The water supply system in our hospital was disabled as its elevated water tank was badly damaged by the earthquake that hit northeast Japan on March11, 2011. Subsequently, the dysfunction of suction equipment of a water seal type threw the whole hospital into utter confusion, though temporarily. We realized that injection of some degree of water could recover the suction system on manual. To minimize the damage from a natural disaster and strengthen the hospital ability for all contingencies, we have decided to employ the oil rotary type rather than the water seal type in the system of suction equipment.

A questionnaire survey conducted on the matter concernmg the centralized management of medical electronic (ME) instruments found that 78% of physicians and nurses were in favor of the proposition. According to this result, our hospital began to manage ventilators and low pressure continuous suction instruments under central control at first, and then 13 types of 142 ME instruments. has also The centralization of ME instruments has made it possible to decrease the number of instruments. It has also enabled clinical engineers to find instrument trouble without delay and repair it in our hospital. It saved 62, 220, 000 yen for new instrument cost and 3, 016, 000 yen a year for repair. We concluded that centralized management of ME instruments was efficient, economical and advantageous in terms of safety.

The maintenance of life-supporting systems, such as respirators, has been the responsibillity of the central management unit since December 1991. The in-house unit was set up to ensure a high-quality level of maintenance and safety of medical equipment.
We analyzed the incidence of trouble with respirators between 1995 and 1999, based on the logs of the machines and check lists. Fifty-one percent of the incidence was found by medical engineers while they were making their rounds of inspection in the wards, thirty-four percent during periodical checkups at the central safety management unit, and fifteen percent upon request for examination. The faults in warmers and humidifiers attached to the respirators were found only at the wards or upon request for examination. The causes of trouble in the respirators were mechanical failures rather than human error. The mechanical factors was responsible for the incidence 2.9 times as much as human factors. The incidence of trouble associated with the warmers and humidifiers notably dropped after the types of instruments were unified in 1997. To ensure safety, we came to the conviction that the dual check system-the regular inspection at the central safety management unit and the engineers' rounds of inspection-is very effective. The selection of appropriate instruments was also important.