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BRIGHT IDEAS
A Cool Solution To Overheating PCs Joe Sheffer
Members of the Clinical Engineering information technology. In addition, we Department at The Royal Melbourne manage a number of projects involved with Hospital are no strangers to modesty. They the installation and replacement of healthcare are quick to point out that their idea to technologies.” improve the reliability of the hospital’s Overall, said Cowley, the department manphysiological monitoring stations is not ages the entire life cycle of healthcare complex. It is simply the application of technology, from procurement to installawell-understood engineering principles, tion, maintenance, management, and, providing an effective low-cost solution to eventually, decommissioning. improve the reliability of a system. Jack Davie, manager of the department, says Challenge his team seeks to manage three risks: substanThe Clinical Engineering department at The tial downtime, incorrect therapy or diagnosis, Royal Melbourne Hospital has developed a and electric shock. simple solution to minimize the amount of “Our role is to provide highly reliable dust and lint collected in personal computers equipment to the hospital,” said Davie. “Our (PCs) used at physiological monitoring product as a department is reliability; reliable stations. These PCs run proprietary software equipment is low-risk that provides real-time equipment.” physiological monitoring, “Literally, when you The Clinical Engineering review, and clinical decision took the lid off, you Department manages a support tools. According to could take out handfuls comprehensive range of David Lierkamp, a biomedihealthcare technologies for cal engineer who played a of dust and lint, and The Royal Melbourne major role in launching this this was causing the Hospital and its healthcare innovation, the hospital was overheating.” network, Melbourne Health, experiencing intermittent — David Lierkamp, explained Simon Cowley, a faults with the PCs at the biomedical engineer. Emergency Department biomedical engineer “We’re responsible for not physiological monitoring only the day-to-day repair and maintenance of stations. Investigation revealed that these faults medical equipment but are also involved in were the result of overheating of the PCs. consultation and advice on healthcare tech“Dust and lint were collecting in the central nologies,” said Cowley. “We also provide station computers,” said Lierkamp. “Literally, significant support in the area of medical when you took the lid off, you could take out
At a Glance SUBJECT
Clinical Engineering Department, The Royal Melbourne Hospital LOCATION
Parkville, Victoria, Australia SIZE
650 beds; the department services 11 physiological monitoring stations STAFF
Eleven in-house biomedical engineering, mechanical engineering, and administration staff
Biomedical Instrumentation & Technology May/June 2014
195
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Columns and Departments
About the Author Joseph Sheffer is publications specialist at AAMI. E-mail: jsheffer@ aami.org
handfuls of dust and lint, and this was causing the overheating.” Other PCs at physiological monitoring stations around the hospital were checked and also found to have considerable dust and lint built up inside. An initial solution to the overheating issue was to routinely clean the dust from the PCs. The physiological monitoring stations were taken offline so that the dust and lint could be vacuumed from inside the PCs. This approach had disadvantages, including considerable dust and noise being generated in the surrounding patient care environment and the possibility of disturbing internal components of the PCs. The most noteworthy disadvantage, however, was the outage of physiological monitoring stations in critical care areas, resulting in a loss of physiological monitoring capabilities for clinical staff.
Solution In 2009, Clinical Engineering devised a pilot scheme for solving the problems related to
Figure 1. A typical physiological monitoring station cabinet contains three PCs, as well as three uninterruptible power supply (UPS) units and associated hardware. The filter fan units can be seen attached to the cabinet doors. Eight filter fan units are operating in this cabinet: two fans for each of the three PCs and two fans for the UPS units and associated hardware.
196
Biomedical Instrumentation & Technology May/June 2014
dust and overheating. “One physiological monitoring PC was already in a cabinet that had slots in the doors that permitted dust ingress,” said Lierkamp. “So, by working with the preexisting cabinet, we blocked the slots and added two filter fan units. That created a positive pressure environment using filtered, clean air.” Lierkamp noted that although this pilot model was enacted to fix the immediate problem at a particular physiological monitoring station, it led to a hospital-wide approach to increase the reliability of this medical technology. “We began researching the area of computer operating temperature,” said Lierkamp, “and we found that the manufacturer specifications for PCs are a maximum of 35°C (95°F) ambient temperature. We also researched electronic components and found that the mean time between failure for components is reduced by 50% for every 10°C (18°F) increase in temperature.” Investigating further, Clinical Engineering began considering two types of fans: sleeve bearing and ball bearing. “Ball bearing fans have a significantly longer mean time between failure than sleeve bearing fans, so we went with them,” said Lierkamp. “We also found that if you use two fans to get the same airway capacity as one fan of the same capacity, there’s much less ambient noise generated. In some clinical areas, fan noise can be an issue. So we chose to go with two fans. That also gave us a degree of redundancy if one fan should fail.” Clinical Engineering now has a standardized design for a single physiological monitoring PC that consists of two 119-mm filter fans per cabinet. This design limits the increase in temperature to approximately 10°C (18°F ) during a one-month period. Some cabinets have more PCs, but the same ratio of two fans per PC is followed. To correctly size the filter fans, the manufacturer’s software tools and design tables were used to select the correct air flow rate. Figure 1 shows a typical physiological monitoring station cabinet, and Figure 2 provides temperature data for a physiological monitoring station cabinet.
