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Program Inspection Dan Preventive Maintenance Alat Kesehatan Di RS

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Program Inspection dan Preventive

Maintenance Alat Kesehatan di RS

H.HENDRANA TJAHJADI, S.T, M.Si


Technical Training Course :
Petugas Paparan Radiasi
Nama : Hendrana Tjahjadi
Badan Tenaga Atom Nasional (BATAN)
Tlp : 0818235971 April 17 to Mei 4, 1995
Jakarta
Alamat : Legenda Wisata, Cluster
X-Ray equipments, VILLA
Cleopatra i2/9,Cibubur. 2nd October to13th October 1995
Italy

USG , ALOKA
Riwayat Pendidikan : 25th August 1996
Singapore
D3 ATEM Kemenkes Jakarta
Magnetic Resonance Imaging (MRI), BRUKER
S1 Teknik Elektro Universitas Indonesia From 11th January to 19th March 1999
France and Germany
S2 Teknik BIomedis Universitas Indonesia
2016-Present. Mahasiswa Program Doktor Teknik Elektro Patient Monitor, SCHILLER
23rd October 2002
Universitas Indonesia France

Work Experience : Radio Frequency Amplifiers MRI, BRUKER


24th October 2002
2010-Present. Dosen tamu Diagnostik dan Peralatan Mata program France

D4. ATEM Kemenkes, Jakarta Supra Conductor Magnet BRUKER


28th October 2002
2016- Present. Dosen tetap D4 Elektromedik Universitas Muhammad France
Husni Thamrin, Jakarta High Frequency X-Ray, Hyundai
August 8 to 12 August 2005
2012-Present KETUM ALFAKES (Asosiasi Lab kalibrasi Swasta) South Korea
August 1994–2009, Senior Service Engineer PT.Bersaudara
QA X-Ray
2009-2016 General Manager PT. Global Promedika Service November 2012
© 2016 PT Global Promedika Service. All Rights Reserved. South Korea
PEMELIHARAAN " tidak diperlukan "

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INFRASTRUKTUR RUMAH SAKIT

37.73% 28.95%
13.76% 13.45%
6.11%

Medical Equipment Non Medical Building Human Operational


Equipment Resource

Source: Profil Kesehatan Indonesia Tahun 2008, Departemen Kesehatan Indonesia (Depkes 2009)

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TAUFIK APRIANSYAH 2012

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ISU PADA TAHAP PENGELOLAAN /
PEMELIHARAAN RUMAH SAKIT

ALAT IMPORT SEHINGGA KETERGANTUNGAN PADA VENDOR/


PRINCIPLE MASIH TINGGI.

ANGGARAN PEMELIHARAAN TIDAK SESUAI KEBUTUHAN / TIDAK


MENCUKUPI.

JUMLAH SDM ELEKTROMEDIS DAN TINGKAT KOMPETENSINYA YANG


MASIH BELUM MERATA.

ALAT SANGAT BERAGAM, SEHINGGA RUMAH SAKIT TIDAK MAMPU


MEMBERIKAN PERALATAN KERJA PEMELIHARAAN YANG SESUAI,
TERMASUK PERSEDIAAN SUKU CADANG.
UTILISASI MASIH RENDAH, INVESTASI MASIH DITITIKBERATKAN
KEPADA PEMBELIAN DIBANDINGKAN DENGAN PROGRAM
PEMELIHARAAN

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HAK PERALATAN
KESEHATAN

1 2 3 4 5

PROGRAM
PROGRAM PROGRAM PROGRAM
PROGRAM SERVICE/ INVENTORY/
SERVICE/ INVENTORY/
KALIBRASI MAINTENANCE
KALIBRASI MAINTENANCE INSPEKSI
INSPEKSI SPARE CONSUMABLE
SPARE CONSUMABLE
PARTS
PARTS

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KALIBRASI

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INSPECTION

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PREVENTIVE MAINTENANCE

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PENGENDALIAN PEMELIHARAAN
PERALATAN KESEHATAN

Mengoptimalkan Usia Mewujudkan Patient Safety


Pemakaian Alat

Mempertahankan Kualitas Efisiensi Biaya Operasional


Peralatan
.

