Equipment planning

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Equipment planning

• Dr. A.K. Jain

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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

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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.

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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

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• (b) Preparing Room by Room Equipment List
• (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

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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

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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.

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• 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

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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.

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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

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Types of equipments

• (a) Built- in Equipments
• (b) Depreciable equipments (Non-expandable)
• (c)Non-depreciable equipments (Expandable)
• (d) Capital Equipments

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Built in Equipments

• Its the Architects Responsibility
• Included in construction contracts
• List includes
• Cabinets counters in
• Pharmacy
• Laboratory
• Other parts of hospitals

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

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(B) Non-Expendable Equipments

• OR Depreciable Equipments
• Def The Equipments that have a life of 5 yrs of
  gt 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

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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

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

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(c) Expendable (non-depreciable) equipments

• These Equipments have life span lt 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.

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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

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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

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Important consideration

• Hospital interest lies in purchasing minimum
  needed Equpts Hospital consultant can help in
  it.

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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

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• 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.

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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

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• (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

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Syllabus

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

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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

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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

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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

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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

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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

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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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