WEGEDA PRIMARY HOSPITAL

TERM OF REFERENCE (TOR)

FOR MEDICAL EQUIPMENT COMMITTEE

For medical equipment management

Implementation based on EHSTG

WEGEDA PRIMARY HOSPITAL

BIOMEDICAL ENGINEERING
DEPARTMENT

Revised April/28/ 2015

BMED Page 0
 Table of content page
1. 1
definitions:- 2
2.1 introduction.......................................................................................................................................4
3. aim and objectives of establishment of MEC.........................................................................6
3.1 the primary objectives of the MEC are:-..............................................................6
4. 1 medical equipment management checklist...........................................................................6
5.1 equipment history file...................................................................................................................7
6.1 equipment development plan (edp).........................................................................................7
6.1 existing medical equipments.................................................................................8
6.2 additional equipment required (based on the medical list)..................................8
7. 1 member of medical equipment committee...........................................................................9
8.1 Role and responsibilities.............................................................................................................9
8.1 medical equipment committee...............................................................................9
8.2 additional to the above points MEC have the roles in the:-..................................9
amending the term of reference......................................................................................................13

BMED Page 1
 1. DEFINITIONS:-
Recognizing that there are multiple interpretations that exist for the terms listed
below, they are defined as follows for the purposes of this Term of Reference (TOR)
manual.

Health technology: The application of organized knowledge and skills in the form
of equipment, medicines, vaccines, procedures and systems developed to solve a
health problem and improve quality of life. Used interchangeably with healthcare
technology.

Medical device: An article, instrument, apparatus or machine that is used in the

prevention, diagnosis or treatment of illness or disease, or for detecting, measuring,
restoring, correcting or modifying the structure or function of the body for some
health purpose.
Medical equipment: Medical equipment requiring calibration, maintenance, repair,
user training, and decommissioning – activities usually managed by Biomedical
engineers. Medical equipments used for the specific purposes of diagnosis and
treatment of disease or rehabilitation following disease or injury; it can be used
either alone or in combination with any accessory, consumable, or other piece of
medical equipment/equipment. Medical equipment excludes implantable, disposable
or single-use medical equipment.

Outsourcing: Form of contracting with pre-specified terms of financing, monitoring

and supervision. Generally engaged over a longer period, outsourcing is delegation
of responsibility partially or wholly towards performance of a set of activities to
achieve pre-specified results based on a mutually agreed form of reporting,
monitoring, evaluation and performance.

Preventive Maintenance: It is an action to eliminate the cause of a potential non-

conformity. The care and servicing by personnel for the purpose of maintaining
equipment and facilities in satisfactory operating condition by providing for
systematic inspection, detection, and correction of incipient failures either before
they occur or before they develop into major defects, including tests, measurements,
adjustments, and parts replacement, performed specifically to prevent faults from
occurring.
Corrective Maintenance: It is an action to eliminate the cause of a detected non-
conformity. It is a maintenance task performed to identify, isolate, and rectify a fault

BMED Page 2
so that the failed equipment, machine, or system can be restored to an operational
condition within the tolerances or limits established for in-service operations.
Equipment Breakdown Rate: Also known as failure rate it is the frequency with
which an engineered system or component fails. It expressed in failure per
equipment per hour /shift/day.

Upkeep time:-
It is the measure of the time a machine has been working or available.

Downtime: - It is the period of time that a maintenance system fails to provide or

perform its primary function in, other words the time for which the dysfunctional
equipment remains dysfunctional.

Maintenance Contracts: It is the legal agreement normally conducted between two

parties where in the latter agrees to render the maintenance service annually to the
formal in the exchange of a nominal amount. It ensures that the latter promises to
provide maintenance services to the former all throughout the year on a regular
basis. It includes service charges only. When charges include spare parts also it is
termed as Comprehensive Maintenance Contract.

BMED Page 3
 2. INTRODUCTION

In Ethiopia, the lack of proper management of medical equipment has limited the
capacity of health institutions to deliver adequate health care. It estimated that only
about 60% of medical equipment found in Ethiopia public hospital and other health
facilities is functional at any one time. Poor equipment handling and utilization,
frequent power surges, the age of the equipment, lack of operator training, lack of
preventive maintenance, lack of spare parts, lack of maintenance capacity and
minimal knowledge regarding sophisticated equipment are factors that contribute to
equipment breakdowns.

As health care delivery continues, to expand and to improve in Ethiopia and an

increasing number of sophisticated medical equipment is introduced a system
capable of supporting and managing the medical technology must be in place.
Medical equipment management defines the organization and coordination of
activities that ensure the successful management of equipment related to patient care
in a health care facility. The medical equipment management cycle includes
planning, assessment of needs procurement, training operation maintenance,
decommissioning and disposal of the item.

BMED Page 4
These structural procedures shows that a hospital should undertake to appropriately
manage its medical equipment allowing for the extension of services while ensuring the
safety of its patients.

In the WEGEDA primary Hospital, biomedical engineering department (workshop)

established in May, 2010 E.C with Biomedical Engineering professional. Until now,
the department saves hospital from extravagance, which related with medical
equipments. In addition to Biomedical Engineering, our Hospital established
Medical Equipment Committee (MEC), which is the bridge between biomedical
department and Senior Management Team (SMT) of the Hospital.

