Investigations of the Quality of Hospital Electric Power Supply and the Tolerance of Medical Electric Devices to Voltage Dips

Hanada, Eisuke; Itoga, Shuuya; Takano, Kyoko; Kudou, Takato

doi:10.1007/s10916-007-9058-z

Cited by 8 publications

(2 citation statements)

References 3 publications

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“…As soon as there is a need for refrigeration, the energy issue takes wider dimensions, as fridges demand predictable electricity or fuel supplies. The everyday menu of power variations in many DCs, and certainly most LDC, consists not only of plain blackouts, but also short‐term drop‐outs, minor variations in peak voltage (so‐called swells and saps), abrupt surges (including those caused by lightning), dips and spikes due to sudden external load changes, and long‐term under‐voltage brownouts, all of which are prone to cause damage to sensitive equipment (51). Even without permanent damage to the equipment itself, power variations cause significant secondary damage, as they do not only disrupt any assay(s) in process, but also lead to the loss of productive hours of up to several days per week, as well as high opportunity costs for air conditioning, which demands the presence of a generator with related fuel expenses.…”

Section: Hardware Issuesmentioning

confidence: 99%

The fragile environments of inexpensive CD4+ T-cell enumeration in the least developed countries: Strategies for accessible support

Larsen¹

2008

Cytometry

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With the advent of affordable antiretroviral treatment (ART), flow cytometry has ventured out of the exclusive realms of First World research to the resource-strapped clinical environment of developing countries (DCs). Flow cytometric instrumentation for ART has become more cost-efficient, thanks to simplified, yet accurate protocols and smart technologies. These positive developments have, however, not taken shape without problems, as health care in DCs remains weak due to chronic underfunding of their primary health systems. In addition, the multiplicity of donors has created parallel infrastructures that are difficult to manage and may undermine the responsibilities of public services. Hence, there is a prevailing lack of attention to maintenance, support, and human resource development. Not uncommonly, the procurement of high-value equipment is guided by nontechnical interests with mixed results. As conventional service contracts are unpopular, the sustainability of equipment is under serious threat after warranty periods, with environmental factors such as dust and unreliable power supplies being well-known culprits. Reagent supplies and servicing constitute further challenges, where a combination of short reagent shelf life, cold-box shipping, huge distances across poor infrastructures, rigid accounting procedures, and erratic customs requirements cause significant delays and extra costs. Although excellent, highly trained or trainable local staff is available, it is frequently diverted by brain drain from the government sector to privately funded hospitals, research facilities, and overseas postings. Despite these challenges, corporate service management has commonly remained loyal to its roots in the developed world.A number of propositions address the current situation: ''Reagent-rental'' agreements represent an attractive alternative to service contracts, while smart instrument design has started to make inroads into more robust device concepts. To avoid logistical bottlenecks, reagents call for lyophilization and increased heat stability. Newly designed remote diagnostic tools are expected to save costs on service visits. Furthermore, web-based customer-relationship management and enterprise resource planning software is expected to ease the existing complex communication-and logistics issues. In addition, a public-private partnership is proposed that involves government, manufacturers, and local distributors with field application specialists. The latter operate crossbrand as independent subcontractors to manufacturers under a nationally endorsed cost-capping and quality assurance agreement to service all cytometric devices common in the region. These locally run networks may serve as ''templates'' for improved laboratory services in general, in collaboration with CD4 counting, haematology and infectious disease diagnostics. q

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Section: Hardware Issuesmentioning

confidence: 99%

The fragile environments of inexpensive CD4+ T-cell enumeration in the least developed countries: Strategies for accessible support

Larsen¹

2008

Cytometry

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“…Just as medical and other devices should be tested under actual conditions of expected use, health care systems would be expected to benefit from pilot‐testing and troubleshooting activities. Examples of previous acute care systems improvement efforts utilizing computational simulation (CS) 30–65 and physical simulation (PS) 66–86 are listed in Tables 2 and 3.…”

Section: Application Of Quality Management and Human Factors Principlmentioning

confidence: 99%

Advanced Medical Simulation Applications for Emergency Medicine Microsystems Evaluation and Training

Kobayashi

Overly

Fairbanks

et al. 2008

Academic Emergency Medicine

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Participants in the 2008 Academic Emergency Medicine Consensus Conference ''The Science of Simulation in Healthcare: Defining and Developing Clinical Expertise'' morning workshop session on developing systems expertise were tasked with evaluating best applications of simulation techniques and technologies to small-scale systems in emergency medicine (EM). We collaborated to achieve several objectives: 1) describe relevant theories and terminology for discussion of health care systems and medical simulation, 2) review prior and ongoing efforts employing systems thinking and simulation programs in general medical sectors and acute care medicine, 3) develop a framework for discussion of systems thinking for EM, and 4) explore the rational application of advanced medical simulation methods to a defined framework of EM microsystems (EMMs) to promote a ''quality-by-design'' approach. This article details the materials compiled and questions raised during the consensus process, and the resulting simulation application framework, with proposed solutions as well as their limitations for EM systems education and improvement. ACADEMIC EMERGENCY MEDICINE 2008; 15:1058-1070 ª 2008 by the Society for Academic Emergency MedicineKeywords: emergency medicine, health services research, health care evaluation mechanisms, simulation, systems analysis, systems theory A ctivities of large organizations can be viewed and studied as the product of highly connected, dynamic, and interdependent groups exhibiting emergent properties, i.e., systems. Application of this framework as a problem-solving approach to contextualize institutions; explore the hierarchies and interactions

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The Clinical Data Recorder: What Shall Be Monitored?

Nascimento

Calil

2010

IFMBE Proceedings

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Investigations of the Quality of Hospital Electric Power Supply and the Tolerance of Medical Electric Devices to Voltage Dips

Cited by 8 publications

References 3 publications

The fragile environments of inexpensive CD4+ T-cell enumeration in the least developed countries: Strategies for accessible support

The fragile environments of inexpensive CD4+ T-cell enumeration in the least developed countries: Strategies for accessible support

Advanced Medical Simulation Applications for Emergency Medicine Microsystems Evaluation and Training

The Clinical Data Recorder: What Shall Be Monitored?

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