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Maintenance Management System in Hospital (Ultrasound & CT Scan Equipments)

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BACKGROUND STUDIES /PROBLEM STATEMENT:

Recent maintenance practices in hospital (health care equipments and services) and use of computerized maintenance management system (CMMs) based hospital information maintenance management system (HIMMs) provide good practices during evaluating performance and effectiveness of equipments. But unfortunately, CMMs and maintenance activities i.e. Breakdown maintenance (BDM), planned preventive maintenance (PPM), productivity is not solve problems at all. Several reasons are: 1. CMMs not solve problems of repetitive failures, BDM , PPM for long term 2. CMMs also not predict life cycle and durability of equipments for long period For this reason, need of such system that can predict and resolve problems at all.

This research project is aimed to provide two ways to solve problems by using theoretically mathematical equations from literature review and modify equations for particular for repetitive failure, BDM, PPM and equipment productivity. Second way CMMs software is to design which is completely reliable; predictable critical factors for not only now, but also long term purpose. The results in terms of system assist facility managers or clinical engineers (biomedical engineers). Sustain life of equipments, easy to replacement and repaired etc.

OBJECTIVES OF RESEARCH PROJECT:

The objectives of the project are: 1) To evaluate maintenance management system in hospital (health care equipments and services) 2) To modify mathematical equations for measuring maintenance activities of ultrasound equipment and CT scan equipment

METHODOLOGY: Data Collection Strategy: Data collection strategy is obtained from visited and observation biomedical engineering department. Select two imaging equipments -ultrasound machine’ & -computed tomography machine’ from various hospitals like Hospital Serdang, Hospital Putrajaya etc., to collect equipments inventory data. Data collection strategy is focus equipment assets history. It includes planned preventive maintenance (PPM), Breakdown maintenance (BDM), Schedule work, work orders (w.o), action taken, vendor services, parts management, utilities, and reports. Data collection is need because: a) Calculate repetitive failures, BDM and PPM b) Measure Productivity and Equipment effectiveness c) Life and use of equipments for long term purpose Analysis of Data Collection: Analysis of the data depends upon asset history of particular equipments. Identify repetitive breakdowns, planned preventive and productivity performance in both medical equipments. The strategy for analyze data is to specified no. of failures, no. of breakdowns and no. of planned preventive for last three years. Analysis of data collection is required because: a) Interpret particular problems b) Apply modify equations to solve problems Mathematical Analysis In general, previous studies on maintenance management system provided mathematical formulas and equations not at all overcome problems of equipments. In medical equipments i.e. reliability equations and availability equations are not enough to measure maintenance performance of ultrasound and CT scan. Predicted Breakdowns

In this project, provide specific and modify equations which is use to solve medical equipments maintenenace problems. (Stephen, 2004) This equations are modified on the basis of productivity and reliability maintenance management.. Stephen defined equations: Breakdown (Excepted)= S (No. of Failures) * Frequency of Failure / Total No. of Failures, But modify equation will be: Breakdowns (predictable) = (a1+a2+a3—-an) * () / Tf Therefore a is no. of repetitive failures, an is nth term of failure which is expecting failure with time, is frequency of failure occurring in duration week, months, Tf is total no. of failures per years. Conclusion In the end, evaluating MMS in hospital is prime consideration for clinical engineers. This modify equations of equipments will improve maintenance practices overall and overcome failures, breakdowns. Successful in implementing and applying mathematical equations will definitely increases productivity and overall equipment effectiveness. Nonetheless, due to the necessity to ensure maintenance management system, figure 4.9 data analyzed and interpreted from maintenance part of the asset of equipments contains several factors that serve as the determinants to the success of maintenance practice for health care sectors. By using mathematical approaches and data analysis from maintenance part of the asset of equipments contains several factors that serve as the determinants to the success of effectiveness of equipment and best maintenance practice in health care industries.

RESULTS: 1. From above calculation, the result shows that repetitive failures, BDM, PPM always key parts and critical factors in maintenance practices.

2. Breakdowns maintenance in ultrasound much more and predictable during last three year so it would be a greater expensive alternatives if equipments not replaced on time. 3. CT scan has low rate of breakdowns maintenance during last three years so it would be predicted that less equipment expensive alternative so no need to replace equipment.