Undang-Undang Rumah Sakit Pasal 16:


“Peralatan medis dan non medis harus memenuhi standar pelayanan, persyaratan mutu, keamanan, keselamatan
dan laik pakai”

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Identifikasi

➢ Nama alat : Electro Cardiography


➢ sistem power supply 220 volt, batere dan elektroda.

Identifikasi Resiko :
Nilai Saverity
Marginal : merugikan pada kesehatan, operasional
atau keuangan : 2
Nilai Probability
Remote : mungkin terjadi pada perangkat
:2 x
Risk ≈ Severity
Probability
≈ 2 x 2
≈ 4 Medium Risk Score:
3-7

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DAMPAK PROGRAM
Inspection Preventive Maintenance

1 AKREDITASI TERCAPAI EFEKTIVITAS BIAYA


5

2 MUTU LAYANAN MENINGKAT DATA BASE TERMONITOR 6

3 PATIENT SAFETY TERPENUHI KOMPETENSI SDM TINGGI 7

4 PERENCANAAN TEPAT SASARAN TERHINDAR DARI MAL PRAKTEK


8

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4. Defibrillator Analyzer
Fungsinya : Pengujian defibrilasi biphas dan denyut-
biphas.

Contoh : Alat Dc- Shock


6. Vital Sign Simulator

Fungsinya : Digunakan untuk mensimulasikan dan menguji 12-lead


EKG, aritmia, non-invasive blood pressure(NIBP),Sp02,dan suhu.

Contoh : EKG, Tensimeter Digital, Manometer, Alat Pacu Jantung.


2. Patient Simulator
Fungsinya : Berfungsi mensimulasikan aritme jantung
dan berbagai kondisi elektrokardiogram,
termasuk simulasi alat pacu jantung dan
orang dewasa dan irama yang normal-sinus
anak.
Contoh : EKG
3. Pressure Parameter
Fungsinya : mengukur tekanan, vakum, dan
pengukuran suhu, aliran gas, tekanan
udara dan kelembaban

Contoh : Tensimeter
5. Electrical Safety Analyzer
Fungsinya : Digunakan untuk pengujian terhadap
standar keamanan listrik.

Contoh : membandingkan hasil batas standart


keamanan kelistrikan
7. O2 Meter
Fungsinya : Digunakan untuk mengukur
kadar kemurnian oksigen
Contoh : Oksigen outlet
1. Tachometer
Fungsinya : Digunakan untuk mengukur RPM motor atau
suatu mesin dengan methode laser photo non
contact.
Contoh : Centrifuge, Mixer dan Rotator.
SIKLUS ALAT KESEHATAN
PEMASARAN
PENGUJIAN MANUFAKTUR
TRANSFER
PENGEMANGAN PENILAIAN
KEBUTUHAN

PENELITIAN
DISTRIBUSI

EVALUASI
PERENCANAAN PENGHAPUSAN

PENILAIAN TEKNOLOGI
PEMELIHARAAN
PEMBELIAN
PEMASANGAN

OPERASIONAL
PENERIMAAN
PELATIHAN

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STANDART DAN AKREDITASI

A RT
A ND 8ART
ST AFNKD 8
STM FK
M
Rumah sakit merencanakan dan mengimplementasikan untuk pemeriksaan, uji coba
Rumah sakit
dan merencanakan dan mengimplementasikan
pemeliharaan peralatan untuk pemeriksaan, uji coba
medis dan mendokumentasikan
ART dan pemeliharaan peralatan medis dan mendokumentasikan
N D T
STA FN 8
DA.1R
K
TA K 8.1
SM Rumah Sakit menumpulkan data hasil monitoring terhadap program manajemen
MF Rumah
peralatan Sakit
medis. menumpulkan
Data data hasildalam
tersebut digunakan monitoring terhadap
menyusun program
rencana manajemen
kebutuhan jangka
peralatanRumah
panjang medis.Sakit
Datauntuk
tersebut digunakan dalam
merencanakan menyusun
peningkatan dan rencana kebutuhan
penggantian jangka
peralatan
panjang Rumah Sakit untuk merencanakan
medis peningkatan dan penggantian peralatan
medis