© Copyright AAMI 2014. Single user license only. Copying, networking, and distribution prohibited.
Columns and Departments
Results According to Davie, after the physiological monitoring station cabinet/fan solution was rolled out across the hospital, the benefits soon became quite evident. “We now have zero downtime at all physiological monitoring stations. The only upkeep is changing the filter media for the fans once a month. The solution has progressed from a novel idea. Now, we’re using it as a standard design for all new installations of this type of medical technology in our organization,” he said. Quantifying the cost savings of the initiative is a tricky proposition, said Davie; however, the positive implications are clear. “With no downtime, the cost related to work interruptions in the Coronary Care Unit, for example, are significantly reduced,” he said. According to Cowley, the days of physiological monitoring PCs requiring service have long passed. “Since we’ve implemented the solution hospital-wide, we’ve had no failures on our physiological monitoring stations in regard to overheating or other maintenance-based issues,” he said. “It’s simply not an issue anymore. The positive
Key biomedical engineering, mechanical engineering, and administration staff involved in the initiative. Back row, from left to right: Prem Krishnan, David Lierkamp, Nikki Donaldson, Simon Cowley, and Hua Pan. Front row, from left to right: Emmanuel Koumoundouros, Shamalka Fernando, Leschelle McCalman, Jack Davie, Ssu Yuan Nolan, and Doris Forde.
“The solution has progressed from a novel idea. Now, we’re using it as a standard design for all new installations of this type of medical technology in our organization.” — Jack Davie, manager of clinical engineering
Figure 2. The sharp decrease in temperature corresponds with the monthly change of the filter media in the cabinet fan units.
Biomedical Instrumentation & Technology May/June 2014
197
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Columns and Departments
pressure of the filtered air created by the filter fan units in the cabinet prevents dust ingress. Since the cabinets were set up, we basically run the PCs for their intended working life, and all we do is change the filter media once a month. Now, the computers require little intervention.” Cowley also described how outage in the hospital’s critical care areas was not a desirable circumstance. “The physiological monitoring stations in the Coronary Care Unit are connected to a cardiac telemetry system, which is the application of wireless networking and ECG (electrocardiogram) monitoring for patients. In that critical care environment, taking the station offline for cleaning created significant clinical risk for patients and the hospital, as the patients were not monitored when the central station was inoperative,” he said. When asked if their innovation had garnered them any accolades at The Royal Melbourne Hospital, Davie and company responded with customary humility. “This
work has been completed as part of our commitment to increase reliability. It hasn’t been a big thing that we’ve pushed or that’s discussed,” said Davie. “With our product as a department being reliability,” said Cowley. “Our goal is to work to maximize reliability on the medical technology that we look after for The Royal Melbourne Hospital and Melbourne Health. Our risk management strategies and other policies and documents are written around this concept of providing reliable equipment to the customer, who is The Royal Melbourne Hospital.” The cooling cabinet solution has been in full swing now for more than two years. Much like the Clinical Engineering department itself, the solution is humming along in the background, performing its task with quiet, reliable savvy. n
ANSI/AAMI EQ56:2013
Recommended practice for a medical equipment management program This popular recommended practice specifies minimum criteria for a management program designed to minimize certain risks associated with equipment that is used during the routine care of patients in a health care organization. EQ56 addresses: ► Structure of the program ► Documentation requirements ► Staffing ► Resources allocated to those responsible for maintaining medical equipment ANSI/AAMI EQ56:2013 Order Code: EQ56 or EQ56-PDF List $120 / AAMI member $60
198
Order your Copy Today! Call +1-877-249-8226 Visit http://my.aami.org/store
Biomedical Instrumentation & Technology May/June 2014
American National Standard
ANSI/AAMI EQ56:2013 Recommended practice for a medical equipment management program
Columns and Departments
BRIGHT IDEAS
A Cool Solution To Overheating PCs Joe Sheffer
Members of the Clinical Engineering information technology. In addition, we Department at The Royal Melbourne manage a number of projects involved with Hospital are no strangers to modesty. They the installation and replacement of healthcare are quick to point out that their idea to technologies.” improve the reliability of the hospital’s Overall, said Cowley, the department manphysiological monitoring stations is not ages the entire life cycle of healthcare complex. It is simply the application of technology, from procurement to installawell-understood engineering principles, tion, maintenance, management, and, providing an effective low-cost solution to eventually, decommissioning. improve the reliability of a system. Jack Davie, manager of the department, says Challenge his team seeks to manage three risks: substanThe Clinical Engineering department at The tial downtime, incorrect therapy