4. Medical Equipment’s productivity factor in ultrasound is 36 % in last three years due to more and more Break downs maintenance and Planned preventive maintenance occurred which is not good for productivity, life of equipment. Step should be taken in early stage of breakdowns. 5. Productivity factor in CT scan is 38 % previous three years, because of less BDM but more PPM. 6. Overall equipment effectiveness of Ultrasound is 38.90, it means equipment is in poor condition and unlimited break downs, more failures occurred. Require proper testing, calibrations, changeovers parts, adjustments. It will contribute to increase in effectiveness in rarely manner. 7. OEE of CT scan is 72 %, it is mean that equipment is in good condition because of breakdowns and failures are limited. In occasionally testing and commissioning, inspection is requiring. It will mostly increase effectiveness in rapid manner.

8. It will increase productivity & It will maintain overall equipment effectiveness.

9. Lastly, it will assist clinical engineers to make decision on need basis of particular equipment or replacement.

REFERENCES:

Albert H.C Tsang (2002). -Strategic dimension of maintenance management-, Journal of Quality in maintenance Engineering, Vol. 8, No. 1, pp. 127-139. A.C., Marquez, Jatinder N.D.G. (2006). -Contemporary maintenance management: process, frame work and supporting pillars-, the international Journal of Management Science, No. 34, pp.313-326. Atkin, B. and Brooks, A. (2009). -Total Facilities Management-, 3rd edition, Wiley-Blackwell, Oxford and New York, pp. 328.

Acevedo, Francisco (2005), -Design of CMMS for the Chilean Naval Hospital BME Department-, Engineering in Medicine and Biology 27th Annual Conference IEEE, shanghai, China pp. 1-4

B.S. Dhillion, Y.Liu (2006),-Human error in maintenance review-, Journal of Quality in Maintenance Engineering Vol.12, No.1, pp.21-36.

Bronizo, Joseph D. (2006). -The Biomedical Engineering Handbook, Third Edition-.

Corder, A.S (1976), -Maintenance Management Techniques-, McGraw-Hill UK, England.

Duffa, S.O., A.Rauof, Campbell, J.D (1999), Library of Congress Cataloging-in- Publication, Volume 20, pp 30-44.

J.J. Smit , J.A van Weelderen, .(1995), – Maintenance Diagnosis of HV installations using an expert support system-, Proceeding 9th ISH, International Symposium on H.V. Engineering, Graz, Austria, pp. 45-56.

Levitt, J. (1997), -The Handbook of Maintenance Management-, Industrial Press Inc, New York, NY.

Niebel, B. W. (1993). -Engineering Maintenance- Ninth Edition. United States of America: Irwin. pp. 335-462.

Mark C.,Eti,S.O.T Ogaji, S.D. Probert (2006). -Strategies Maintenance Management in Nigerian Industries-, Journal of Applied Energy, No. 83, pp. 211-227.

Marvin Raushad, (1998), -Reliability Centered Maintenance-, Reliability Engineering and System Safety, vol. 60, pp.121-132.

Swanson, L., (1997), -An empirical study of the relationship between production technology and maintenance Management-, International Journal of production economics No. 53, pp. 191-207.

Shamsuddin, A., Masjuki, H., Zahiri, (2004), -State of Implementation of TPM in SMIs: a survey study in Malaysia-, Journal of Quality in Maintenance Engineering, vo1 10 No.2, pp. 93-106.

Sherwin, D. (2000), -A review of overall models for maintenance management, Journal of Quality in Maintenance Engineering-, Vol.6 No.3, pp. 138-164.

Stephen, M.P (2004), -Productivity and Reliability- Based Maintenance Management-, Pearson Education Inc., New Jersey, New York, pp.276.

Ted Cohen, (2003) -Computerized Maintenance Management Systems for Clinical Engineering-, Second Edition, AAMI MIR no. 3, pp. 7-10.

Vukan Polimac, Jelica Polimac, (2001) -Assessment of Present Maintenance Practices and Future Trends-, Transmission and Distribution Conference and Exposition, pp.891-894.

Valma J Robertson, Kerry Gbaker (2001), -A review of Therapeutic Ultrasound: Effectiveness Studies-, Volume 81, No. 7.pp. 12-20

Yusof, M, Bakri Rugayah, Musa Zaharah (2006), -Electrical Impedance Tomography-. Health Technology Assessment section, Medical Development section, Ministry of Health, Malaysia, Technology report, pp. 1-6.

Wilhelm Burger and Mark J. Burger (2007), -Digital Image Processing: An Algorithmic Approach Using Java-, Spinger, Volume 30 No 1, pp. 10-18.

Wireman,T.,(1991), -Total Productive Maintenance- , an America Approach, Industrial Press, NewYork. PP. 16-21.

