Paper Edited

CHAPTER 1: TOPIC AND PROBLEM

Introduction

The research approach which shall be considered for this paper is qualitative in nature. Qualitative research helps in tackling many topics. It is generally used to explore opinions, values, feelings, and behaviors of individuals towards a certain topic. This type of research is significant for developing theory, improving educational practice, justifying change, developing policy, and illuminating social issues (Sutton & Austin, 2015). It is for these reasons that this paper is inclined towards employing the principles of qualitative research. Maintenance of medical equipment has been a great challenge in the army, and it is an area which is a bit overlooked. The operational environment in which the army operates is one that creates unplanned challenges which include rough terrain, extreme temperatures variations, and limited access to a reliable source of energy (Censer & Dupont, 2008). With such challenges, handling medical equipment may contaminate them. Also, laboratory calibration is a process which takes time. This may become a hindrance to the operations of the army which are time sensitive. Commanders face challenges when it comes to issuing commands in time. This is because their decisions and readiness is affected by the state of the medical equipment at the designated time for the mission at hand. The commanders may face a dilemma of whether to advance with their mission without the readiness of the medical equipment or not to pursue their mission until the condition of their medical equipment is improved. The former option might risk the lives of the military personnel who might be exposed to ineffective medical attention, and thus putting a risk to their health and lives. The latter option might give the adversary a chance to get away or even ambush the military base because of wasting time due to the delays in maintenance of medical equipment. The purchase of new equipment by the U.S. government also becomes a challenge due to the high costs involved. These are just some of the few problems encountered by maintenance of army equipment (Censer & Dupont, 2008).

Topic

The topic considered for this paper is reserve equipment maintenance. Maintenance of army medical equipment is a major problem which affects the performance of the military group to some extent. The choice for this topic was influenced by the fact that it is an area which has not be researched on by many individuals.

Problem Statement

There is a problem in maintaining medical equipment in military bases. Despite many efforts to make sure that armies prioritize maintenance, there are some factors which are acting as a hindrance to this development. This problem has affected the army personnel in various ways. The efficiency of the operations of the army has been affected despite the many regulations set aside by AR750-1 which requires that medical equipment be maintained for the various deployments of troops ("Army Material Maintenance Policy (AR750-1)," 2013). A possible cause of this problem is the allocation of few resources to the army which makes it hard to maintain the medical equipment. Another probable cause may be due to the fact the turnaround time may take which may hinder the operations of the army. The army, is therefore forced to handle the medical equipment with contamination which negatively affects the maintenance process (Censer & Dupont, 2008). This calls for researchers to do more studies in this area which would help in suggesting the best possible solutions.

Purpose Statement

With this research, I hope to understand the nature of army operations and it affects maintenance of medical equipment, factors which affect maintenance, challenges experienced, and solutions to the problem. Understanding the nature of this problem would help provide recommendations to the army on how they might incorporate equipment maintenance amidst their operations.

Research Questions and Strategy

1. What are the factors which hinder the maintenance of medical equipment in military setting?

2. What are some of the solutions to the problems encountered during medical equipment maintenance?

It is expected that proper training of medical personnel, allocation of funds, and proper planning among other practices will help in improving maintenance of army medical equipment.

CHAPTER 2: LITERATURE REVIEW

Many researchers have tackled on various aspects related to maintenance of army medical equipment maintenance. This section shall discuss some of the various themes developed from the scholarly sources. The review of literature revealed various topics like what is entailed by current medical equipment maintenance programs, factors affecting maintenance, and solutions to problems affecting maintenance of medical equipment.

Current Medical Equipment Maintenance Programs

Resnick, Connor, Wirth & DuBois speak on how the U.S. Army Medical Command (MEDCOM) has devised an effective strategy which makes sure that funds are allocated to the field of maintenance. The funds are used by the organization to balance risks across the force and also during missions. The guidance of most matters of medicine in the U.S. is guided by the Army Medicine Equipping Strategy. The (Combat Support Hospitals) CSHs are the primary focus of several medical material programs which is explained in subsections like U.S. Army Forces Command (FORSCOM) CSH 164-Bed Companies, U.S. Army Reserve (USAR) CSHs in which the USAMMA sustains four 248-bed CSH sets, and Shelf-Life Items which are part of the basic unit loads across the force structure. In order to reduce costs, the army medical material strategy teams defer a large number shelf-like items across the force. To achieve risk mitigation, the USAMMA maintains four 248-bed CSH sets at (Sierra Army Depot) SIAD through the Medical Material Readiness Program (MMRP) (2019).

Crown also expounds on the current program structure. The focal point for medical maintenance in the Army Medicine is the USAMMA, which is a child organization of the Army Medical Research and Materiel Command. About 40 percent of the 500 employees working for USAMMA are concerned with maintenance under an organization known as Medical Maintenance Management Department (M3D). M3D is further divided into two subordinate organizations; Medical Maintenance Policies and Analysis (M2PA) which is concerned with formulation of policies and medical maintenance which is patient-oriented and quality-centric. The other organization is the Medical Maintenance Operations Division (MMOD) which oversees depot-level medical maintenance operations at three locations. The two aforementioned organizations work hand in hand to ensure that maintenance of army medical equipment is taken seriously (2019).

