1.1 Traditional Model of Clinical Engineering
Medical equipment (ME) is defined by the World Health Organization (WHO) as a medical devices that require calibration, maintenance, repair, user training, and decommissioning − activities usually managed by clinical engineers (WHO, 2011).
Nowadays, Clinical Engineering (CE) performs support activities in ME through organized human work in conjunction with other healthcare professionals. However, these activities are influenced by the interaction of various elements, along which the CE must also act in a complementary manner and constituent with approaches that help management in ME through a process perspective. For the CE, this perspective should reflect the interaction of ME with human resources for patient care (Moraes, 2007).
Therefore, the technological process in health is defined as the interaction between human resources, infrastructure, ME, methods and technical standards required for the transformation of the health of the patient within a health care environment. Figure 1 shows the traditional model of CE, highlighting the areas of infrastructure, human resources and ME; which support the quality in the appropriate use of ME.
Figure 1. Traditional model of clinical engineering
This model is part of the Center in Management and Development of Medical Equipment (Ceged-TMH) of the Biomedical Engineering Institute (IEB-UFSC) and allows the managing of all phases in the equipment life cycle: incorporation, utilization and renewal / disposal. Figure 2 shows this life cycle.
Figure 2. Medical equipment life cycle
In the incorporation stage is made:
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The technical specifications for the procurement of new ME, as indicated by the clinical needs of the clinical staff.
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After it conducted a technical evaluation of proposals submitted by companies, is provided the proposals that meet the technical descriptors required for each ME. After it conducted a technical evaluation of proposals submitted by companies, is provided the proposals that meet the technical descriptors required for each ME.
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The Local Centers of Clinical Engineering (CELEC) guides the clinical sector during the course of adaptations in infrastructure and proper installation of the ME; as well as manage all training provided by the companies.
In the use stage is made:
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The routing of the standardized form for opening called maintenance to ME.
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The Technical Assessment Laboratory (LAT) performs technical evaluations, calibrations and testing of security and functionality, ensuring that the ME is within the parameters recommended by standards.
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Contracts with other technical assistance are triggered in cases where maintenance is of high complexity or do not have tools or spare parts.
In the renewal step is made:
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Through a management software are followed the historical maintenance of all MS. From this information is managed the life cycle of the equipment and in the case of detecting technical or financial infeasibility for recovery is made low asset (García, da Luz Santos, de Avelar, Zaniboni, & García, 2011).