Optimized Medical Equipment Replacement Planning
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Date
2021-02
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Addis Ababa University
Abstract
Owing to the limited hospital replacement budget, making selection concerning medical device substitution is a difficult task. If the selection is not planned, it could have a serious impact within the replacement process, which in turn could cause a possible hazard and accident or fatality to patients. This might result in operational and maintenance costs and premature substitution of medical device while failing to replace other devices that need urgent replacement. In this regard, developing a replacement framework that allows optimal use of the available budget is crucial. Managing non-optimized medical device replacement planning in hospitals is often time-consuming and expensive. Competent replacement planning allows a significant reduction in operational and other maintenance related costs. However, most hospitals often replace their medical devices after they have stopped working for an extended period. On the other hand, when a medical device is replaced too early, that involves additional cost to the procurer. Therefore, a technique has to consider the decision-makers to avoid any risk for patients and additional costs to the hospital. This thesis study proposes a comprehensive framework for an optimized replacement planning for medical devices based on the available budget. The system is supposed to take into account the ever-changing technologies in the field of medical devices thereby avoiding the traditional replacement paradigm. The proposed method uses the TFN-AHP model to set up the assessment criteria and evaluate them by contemplating qualitative/quantitative replacement criteria and a Tabu Search based optimization technique to generate a prioritized list of devices to be replaced. Data was collected at selected hospitals picked as pilots in the current study through structured questioners. The model architecture includes fourteen quantitative and qualitative factors descending as main and sub-criteria, which can affect the replacement decision. The proposed model was applied on thirty-five selected medical devices in several categories where devices with higher ERPW (Equipment Replacement Priority Weight) take higher order for replacement and devices with lower ERPW take lower order for replacement. The proposed model uses both relative and absolute measurements to determine score weight for all criteria. Following analysis of the questioners distributed to respondents, eight main factors and three sub-factors were identified for affecting the replacement process. From the distributed questioners, 85% of the participants agreed that there was a major gap in their hospital when medical device has to be replaced. Furthermore, 73% of the respondents agreed that medical device replacement does not consider the most influential replacement factors. In addition, 89% of the respondents agreed that no device replacement plans is practiced in their hospitals. Moreover, 81% of the respondents agreed that hospitals are not accustomed to efficient replacement techniques. About 85% of the respondents agreed that the available hospital budget affected the replacement process. In the proposed model, the identified eight main-factors and three sub-factors score weights were determined by using TFN-AHP technique. This technique combined with respondents scored criteria weights given for the 35 medical devices determined the ERPW for each individual device in order to prepare the priority list. The search for optimal/prioritized list of devices to be replaced was carried out using Tabu search algorithm based on TSPDC optimization setup. Results showed that the developed medical device replacement model quantitatively prioritized the medical devices.
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Keywords
Equipment Replacement Planning, Equipment Replacement Priority Weight, Multi Criteria Decision, Optimization, TFN-AHP, Tabu Search