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Healthcare Technology Management

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Healthcare Technology Management

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HEALTHCARE TECHNOLOGY
MANAGEMENT

INVENTORY BARCODE
arcode DATABASE (WEB
Database BASED)
(Web base)

INSPECTION
Inspection and
PREVENTIVE KALIBRASI SPARE PARTS BIAYA
preventive
MAINTENANCE CONSUMABLE
maintenance
REPAIR

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PERBANDINGAN KINERJA PELAKSANAAN
MANAJEMEN PEMELIHARAAN

KSO
MRI, CT Scanner, Agiogram, Linac
HIGH END (20%^30%)

MID RANGE
Internal n Pihak ketiga
Ventilator, USG, Lab Analyzer etc
(LIFE SUPPORT & DIAGNOSTIC (60%-70%)
EQUIPMENT)

Internal
LOW END EQUIPMENT Infusions Pumps, Suction, ECG,etc
(5%-10%)

DARI SISI PEMBIAYAAN MENJADI PIRAMIDA TERBALIK


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Pembelian Peralatan

Pemeliharaan
Maximum Maintenance Expenditure Limit

MMEL
Pastikan Usia Pakai, Usia Teknis dan Harga Pengganti alat kesehatan
tersebut.
Usia Pakai dihitung sejak alat kesehatan tersebut digunakan sampai saat
perhitungan dilakukan dan Harga Pengganti adalah harga alat kesehatan saat
perhitungan dilakukan dengan spesifikasi setara.
Tentukan sisa usia manfaat alat kesehatan tersebut.

Sisa Usia Manfaat = Usia Teknis – Usia Pakai. M Hitung Persentasi Manfaat.

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MAINTENANCE HISTORY

RECENT GENERATION

- RISK BASED
INSPECTION
THIRD GENERATION
- RISK BASED
- CONDITION BASED MAINTENANCE
MAINTENANCE - RISK BASED
LIFE ASSESSMENT
- REALIBILITY CENTERED
MAINTENANCE - REABILITY CENTERED
MAINTENANCE
SECOND GENERATION - COMPUTER AIDED
MAINTENANCE - CONDITION BASED
- PLAND PREVENTIVE MANAGEMENT AND MONITORING
MAINTENANCE INFORMATION SYSTEM
- COMPUTER AIDED
FIRST GENERATION - TIME BASED - WORKFORCE MULTI- MAINTENANCE
MAINTENANCE SKILLING AND TEAM MANAGEMENT AND
- FIX IT WHEN IT BROKE
WORKING INFORMATION SYSTEM
- BASIC AND ROUTINE
- SYSTEM FOR PLANING
MAINTENANCE
AND CONTROLLING - PROACTIVE AND
WORK STRATEGIC
- CORRECTIVE
MAINTENANCE

1940 1950 1960 1970 1980 1990 2000 PRESENT


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Saverity

Saverity adalah besarnya potensial efek samping dari


kegagalan ketika kegagalan terjadi, di mana tingkat efek
keparahan diklasifikasikan sebagai berikut :

Negligible (1) : tidak ada efek buruk pada kesehatan,


operasional atau keuangan
Marginal (2) : merugikan pada kesehatan,operasional
atau keuangan
Critical (3) : cacat permanen merugikan pada
kesehatan, operasional atau keuangan
Catastrophic (4) : hilangnya nyawa, penghentian
operasional, bencana keuangan

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Probability

Probability adalah kemungkinan terjadinya kegagalan yang


berpotensi merugikan. Probabilitas kegagalan diklasifikasikan
sebagai berikut;