or diagnosis, Royal Melbourne Hospital has developed a and electric shock. simple solution to minimize the amount of “Our role is to provide highly reliable dust and lint collected in personal computers equipment to the hospital,” said Davie. “Our (PCs) used at physiological monitoring product as a department is reliability; reliable stations. These PCs run proprietary software equipment is low-risk that provides real-time equipment.” physiological monitoring, “Literally, when you The Clinical Engineering review, and clinical decision took the lid off, you Department manages a support tools. According to could take out handfuls comprehensive range of David Lierkamp, a biomedihealthcare technologies for cal engineer who played a of dust and lint, and The Royal Melbourne major role in launching this this was causing the Hospital and its healthcare innovation, the hospital was overheating.” network, Melbourne Health, experiencing intermittent — David Lierkamp, explained Simon Cowley, a faults with the PCs at the biomedical engineer. Emergency Department biomedical engineer “We’re responsible for not physiological monitoring only the day-to-day repair and maintenance of stations. Investigation revealed that these faults medical equipment but are also involved in were the result of overheating of the PCs. consultation and advice on healthcare tech“Dust and lint were collecting in the central nologies,” said Cowley. “We also provide station computers,” said Lierkamp. “Literally, significant support in the area of medical when you took the lid off, you could take out
At a Glance SUBJECT
Clinical Engineering Department, The Royal Melbourne Hospital LOCATION
Parkville, Victoria, Australia SIZE
650 beds; the department services 11 physiological monitoring stations STAFF
Eleven in-house biomedical engineering, mechanical engineering, and administration staff
Biomedical Instrumentation & Technology May/June 2014
195
© Copyright AAMI 2014. Single user license only. Copying, networking, and distribution prohibited.
Columns and Departments
About the Author Joseph Sheffer is publications specialist at AAMI. E-mail: jsheffer@ aami.org
handfuls of dust and lint, and this was causing the overheating.” Other PCs at physiological monitoring stations around the hospital were checked and also found to have considerable dust and lint built up inside. An initial solution to the overheating issue was to routinely clean the dust from the PCs. The physiological monitoring stations were taken offline so that the dust and lint could be vacuumed from inside the PCs. This approach had disadvantages, including considerable dust and noise being generated in the surrounding patient care environment and the possibility of disturbing internal components of the PCs. The most noteworthy disadvantage, however, was the outage of physiological monitoring stations in critical care areas, resulting in a loss of physiological monitoring capabilities for clinical staff.
Solution In 2009, Clinical Engineering devised a pilot scheme for solving the problems related to
Figure 1. A typical physiological monitoring station cabinet contains three PCs, as well as three uninterruptible power supply (UPS) units and associated hardware. The filter fan units can be seen attached to the cabinet doors. Eight filter fan units are operating in this cabinet: two fans for each of the three PCs and two fans for the UPS units and associated hardware.
196
Biomedical Instrumentation & Technology May/June 2014
dust and overheating. “One physiological monitoring PC was already in a cabinet that had slots in the doors that permitted dust ingress,” said Lierkamp. “So, by working with the preexisting cabinet, we blocked the slots and added two filter fan units. That created a positive pressure environment using filtered, clean air.” Lierkamp noted that although this pilot model was enacted to fix the immediate problem at a particular physiological monitoring station, it led to a hospital-wide approach to increase the reliability of this medical technology. “We began researching the area of computer operating temperature,” said Lierkamp, “and we found that the manufacturer specifications for PCs are a maximum of 35°C (95°F) ambient temperature. We also researched electronic components and found that the mean time between failure for components is reduced by 50% for every 10°C (18°F) increase in temperature.” Investigating further, Clinical Engineering began considering two types of fans: sleeve bearing and ball bearing. “Ball bearing fans have a significantly longer mean time between failure than sleeve bearing fans, so we went with them,” said Lierkamp. “We also found that if you use two fans to get the same airway capacity as one fan of the same capacity, there’s much less ambient noise generated. In some clinical areas, fan noise can be an issue. So we chose to go with two fans. That also gave us a degree of redundancy if one fan should fail.” Clinical Engineering now has a standardized design for a single physiological monitoring PC that consists of two 119-mm filter fans per cabinet. This design limits the increase in temperature to approximately 10°C (18°F ) during a one-month period. Some cabinets have more PCs, but the same ratio of two fans per PC is followed. To correctly size the filter fans, the manufacturer’s software tools and design tables were used to select the correct air flow rate. Figure 1 shows a typical physiological monitoring station cabinet, and Figure 2 provides temperature data for a physiological monitoring station cabinet.
