i. without compromising on the quality of care.

i. Physical plant,

ii. Hospital furniture and appliances,

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iii. General purpose furniture and appliances, and

iv. Therapeutic and diagnostic equipment.

It is the manufacturer’s interest to see that hospitals buy and install as much equipment as possible, whileas it is in the hospital’s interest to have the minimum needed to carry out its essential functions.

The hospital consultant with his knowledge and experience enables the hospital to select from what is available in the market only as much as is essential, convenient, efficient and economical without compromising on the quality of care.

In the selection of diagnostic and therapeutic equipment, it is not uncommon that complex and sophisticated equipment has been ordered for prestige reasons when simpler versions could do the same job.

It is also of no use to buy equipment just because it is readily available in the market rather than plan acquisition; of standardised equipment in advance.

Often, different opinions are found among our clinical experts when their advice on evaluating costly equipment is sought, because they have different sources for their technical information, and also because at times they are involved in a particular system.

A subcommittee must try to separate opinion based on good information from that based on different loyalties and personal preferences.

Generally, all plant and equipment which are attached to the buildings or to mechanical services, such as cabinets and counters, laundry and kitchen equipment, boilers, etc. are included in the construction contract and the responsi­bility of their installation should be by the contractor.

Diagnostic and therapeutic equipment, surgical apparatus, etc. are not included in the contract and are the responsibility of hospital administration, so is furniture required in connection with patient care and other movable equipment.

Plants and equipments required in a general hospital

A. Physical plant

Lifts
Refrigeration and air-conditioning
Fixed sterilisers
Incinerators
Boilers
Pumps
Kitchen equipment
Mechanical laundry
Central oxygen, suction
Generator Hospital furniture and appliances
Beds
Stretchers
Trolleys
Wheelchairs
Bedside lockers
Dressing drums
Kitchen utensils
Bedside lamps
Movable screens
Handwash stands
Operation tables
Instrument trolleys
Bedpans
Wastebins
Hospital linen

B. General purpose furniture and appliances

1. Office machines

Intercom sets
Typewriters
Calculators
Cash registers
Filing systems
Electronic exchange
Computer

2. Office furniture

3. Crockery and cutlery

C. Diagnostic and therapeutic equipment

1. Equipment for general use

Surgical instruments
BP instruments
Suction machines
Rehabilitation department equipment
Physiotherapy department equipment
Sterilisers
Equipment for clinical laboratory
Glassware washers
Voltage stabilisers
Refrigerators
Chemical analysers microscopes

2. Equipment interacting with patients during diagnostic and therapeutic procedures

Short-way diathermy machines
Electric cautery machine
Defibrillators
X-ray machines
Monitoring equipment
Respirators
Incubators
ECG machines
USG machines

During the last decade, there has been an explosive growth of sophisticated electronic biomedical equipment in the hospital field.

However, introduction of electronic equipment in haste without thorough assessment may pose problems of economy, safety, and obsolescent systems.

Government officials and donor agencies also try to provide hospitals in developing countries with many kinds of most expensive electronic equipment without realising the extent of their actual use.

Apart from selection of the equipment, it is equally important that procurement of each item of major equipment is planned so as to arrive at the construction site at the required time.

Schedules of installation of equipment will have to be planned in advance, with follow-up action at intervals. Complex and time-consuming bureaucratic procedures, especially in the government may lead to arrival of the equipment much later after the initial proposal. This has to be guarded against.