Improbable (1) : sangat tidak mungkin terjadi pada


perangkat
Remote (2) : mungkin terjadi pada perangkat
Occasional (3) : mungkin terjadi kadang-kadang dalam
perangkat
Probable (4) : sangat mungkin terjadi beberapa kali
dalam perangkat
Frequent (5) : mungkin terjadi sering dalam perangkat /
sistem seumur hidup

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Risk Level
Low Risk Score: 1-
2

Risiko dapat diterima tanpa ulasan: tidak memerlukan penelaahan lebihlanjut atau persetujuan

Medium Risk Score:


3-7
Resiko dapat diterima dengan ulasan : Risiko & rencana mitigasi risiko harus ditinjau / diterima oleh
manajemen risiko, keselamatan (atau lainnya yang ditunjuk) komite

Serious Risk Score: 8-


12

Risiko yang tidak diinginkan: Risiko & rencana mitigasi risiko harus ditinjau / diterima oleh manajer
program yang relevan (yaitu, direktur medis)

High Risk Score: 12


-20
Risiko yang tidak diinginkan: Risiko & rencana mitigasi risiko harus ditinjau / diterima oleh manajer
program yang relevan (yaitu, direktur medis)

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Equipment Management (EM) Number
WHO

EM number :
EM # = Function # + Clinical Application # + Maintenance # + History #

Peralatan dengan angka EM ≥ 12 harus dimasukan


kedalam daftar peralatan yang wajib dilakukan
preventive maintenance.

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Function Number
Category Function description Point score

Life support 10

Surgical and intensive care 9


Therapic
Physical therapy and treatment 8

Surgical and intensive care monitoring 7


Diagnostic
Additional physiological monitoring and 6
diagnostic

Analytical laboratory 5

Laboratory accessories 4
Analytical
Computers and related 3

Miscellaneous Patient related and other 2

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Clinical Aplication
Number
Description of use risk Point score

Potential patient death 5

Potential patient or operator injury 4

Inappropriate therapy or misdiagnosis 3

Equipment damage 2

No significant identified risk 1

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Maintenance Number

Maintenance requirement Point score

Extensive: routine calibration and part replacement


5
required

Above-average 4

Average: performance verification and safety testing 3

Below-average 2

Minimal: visual inspection 1

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History Number

Average equipment failures Factor

Significant: more than one every 6 months +2

Significant: more than one every 6 months +1

Significant: more than one every 6 months 0

Significant: more than one every 6 months -1

Significant: more than one every 6 months -2

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Equipment Clinical Maintenance Incident Inspection
function application requirement history frequency
Device description EM # Inspection
Anaesthesia machine 10 5 5 0 20 I T
Anaesthesia vaporizer 9 5 3 -2 15 I S
(enflurane/ethrane)
Arthroscopic surgical unit 9 4 2 -2 13 I A
Breast pump 3 4 3 -2 8 N -
Aspirator, mobile 8 5 4 -1 16 I S
Blood warmer 9 4 3 -1 15 I S
Bonesaw 9 4 2 -2 3 I A
Blood pressure module 7 3 2 0 12 I A
Camera, video, medical 6 3 3 0 12 I A
Castcutter 2 4 3 -2 7 N -
Castcuttervacuum 2 2 3 -2 5 N -
Cardiac output computer 7 3 2 0 12 I A
Computer, micro (pc) 3 3 1 -2 5 N -
Cryosurgical unit 9 4 3 -1 15 I S
Defibrillator/monitor 9 5 4 0 18 I S
Electrocardiograph, 3-channel 6 3 5 2 16 I S
Endoscopic video system 6 3 3 0 12 I A
Electrosurgical unit 9 4 3 0 16 I S
Fetal monitor 7 3 3 0 13 I A
Humidifier, heated 8 3 3 1 15 I S
Hypo/hyperthermia machine 9 4 5 0 18 I S
Light, surgical portable 2 4 3 -1 8 N -
Light source, fibre optic 7 3 3 -2 11 N -
Microscope, ophthalmicslit lamp 6 3 3 -2 10 N -
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Minor IPM Minor IPM Major IPM Major IPM
frequency time frequency time Total time
Medical equipment (per year) (hours) (per year) (hours) (hours/year)
Laboratory chemistry department
Laboratory blood refrigerator 11 0.2 1 0.5 0.7
Laboratory specimen refrigerator 1 0.5 1 0.5 1
Heating block 2 0.25 0 0 0.5
Spectrophotometer 3 0.5 1 0.75 2.25
Bilirubin analyser 2 0.75 1 1.0 2.5
Chemistry analyser 3 3.0 1 4.0 13.0
Printer module 2 0.3 0 0 0.6
Computer printer 2 0.3 0 0 0.6
Computer monitor 1 0.25 0 0 0.25
Chemistry analyser 3 4.5 1 6.0 19.5
Microscope 1 0.5 1 1.5 2.0
Laboratory freezer 1 0.3 1 0.5 0.8
Laboratory mixer 2 0.25 0 0 0.5
Centrifuge 2 0.5 1 1.0 2.0