© Copyright AAMI 2014. Single user license only. Copying, networking, and distribution prohibited.
Columns and Departments
Results According to Davie, after the physiological monitoring station cabinet/fan solution was rolled out across the hospital, the benefits soon became quite evident. “We now have zero downtime at all physiological monitoring stations. The only upkeep is changing the filter media for the fans once a month. The solution has progressed from a novel idea. Now, we’re using it as a standard design for all new installations of this type of medical technology in our organization,” he said. Quantifying the cost savings of the initiative is a tricky proposition, said Davie; however, the positive implications are clear. “With no downtime, the cost related to work interruptions in the Coronary Care Unit, for example, are significantly reduced,” he said. According to Cowley, the days of physiological monitoring PCs requiring service have long passed. “Since we’ve implemented the solution hospital-wide, we’ve had no failures on our physiological monitoring stations in regard to overheating or other maintenance-based issues,” he said. “It’s simply not an issue anymore. The positive
Key biomedical engineering, mechanical engineering, and administration staff involved in the initiative. Back row, from left to right: Prem Krishnan, David Lierkamp, Nikki Donaldson, Simon Cowley, and Hua Pan. Front row, from left to right: Emmanuel Koumoundouros, Shamalka Fernando, Leschelle McCalman, Jack Davie, Ssu Yuan Nolan, and Doris Forde.
“The solution has progressed from a novel idea. Now, we’re using it as a standard design for all new installations of this type of medical technology in our organization.” — Jack Davie, manager of clinical engineering
Figure 2. The sharp decrease in temperature corresponds with the monthly change of the filter media in the cabinet fan units.
Biomedical Instrumentation & Technology May/June 2014
197
© Copyright AAMI 2014. Single user license only. Copying, networking, and distribution prohibited.
Columns and Departments
pressure of the filtered air created by the filter fan units in the cabinet prevents dust ingress. Since the cabinets were set up, we basically run the PCs for their intended working life, and all we do is change the filter media once a month. Now, the computers require little intervention.” Cowley also described how outage in the hospital’s critical care areas was not a desirable circumstance. “The physiological monitoring stations in the Coronary Care Unit are connected to a cardiac telemetry system, which is the application of wireless networking and ECG (electrocardiogram) monitoring for patients. In that critical care environment, taking the station offline for cleaning created significant clinical risk for patients and the hospital, as the patients were not monitored when the central station was inoperative,” he said. When asked if their innovation had garnered them any accolades at The Royal Melbourne Hospital, Davie and company responded with customary humility. “This
work has been completed as part of our commitment to increase reliability. It hasn’t been a big thing that we’ve pushed or that’s discussed,” said Davie. “With our product as a department being reliability,” said Cowley. “Our goal is to work to maximize reliability on the medical technology that we look after for The Royal Melbourne Hospital and Melbourne Health. Our risk management strategies and other policies and documents are written around this concept of providing reliable equipment to the customer, who is The Royal Melbourne Hospital.” The cooling cabinet solution has been in full swing now for more than two years. Much like the Clinical Engineering department itself, the solution is humming along in the background, performing its task with quiet, reliable savvy. n
ANSI/AAMI EQ56:2013
Recommended practice for a medical equipment management program This popular recommended practice specifies minimum criteria for a management program designed to minimize certain risks associated with equipment that is used during the routine care of patients in a health care organization. EQ56 addresses: ► Structure of the program ► Documentation requirements ► Staffing ► Resources allocated to those responsible for maintaining medical equipment ANSI/AAMI EQ56:2013 Order Code: EQ56 or EQ56-PDF List $120 / AAMI member $60
198
Order your Copy Today! Call +1-877-249-8226 Visit http://my.aami.org/store
Biomedical Instrumentation & Technology May/June 2014
American National Standard
ANSI/AAMI EQ56:2013 Recommended practice for a medical equipment management program