BMED Page 5
 3. Aim and Objectives of Establishment of MEC
The main purpose for establishing the MEDICAL EQUIPMENT COMMITTEE
(MEC), in the hospital to support the implementation of the EHSIG for medical
equipment management at WEGEDA PRIMARY HOSPITAL
3.1 The primary objectives of the MEC are:-
1. To contribute, to meet hospital annual plan; objectives of implementing the
medical equipment management practice as national guidelines for hospital
reform.
2. To monitor and provide monthly reports to hospital CEO/MD on Medical
Equipment management performance indicators.
3. To act as a communication bridge, between the senior management team and all
biomedical engineers and technicians of the hospital.
4. To advice engineers and technicians on colleagues and senior management team
(SMT) on aspects of medical equipment management service and their
professions, management practice and patients safety.
5. Oversee the percentage of medical equipment identified on Model Medical
Equipment List; provide the checklist to record the implementation activities and
proof all indicators existed in at the hospital.

4. MEDICAL EQUIPMENT MANAGEMENT CHECKLIST

1. A MEC has been established

2. TOR for MEC is defined
3. An inventory management system to manage medical equipment has been
established
4. An inventory management system to manage spare parts of medical
equipment has been established
5. An Equipment History File has been established
6. There are policies and procedures for medical equipment acquisition
7. There are policies and procedures for medical equipment commissioning and
decommissioning
8. There are policies and procedures for medical equipment donation
9. There are policies and procedures for medical equipment disposal
10. There are policies and procedures for outsourcing medical equipment
servicing
11. A maintenance notification and work order system has been established
12. Preventive maintenance of medical equipment is scheduled and conducted
13. Inspection and testing of medical equipment is scheduled and conducted
14. All new equipment undergoes accepting testing

BMED Page 6
 5. Equipment history file

An individual file/folder should be established for each item of equipment. This file
should be held in the equipment maintenance department. The file should contain:-
1. Inventory data collection form
2. Acceptance test log sheet
3. SOP for operation and maintenance of item
4. Planned preventive maintenance schedule
5. Medical equipment Risk Assessment Form
6. The address of manufacturer, supplier and local agent and Copy of warranty
(if relevant)
7. Details of a maintenance contract and maintenance contractor (if relevant)

6. EQUIPMENT DEVELOPMENT PLAN (EDP)

The Equipment Development Plan (EDP) is the plan to define goals for acquisition,
maintenance and replacement of equipment in the short term and long term.
Equipment Development Plan should be developed taking into the consideration the
current equipment inventory and “model equipment list”.

The EDP should be developed by the MEC, and approved by the Hospital
Management. The EDP is the basis for annual equipment budget. The Head of
Equipment Maintenance is responsible to implement the EDP, with assistance of
other department where relevant (for e.g. Administration and finance). He/she
should present quarterly reports to the MEC on the status of implementation of the
EDP.

A Sample template for an EDP is presented in the table below

DEPARTMENT/ ROOM …………………………………………

Prepared by: - ……………………….. Date: - ………………….
Name of Condition Short Term Short Longer Term Long Term
Equipme Action (1 Year) Term Cost Action (2-5 Cost
nt Estimate Years) Estimate
Type For example:- For example:- For example:-
And  age and  repair needed;  replacement
Inventory expected life;  replacement needed,
Number  working needed,  first time
condition (good,  user training purchase
fair, poor, needs needed, needed
repair, damaged  first time

BMED Page 7
 beyond repair, purchase
obsolete) needed
A. Existing Medical Equipments
1. ………….
2. ………...
3. ………….. etc
B. Additional equipment required (based on the medical list)
1. ………….
2. ………….
3. ………….etc

6.1 EXISTING MEDICAL EQUIPMENTS

DEPARTMENT/ ROOM………………………………………………..
Prepared by: - ………………………Sign ……. Date: - ………………
Name of Inventory Condition Short term Short Longer term Long
Equipment No, action term action term
Order

(1 year) cost (2-5 years) cost

estimate estimate
1.

2.

3.

4.

6.2 ADDITIONAL EQUIPMENT REQUIRED (BASED ON THE MEDICAL

LIST)

DEPARTMENT/ ROOM…………………………………………………………..
Prepared by: - ………………………..… Sign ……… Date: - ………………….
Name of Condition ( problem Short Short Longer Long
Equipment faced because of item term plan term cost term plan term cost
Order

absence or less in (1 year) estimate (2-5 years) estimate

number)
1.

BMED Page 8
 2.
3.
....

7. MEMBER OF MEDICAL EQUIPMENT COMMITTEE

The hospital’s medical equipment committee composed of doctors, nurses,

technicians, pharmacists, and administrative personnel that oversee the medical
equipment management program.