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INSTALASI
ELEKTROMEDIK
DIVISI SERVICE
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WARANTY PERIODE

CONTRACT SERVICE

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DIVISI INSPEKSI PEMELIHARAAN DAN MAINTENANCE (IPM)
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DIVISI KALIBRASI

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DIVISI INVENTORY ALAT KESEHATAN
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PARTS AND CONSUMABLE

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www.companyname.com
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JUMLAH KABUPATEN/KOTA YANG MEMILIKI
JUMLAH KECAMATAN YANG MEMILIKI MINIMAL 1
MINIMAL 1 RSUD YANG TERSERTIFIKASI
PUSKESMAS YANG TERSERTIFIKASI AKREDITASI
AKREDITASI NASIONAL

*Jumlah Kumulatif 5600*) *Jumlah Kumulatif 482*)


4900*) 434*)
2800*) 287*)
700*) 190*)

350*) 95*)
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JUMLAH PUSKESMAS

ACEH

215
SUMATERA UTARA

285
SUMATERA BARAT

103
RIAU

84
JAMBI

67
SUMATERA SELATAN

104
BENGKULU

46
LAMPUNG

111
BANGKA BELITUNG

28
KELUARGA

KEPULAUAN RIAU
DKI JAKARTA

49 44
JAWA BARAT
210

JAWA TENGAH
301

DI YOGYAKARTA 29
JAWA TIMUR
360

BANTEN
63

BALI
51

NUSA TENGGARA BARAT


86

NUSA TENGGARA TIMUR


37

PROPINSI
KALIMANTAN BARAT
103

KALIMANTAN SELATAN
69

KALIMANTAN TENGAH
25

KALIMANTAN TIMUR
47

KALIMANTAN UTARA
14

SULAWESI UTARA
42

SULAWESI TENGAH
79

SULAWESI SELATAN
135

SULAWESI TENGGARA
32

GORONTALO
LOKUS PUSKESMAS PENDEKATAN

SULAWESI BARAT
MALUKU
MALUKU UTARA
12 11 16 16

PAPUA
35

PAPUA BARAT
17
IRISAN PUSKESMAS LOKUS PIS-PK, PUSKESMAS
TERAKREDITASI PER DES 2016 & RENCANA AKREDITASI TAHUN
2017

PUSKESMAS
TERAKREDITASI PER PUSKESMAS RENCANA
DES 2016 LOKUS PIS-PK AKREDITASI 2017
(1479) (2926) (3075)

824 655 1139 1132 1943

➢ Puskesmas Lokus Program Keluarga Sehat yang harus disurvei pada tahun 2018 : 1.139
Puskesmas
➢ Dari 1139 Puskesmas, sebanyak 620 Puskesmas sudah diusulkan dan 519 Puskesmas yang belum
diusulkan oleh Daerah untuk diakreditasi tahun 2018
DUKUNGAN ASPAK
APLIKASI SARANA PRASARANA DAN ALAT (ASPAK)

• PENGISIAN TEPAT
WAKTU
• DILAKUKAN VALIDASI
• DILAKUKAN EVALUASI

AKREDITASI

PERIZINAN

PERENCANAAN

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