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									        Medical Maintenance
     Unable to Locate Procedure
Why is it important to have an efficient process to
successfully manage equipment that is not located
for preventive maintenance?
-Because the P-5132 says we have to?
-Because it is JC hit?
-Because NAVMEDLOGCOM is watching?
-Because staff members are selling equipment on
EBay?
       Medical Maintenance
    Unable to Locate Procedure
All these are important reasons, but the
most important reason as far a Biomedical
Engineering is concerned is?
      PATIENT SAFETY
            &
 PROTECTING YOUR DIVISION
       Medical Maintenance
    Unable to Locate Procedure
Case scenario
-You are a Third Class Biomedical
Equipment Technician (BMET). You are
looking for an ESU that is due for an
inspection.
-An ESU is a risk level ____ due ____.
        Medical Maintenance
     Unable to Locate Procedure
-After looking in the location listed in DMLSS and
talking with the equipment custodian, you still can
not find the equipment.
-Three months go by, and you have moved on to
other things.
-The equipment custodian discovers the ESU in
the closet and decides that it could be used, since
their main ESU is down for repair.
        Medical Maintenance
    Unable to Locate Procedure
-The ESU malfunctions and the patient
is burned severely.
-The doctor suddenly notices the
equipment PM sticker is three months
out of date.
-Who is at fault?
       Medical Maintenance
    Unable to Locate Procedure
-The  doctor informs JC, PI, and other
external and internal entities. It appears
that BIOMED did not service the
equipment. The MMD Department Head
calls BIOMED and asks what happened?
- BIOMED states they were unable to
locate the ESU during a scheduled
inspection, so BIOMED is in the clear.
       Medical Maintenance
    Unable to Locate Procedure
-The MMD Department Head says “Just
bring me the documentation you notified
the department their equipment was
missing and we will be all set.”
- You do have the documentation don’t
you?
- What documentation?
         Medical Maintenance
      Unable to Locate Procedure
-As  you can see, BIOMED will be held
responsible for not performing maintenance on
time, unless they can prove every effort was made
to find the piece of equipment.
-We also need to prove we notified the department
their equipment was not found.
MEDIG checksheet
       Medical Maintenance
    Unable to Locate Procedure
-This is why we at NMC Portsmouth
devised an efficient UTL process making
the department share responsibility for
their equipment.
        Medical Maintenance
     Unable to Locate Procedure
             The Process
- Maintenance Control PO assigns all scheduled
work orders by the 3rd working day of the month.
- BMETs will notify equipment custodians in
advance to set up a convenient time to locate
equipment for PMs.
           Medical Maintenance
        Unable to Locate Procedure
                The Process
-This  is not always possible, so if it does not
happen, it is okay.
- The BMET will first look in the location listed in
DMLSS.
- If the equipment is not in the location, the BMET
will try to locate it elsewhere with the help of the
Equipment Custodian.
       Medical Maintenance
    Unable to Locate Procedure
            The Process
- If Equipment Custodian is not available, the
BMET will attempt to find help with any other
senior staff member. (Charge Nurse, LPO, Senior
Corpsman)
- If equipment still cannot be located, the BMET
will have a contact sheet signed by the staff
member who is assisting with location of
equipment.
        Medical Maintenance
     Unable to Locate Procedure
             The Process
- BMET must return to the department on two
separate occasions, on at least two different days,
and have a staff member sign for both days.
(Does not have to be the same staff member,
actually more is better) Why?
- BMET also signs the contact sheet.
-At the end of the month, the LPO or ALPO will
randomly check contact sheets for accuracy.
Failure to complete contact sheets correctly can
result in disciplinary action.
          Medical Maintenance
       Unable to Locate Procedure
               The Process
-All contact sheets must be turned in by the 25th of
the month.
-The status of all work orders, for equipment that
can not be located, must be changed to UTL by the
25th of the month. This is done by the BMETs.
        Medical Maintenance
     Unable to Locate Procedure
            The Process
- The ALPO will cancel all risk level 2s, 3s, and
4s, as unable to locate, before the last workday of
the month. (BMET’s cannot cancel their own
work orders. Local policy).
- Do not cancel risk level 1s!!!!!!!! (P-5132
requirement)
- It is very important to not let these work orders
remain open beyond the last workday of the
month. If this happens, your PM completion rate
will suffer in JMAR and Mr. Ortega will become
very angry.
        Medical Maintenance
     Unable to Locate Procedure
             The Process
- When can you cancel risk level 1s?
- When the equipment is excessed or a DD-200 is
successfully completed.
- Note, an initiated DD-200 is not good enough. I
only cancel risk level 1s in DMLSS, when a DD-
200 is signed and completed. Why?
- Equipment Management only removes
equipment from DMLSS when they have a signed
DD-200 or excess item.
         Medical Maintenance
      Unable to Locate Procedure
              The Process
- After UTL work orders are canceled, Biomed’s Chief will
compile a list and send notification to department heads and
Equipment Management via certified e-mail.
- Does it have to be the Chief?
- Why e-mail? Why not guard mail?
- Read receipts are the best thing since sliced bread!!
- How many times have you forwarded guard mail and the
person, you sent it to, says they never received the
correspondence?
         Medical Maintenance
      Unable to Locate Procedure
    Meanwhile back at the case scenario.
- MMD Department Head asks BIOMED what
happened?
- BIOMED states, the ESU was not located and
that BIOMED is in the clear.
-The MMD Department head says “Great, I will
just need to see your documentation.”
         Medical Maintenance
      Unable to Locate Procedure
    Meanwhile back at the case scenario.
- BIOMED says no problem.
- Contact sheet provided. BMET searched for
equipment on the 5th and 19th. PO Smith signed it
on the 5th, and LT Nelson signed it on the 19th.
- Additionally, Chief sent out an e-mail to
Department Head notifying equipment was
missing. Department Head received the e-mail on
the 3rd and read it on the 4th of the following
month.
     Medical Maintenance
  Unable to Locate Procedure
Meanwhile back at the case scenario.
-Itwill be very difficult for BIOMED to be at fault
for this missing ESU with all the documentation
kept.
        Medical Maintenance
     Unable to Locate Procedure
- You are notifying Departments up front with the
contact sheets.
- You are notifying Departments in the end with
email from BIOMED Chief.
- Is this the perfect process?
- Efficient, accountable, and relatively easy to
manage.
        Medical Maintenance
     Unable to Locate Procedure
                   Summary
- Missing equipment is about patient safety first.
- BIOMED must have an efficient and realistic
process in place for UTLs.
- Why realistic? KISS
- Departments will blame you, so you must protect
yourself and your division.
- Documentation is everything. If it is not
documented, it did not happen.
      Medical Maintenance
   Unable to Locate Procedure
This concludes the Medical Maintenance
     section of the UTL procedure.