Factors Affecting Maintenance

Bahreini, Doshmangir, & Imani discuss on the influential factors on medical equipment maintenance management. The factors include; physical resources which include tools and test equipment, workspace, replacement parts, supplies, and operation and service maintenance manuals; human resources which entails skilled and trained who perform the performance procedure; financial resources which focus on monitoring costs and budget management; quality control which is comprised of safety tests, performance tests, and adjustments and calibrations; documentation of the maintenance procedures which can be categorized into four sub-themes namely provision of medical devices identification, provision of user manual, of local and global evidence, and recording of executive resources; education which entails user and biomedical engineer training; service which entails repair, outsourcing, decommissioning, reporting adverse events and recall systems, and reform and improvement systems; inspection and preventive maintenance; and designing and moment (2018).

Chengyuan & Shaoluo also discuss on various factors which affect equipment maintenance. They include; maintenance support difficulty which is caused by the increasing complexity of the medical equipment; military and civilian versatility which is narrowing the gap between medical technologies used by civilians and the military, and this makes is possible to have many people who can perform maintenance; the level of secrecy in the army may also hinder maintenance; combat missions may also affect maintenance especially in scenarios where the army has to make drastic decisions on an impeding attack; military maintenance support force plays a major role in determining the plan which should be undertaken for maintenance process; and research contractor who also plays a major role in maintenance process (2017).

Solutions to Problems Affecting Maintenance of Medical Equipment

Stern speaks on one of the solutions to the problems affecting. Training is an effective solution to ensuring that maintenance is done effectively. Every year, around one-third of the staff trained on matters of maintenance in the military is rotated. This means that there are new employees who are new on matters of equipment maintenance every year at Tripler Army Medical Center (TAMC). The department is aware of the current problems facing equipment maintenance which range from high complexity of machines to high risks. Therefore, it practices sustainment training and supplemental original equipment manufacturer training. This ensures that operator errors are avoided which have been a major problem in the army. Spot training is also practiced where trainers instruct a large number of people which helps in saving cost. Also, they have technicians who focus their expertise on one department at a time. Generalizing duties of the technicians may cause havoc, and in the process, bad maintenance practice which could affect the effectiveness of the army. The army also uses radio-identification system (RFID) which tracks medical equipment, and is a significant tool which has been used to aid in the maintenance procedure (2017).

Wu & Do also tackle on the aspect of maintenance modelling. The first tool discussed is reliability, availability, and maintainability (RAM) analysis which focuses on reliability indexes. Secondly, corrective maintenance which carries out fault recognition and puts an item in a state in which it will be able to perform the intended function. Thirdly, preventive maintenance aims at reducing probability of failure or degradation of the functioning capability of the equipment. Predictive maintenance which utilizes prognostic health management techniques for cost-effective maintenance. Fourthly, optimization of spare parts which makes sure that there are enough spare parts being produced so that maintenance is made possible. Lack of spare parts may slow down the process of maintenance especially where a certain part of the medical equipment has to be fully replaced. This could have negative implications on the effectiveness of the army on matters of combat. Fifthly, asset management is a process which deals with deploying, operating, maintaining, upgrading, and disposing assets in a cost-effective manner. These processes take into consideration the maintenance aspect of the equipment as well. Lastly, warranty analysis which makes sure that the buyer of the equipment maximizes on the services of the seller in case the equipment breaks down (2017).

Summary of Findings

The army medical department is currently tasked with the responsibility of maintaining the medical equipment they use. They receive funding from the government through various departments. Maintenance is not an easy task and it is affected by various factors as discussed in the second theme above. The factors include physical, human, and financial resources allocated to the department, and quality control to mention but a few. Proper planning, allocation of enough funds, and proper training are some of the ways to deal with the problems associated with maintenance of army medical equipment.

Links to Professional Practice

The research topic for this paper gives an insight on the field of army medicine especially about maintenance of the equipment. The knowledge learned here can help a professional in the area by informing them on the current state of the maintenance programs, factors which influence the maintenance process, and some of the solutions to these problems. The literature review helps in identifying the areas which have not been researched on by many individuals, and this can help one to tap into those areas. It also gives various solutions to the problems associated with maintenance. The lesson learnt is that it is impossible to eliminate the complications associated with equipment maintenance, but with the right solutions in mind, it is possible to prevent most of the risks associated with maintenance. The information would help me as a senior enlisted officer on matters of planning for the combat missions.

Links to Policy

The army is utilizing CSHs by deploying them in army hospitals during the various rotations. Its work is to ensure of the medical equipment, and it gets funding to do so. It also utilizes the current technological advancements to advice the army on what medical equipment they should invest in (Lewis et al., 2012). My recommendation as a senior enlisted leader is that the army medical team should embrace proper planning in terms of equipment maintenance so that they do not inconvenience the operations of the army.

Conclusion

The maintenance of the army medical equipment is an area which has been overlooked by many researchers. The field is concerned with the maintenance of the equipment used by the army on matters of medicine. It is an important area which determines the next steps of the combat operations. However, due to the developments made by technology, it has become easy to perform maintenance with a bit of ease and quickly (Dana & Mohammadimehr, 2017). Therefore, the future of maintenance of army medical equipment is bright.

References

Bahreini, R., Doshmangir, L., & Imani, A. (2018). Influential factors on medical equipment maintenance management. Journal of Quality in Maintenance Engineering. DOI 10.1108/JQME-11-2017-0082

Censer, M. & Dupont, D.G. (2008). Winners: FCS, JTRS, WJN-T, GSS: ARMY POM SLASHES ABRAMS, BRADLEY FUNDS TO PAY FOR HIGHER PRIORITIES. Inside the Army, 20(32): 1-8

Chengyuan, S. & Shaoluo, H. (2017). Analysis of influencing factors of civil-military integration equipment maintenance support mode based on ISM. Advances in Social Science, Education and Humanities Research, 72: 531-534