Benefits Of Real Estate Business And Investment

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In the domain of real estate business there is no need to be apprehensive as yet for the Americans, are still recovering from the fear of debts which had controlled their finances until recently and it is only with the help of such resources as a low interest consolidation or the best debt management programs that the citizens could finally get respite from the trap of debts. But now when the economy has started to look up from the financial void, it is time for the citizens to change their views about some of the businesses which are capable of providing better returns in the long run. Gone are those days when businesses were looked with greater awe. Though there are persistent risks which are involved with this business, it is of more worth to calculate the advantages of being involved in this business.
Let us have an overview of the same in the next few lines:
If you have been comparing an array of business opportunities lately, you will be glad to know that a real estate investment is less risky than other businesses and they are in fact quite stable provided that you have actually been able to encompass the pettiest of aspects that are related to this business, and you have taken this opportunity seriously. However the lesser risks are associated with such factors as stability in the rate of mortgage followed by the appreciating value of the land and various other socio economic issues.
There is no need to have a huge capital at least initially to start off with the business. The property can be secured by negotiating a lower amount, and some money should be kept for holding the property as a security.
A real estate investment will not tale up a hell of all your time but only if you are calculating and clear sighted about the prevailing marketing conditions at that point of time.
As far as investing in real estate is concerned leveraging still remains as the best option wherein you can invest a portion of your money and the rest can be borrowed from a bank or any other financial institution.
If you are able to select the correct geographical location, you are likely to get a high value of appreciation over a period of time.
Along with paying your mortgage debts you will be creating a home line of equity which is to imply that you will be able to approach the original price of the property without any debt.
Unlike other investments where you may lose a lot of your money for paying the tax amounts, the tax exemptions on a real estate investment is much more than any other business.
Therefore a real estate investment is the best bet for the value of a property is almost always on the rise which provides a good impetus for the growth of this business, but you have got to treat it with the necessary vigilance and the required acumen.

How To Minimize Small Business Taxes A Tax Professionals Guide

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Knowing how to minimize small business taxes means you get to keep Uncle Sams hand from picking your pocket of hard earned money at tax time. If you are not taking advantage of every available, legal, tax loophole, your business profits are being handed over to the IRS.

The following tips will help you reduce small business taxes.

It is recommended to take full advantage of ones claim on Capital Cost Allowance. If you need to buy supplies, machinery, and technology, time it for maximum savings. If doing the math shows you will minimize your tax exposure deducting the expenses this year, do not delay. Using Capital Cost Allowance on your new property, you will still increase the CCA for the current year and will have increased CCA claims for the next year.

Consider postponing disposal of depreciable resources. Do not dispose of business equipment until the following year depending on which will better reduce the tax liability for your business.

Planning income deferments can also help minimize your business tax liability. Postponing or putting off income is recommended if business profit will be higher or if the tax rates in the following tax year are expected to be reduced.
Through smart tax planning managing your expenses to meet higher profits is another strategy for further minimizing tax. Let the tax implications dictate the timing of improvements, supply purchases and equipment upgrades.

Make the most of Registered Retirement Savings Plan (RRSP) payments possible as a means of minimizing small business taxes. Contribution of up to eighteen percent in any given year of the profit, along with a Registered Retirement Savings Plan (RRSP) payment is deducted from the income. An RRSP is advantageous to be considered for tax deduction for small businesses. Additional deductions you may or may not be taking full advantage of include write-offs for start-up expenses; office costs; furnishings; advancement through education; travel expense; insurance premiums; affiliations; and conferences.

Employ members of the family. The government is particularly understanding to family-run businesses when salaries are concerned. You are not required to provide payment for federal unemployment taxes if you employ in your business your husband or wife or parents. There is no need to hold back income taxes and Social Security if siblings work in your business. However, child labour laws are still applied even if they are your children so age restrictions must be considered. As employees they must receive proper salaries and must be assured that the company is benefited in order to be eligible for these exemptions that can help dramatically reduce small business tax exposure.

Employ independent contractors so you will not have to withhold state income taxes from their salaries. As the business owner, you will not have to provide withholding payment for the employers contribution for Social Security as well as Medicare taxes. There is also no need to provide unemployment benefits for independent contractors. However, make certain that the IRS does classify the independent contractor as your employee. If they do, you will be requested to provide payment for taxes including fines levied for any missed withholdings you may or may not have been aware of. Consult your tax expert before categorizing an individual as an independent contractor to be sure you are properly doing so.

Contributing to charity can help reduce small business taxes. Donating to non-profit groups that work to help others who need assistance is a great way to reduce tax liability. In this way, you will be able to decrease the tax exposure of your business. Tax incentives are offered by the IRS for businesses and individuals who give contributions, so why not take advantage of these opportunities that are mutually beneficial by creating a tax plan of donation to your favorite charities.