             QUESTIONS?
              Equipment Management
            Unable to Locate Procedure
- Equipment Management receives Unable to Locate
    Notification Report (UTL Rpt) from the Senior
    Biomedical Engineer Technician (BMET)
- Assigned Equipment Assistant will begin researching
    missing medical property by following one or more
    of the following steps until the property is located or
    Department submits a DD 200 Form.




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             Equipment Management
           Unable to Locate Procedure
Research Steps:

- Check property record in DMLSS for all notes
pertaining to the equipment and entries on location
under Equipment Maintenance Activity Module
(DMLSS/MA).

- Check Maintenance History and for all notes under
 each work order (W/O) open or
completed.

                                                      25
               Equipment Management
              Unable to Locate Procedure

- Research Manufacturer and Model Number on Internet (so we
know what missing equipment looks like).

- Call and/or email Biomedical Engineer, assigned to the PM
work order, to see if the picture they have is same as what
BMETs were looking for when they marked the W/O UTL.

- Call and/or email Department Representative to see if they
know where the equipment is located.




                                                               26
             Equipment Management
            Unable to Locate Procedure



- Visit department and look for medical property,
   starting at last location indicated in DMLSS.
- Inform Department Representative, via email, by the
   15 of each month, if equipment is not located, a
   DD200 Form will need to be submitted




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               Equipment Management
              Unable to Locate Procedure
Formal notifications from Equipment Management
1st notification is email (on 15th of each month) from
Equipment Management to Department Head that is
missing equipment from the BIOMED UTL listing.

-   If no action is taken by department within 45
    days, then a 2nd notification is forwarded from
    Materiel Management Department Head to
    Department Head (attached copy), with prefilled
    DD200 attached.

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             Equipment Management
            Unable to Locate Procedure

-   If no action is taken by Department
    within 15 days, then a 3rd notification is
    forwarded from Director of
    Administration to Director, with prefilled
    DD200 attached.
-   If no action is taken within 15 days, a
    letter will be forwarded from Executive
    Officer to Director.
                                             29
             Equipment Management
           Unable to Locate Procedure
If equipment is found:
- Equipment Assistant will notify BIOMED and
update the DMLSS location and including adding notes
in note field. They will also update the medical
property (local form)
on the UTL Rpt under the “Remarks” column on the
“Found Equipment” worksheet for the month in which
the item was reported a UTL.
- Inform Clinical Staff that item needs to be inspected
 by BIOMED Staff.                                     30
             Equipment Management
           Unable to Locate Procedure
End of the month check:
- At the end of each month, Equipment Assistant
Supervisor will total all UTL worksheets and annotate
totals on the Fiscal Year Monthly UTL Risk Level (on
local spread sheet (attached)).




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 Equipment Management
Unable to Locate Procedure




QUESTIONS?



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