, attrezzature e personale medico. In conclusione, il contributo dell'indicatore OEE è stato riconosciuto dai professionisti, tuttavia i limiti identificati indirizzano per ulteriori sforzi di ricerca.
Development of an adapted overall equipment effectiveness (OEE) indicator for medical equipment management
VALVO, ALESSIA
2018/2019
Abstract
Purpose: Recently, the availability and utilization of healthcare equipment has been emphasized for effective and efficient service delivery. Nevertheless, in common practices, there is a general lack of measurement systems, indicators, and methodologies to support the effective management of the equipment in hospital so that they are operated to their full operational potential and maintained at that level. The purpose of this thesis is to understand indicators and measurements used in healthcare sector, develop an indicator to support healthcare equipment management and finally validate empirically the indicator in a leading hospital in Lombardy. Design/Methodology/Approach: The research process followed in this thesis was carried out implementing three main phases. Firstly, a literature review was performed in order to define the state of the art of maintenance performance measurement systems in healthcare sector. Then, based on the findings from the literature and by comparing it with existing industrial practices and indicators, an adapted overall equipment effectiveness (OEE) indicator was developed for medical equipment. Finally, to adjust the theoretical indicator, an empirical case study was conducted, implementing the developed adapted indicator on three typologies of equipment at the Varese Hospital Company, Sette Laghi, in collaboration with the clinical engineers. Main Findings: The literature search confirms the growing interest of industrial practices on healthcare process but, several gaps come out: the literature on asset management in healthcare organizations is limited and not well suited with the real environment. Although healthcare organizations have great maintenance needs for their medical equipment there is an overall lack of measurement systems, metrics and indicators that take into account time wastes leading to inefficiencies in the use of medical equipment. In this thesis, an adapted Overall Equipment Effectiveness (OEE) for medical equipment was developed and applied. Overall, the indicator proved to be useful for assessing the use of medical equipment in the hospital, nevertheless, several limitations have been identified, for its full adoption in practice. Research Limitations and Implications: The analysis is limited by the number of equipment under study in Varese Hospital and by the scant number of reliable data. The data actually available in the hospital database weren’t immediately suitable to apply the OEE indicator. Moreover, given by the recognition on the adapted indicator by the clinical engineers in the Hospital, there is a large space for further research. Practical Implications: The literature analysis findings and the empirical case let emerge evident existing limitations between practice and theory: nowadays the hospitals don’t have reliable data suitable to support the needs of academic solutions, the possible losses affecting the medical equipment utilization aren’t entirely understood, and it is difficult to group them in categories, and finally, there is a difficulty to standardize the time given that is highly depend to the interrelation between patient, equipment and medical staff. In conclusion, the contribution of the OEE indicator have been recognized by the practitioners, nevertheless the identified limitations open for further research endeavours.| File | Dimensione | Formato | |
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2019_10_Valvo.pdf
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Descrizione: Testo della tesi
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https://hdl.handle.net/10589/149698