No ………..Name … ……………..Their role …………….Sign

1. Dr. Negesu Demsie ……….………….chair person……………

2. Ato Agmas Getenet . ……… ..………..secretary……………….
3. Ato Moges Minyibelu…………… …… Member……………….
4. Ato Sisay Sitotaw.……….. ……………Member ………………
5. Ato Yeshiwas mequanent…………...….Member ………………
6. Ato Mulat Sitotaw ……………………..Member ……………….
7. Ato Adane Mulat…………… …………Member ……………….

8. ROLE AND RESPONSIBILITIES

8.1 Medical equipment committee (MEC)

a) Develop and monitor implementation of a medical equipment strategy,
b) Oversee establishment of medical equipment inventory,
c) Develop a model medical equipment list,
d) Establish and monitor the implementation of policies for:-
i) Procurement of medical equipment
ii) Donation of medical equipment
iii) Acceptance testing and installation of medical equipment
iv) Maintenance of ME, including a list of external suppliers of
maintenance services
v) Disposal of ME
vi) Training of hospital staff for the use of ME
e) Determine the annual budget for implementation of the ME strategy,
f) Review incident reports related to medical equipment,

BMED Page 9
8.2 Additional to the above points MEC have the ROLES:-

 In developing the Equipment Development Plan (EDP).

 In the establishing the list of desired medical equipment that is based on the
Medical Equipment List and associated with EDP.
 Review and approve donation of medical equipment before acceptance.
 Will have to, decide the training of staff.
 Must work with supplier, to rectify the situation as quickly as possible.
 Should develop, the policy for the use of outside contractors.
 Responsible for overseeing all users training on medical devices, whether in
service or conducted by suppliers/external parties.
 Should establish, the Equipment Training Plan that describes the training needs
for hospital staffs for the use of medical equipment.
8.3 MEC members have a duty:-
a) Attend meetings, respecting the time,
b) Accept and implement a decision passed by the majority,
c) Prepare for each meeting by reading agendas, minutes of the previous meeting
and other documents distributed for consideration,
d) Follow up on any action agreed by the group in a timely manner and,
e) Maintain confidentiality on all matters discussed by the group or with SMT.
8.4 MEC Group meeting
A) The group will have a permanent chairperson who will be assigned by the SMT
(CEO/MD) prior to their first meeting to preside over MEC meetings.
B) A secretary will be assigned by the SMT/CEO/MD/ in the same manner as
detailed by above.
C) The MEC will have regular meetings every month for the first three months
and fortnightly there after quarterly in the left time of the year, but may
organize urgent meetings as needed.
D) The forum of each meeting of the MEC shall have eight (8) members and
above.

8.5 Chairperson of MEC

8.5.1 The chairperson should preside /chair all MEC meetings and direct the overall
functioning of the group. The chairperson should take the lead in clarifying the
goals of MEC work program/ assignments.
8.5.2 The chairperson should ensure that the regular MEC meetings take place in
accordance with this TOR and should convene extraordinary meetings in as
determined either by the group or SMT/CEO/.
8.5.3 The chairperson should ensure that meetings are conducted in a professional
manner and are constructive for both the biomedical profession and the
BMED Page 10
 department performances. The chairperson therefore must oversee the
development of the well-thought out agenda and supporting materials. The
agenda should be a collaborative effort with the secretary.
8.5.4 The chairperson should expect members to arrive at the meetings fully prepared
to participate in MEC meetings.
8.5.5 The chairperson should ensure that meeting discussions are summarized to steer
members to a decision as well as set aside sometime at the end of the meeting for
feedback on how the meeting went
8.5.6 The chair person should take the lead in establishing the tone for shared decision
marking by inviting participation, encouraging varying points of view and
promoting an open and honest exchange of ideas about issues.

8.6 Secretary
8.6.1 The secretary is responsible for taking minutes of MEC meetings minutes
should be reviewed and approved by the group and signed by the
Chairperson before distribution to the MEC member and shared with SMT
and case teams.
8.6.2 The secretary should inform MEC members of meeting schedules
(including agendas and accompanying information) after prior discussion
with the chair person.
8.6.3 The secretary should assist the chairperson in the conduct of MEC
meetings and chair MEC meetings in the absence of the chair person.

BMED Page 11
AMENDING THE TERM OF REFERENCE

Any section or part of the TOR is subject to change at any time based on the
decision or recommendation of the MEC or SMT/CEO/MD.

Sorted by: - Agmas Getenet (Biomedical Engineer -Bsc)

Reference

1. Ethiopian Hospital Reform Implementation Guide (Ehrig)

2. The Ethiopian Hospital Services Transformation Guidelines (Ehstg)
3. Biomedical Equipment Maintenance And Management Program Text Book

BMED Page 12
 Member of Medical Equipment Committee

Name Position Responsibility signature

1. D.r Negesu Demsie medical doctor chair person…. ...….
2. Ato Agmas Getenet Head of BMED Secretary…………….
3. Ato Moges Minybelu head of finance Member………………
4. Ato Yeshiwas Mequanent Member………………
5. Ato Sisay Sitotaw head of pharmacy Member……………..
6. Ato Mulat Sitotaw head of laboratory Member……………..
7. Ato Adane Mulat BMT Member …………….
8. Ato Solomon Tibebu Head of EOPD Member……………

BMED Page 13