Prior to making a contribution, be sure the charitable organization qualifies for the deduction you seek. The IRS also requires you to document with the organization donations of $250 or more.

No one is exempt from paying taxes; however, executing a proactive, smart business plan to reduce the business tax exposure for your business is good business. Small deductions when added up, combined with a tax aware financial plan created with an experienced accountant can help not only to minimize your business taxes but grow the future you are working so hard to create.

Ian Driscoll worldwide marketing manager

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The perks of running your very own home based business are really obvious, but exactly what is frequently forgotten are the subtle issues that will certainly be come across along the road. You could never ever predict each change in law, technology, or business world; nonetheless, you can ready on your own with advice that permits you to adjust and relocate with the globe around you./p>

Do you have a workplace with the needed materials that you really feel comfy in? If you have a peaceful space without diversions, you’ll quickly end up being focused on job.

Behave to your customers. Many people are fantastic to manage, however you will unavoidably encounter a miserable buyer, which is discourteous to you. Recognize that it isn’t really worth your time to suggest or to name-call. Addressing impolite people with kindness normally calms them down and besides, you do not have time to obtain into fights, anyhow. You have a company to run.

Arrange to have a toll welcome 800 number related to your home business. Taking this action permits you to keep your individual information private. If your business is successful, having an 800 number likewise leaves your residence number complimentary to take calls from your friends and family, which may have problem getting through or else.

Definitely look for the assistance of others in home based business that are similar to yours. You could either produce your very own network or find a set up one. These people could originate from totally various industries, yet they, too, will certainly be making every effort to run a successful home business.

Develop a flier for your home business. Promote your firm by sending out the flier out to others and posting it in different locations in the neighborhood. You can likewise scan the flier and put it up as an attachment on your website page. Each of these actions will enhance the visibility of your company.

Make certain you reply to any type of customer questions in a quick fashion. Take note of your messages to ensure every question obtains addressed. This will reveal consumers you love your business and they will certainly return to do company with you for their future acquisitions or company necessities.

Keep coupons with you in any way times. Decline your item promos off when you visit your medical professional’s workplace, dental expert, beauty consultant, school, daycare, and any other area you constant. If you trust these service providers and know them well, ask if you can leave some examples for their customers to try.

In order to make as much money as possible, your home business should have a professional looking internet site. Whether you make your website on your own or employ somebody to do it, make sure that the marketing on your website is proper, and be sure there are no missing out on links or photos. If your company has an incompetent looking site, you will certainly lose customers.

If you go along with the details noted below, you will certainly find yourself in a better position from a successful perspective and still keep the flexibility and leisure of overcoming residence. Naturally, some adjustments will certainly be required, however the factor is to proceed adapting with the circulation and staying two steps ahead of the competitors.

If you are aiming to take your business to the next degree then you may well should make use of the solutions of Ian Driscoll who presently is leading the Flexkom International company procedures within the UK. Learn more at http://www.IanDriscoll.co.uk

Vans Shoes Are Not Limited To Skaters

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Whatever sport it is, participants always require a complete outfit to perform better. In this regard, the role of shoes cannot be ignored that not only provides safety to your feet but also promises to give maximum satisfaction. Vans Shoes were launched with the same vision and those who like to sport trendy and stylish canvas shoes would find it a better option than others. Vans has gained huge reputation over years and now it has become an inevitable part of many wardrobes.

Whether it is Vans high tops or low top, customers can feel its comfort level with every step. This brand was launched specially considering the demand of skaters who wish to have a good grip on the skating board. But it does not mean that Vans authentic shoes are limited to skaters, and you can find variety of designer shoes for other age groups also. They are also perfect for any formal or informal occasion. There are several fashion icons labeled with this brand and famous for both genders.

Shoe is an important accessory that demands a lot of care and assessment when purchasing. Want to see more designs of Vans then online portals will be the best source. By going through online portals, you can view a range of designer shoes of Vans available at different price tags and sizes. There are different varieties and models of this brand that attract different genre from teenagers to senior citizens. These shoes are modeled in so many varieties and you can find almost all patterns suitably displayed online in different shoe galleries. Since the establishment of the company in 1966, Vans has maintained a high quality in every model launched for men and women.

There are almost 70 different designs of Vans Authentic Shoes available in the market. All of them are different from others in terms of colors, designs, used materials and prices. But one thing is common in all that they have durable quality materials that promise to give maximum comfort to the wearers. For example, two most popular designs of Vans shoes include Era shoes and Slip On. You can easily purchase them online at a very reasonable price.