From Design To Disposal: A Systematic Review Of Sustainability Practices In Medical Equipment Lifecycle Management

Abstract

Modern healthcare critically depends on complex medical equipment, whose failure poses a direct and significant threat to patient safety, making a shift from traditional, reactive maintenance paradigms imperative. This systematic review synthesizes literature to critically evaluate risk management strategies in hospital-based operation and maintenance, comparing traditional methods (Corrective and scheduled Preventive Maintenance) against proactive, system-based approaches like Failure Mode and Effects Analysis (FMEA) and Reliability-Centered Maintenance (RCM). The findings demonstrate that while traditional maintenance is a necessary foundation, it is insufficient on its own to manage modern technology risk. Proactive methodologies—FMEA for component-level risk prioritization and RCM for the strategic design of function-oriented maintenance programs—provide a demonstrably more robust framework for prospectively identifying and mitigating equipment-related risks before they cause patient harm. Importantly, the ultimate success of any technical strategy is profoundly moderated by non-technical, organizational factors, including a strong, non-punitive safety culture, visible leadership support, and the strategic allocation of resources. Therefore, the most effective approach is an integrated one, which synergistically combines the predictive power of analytical tools like FMEA and RCM with robust operational practices, all underpinned by a committed organizational safety culture, reframing equipment management as a strategic imperative central to ensuring patient safety and quality of care.Modern healthcare critically depends on complex medical equipment, whose failure poses a direct and significant threat to patient safety, making a shift from traditional, reactive maintenance paradigms imperative. This systematic review synthesizes literature to critically evaluate risk management strategies in hospital-based operation and maintenance, comparing traditional methods (Corrective and scheduled Preventive Maintenance) against proactive, system-based approaches like Failure Mode and Effects Analysis (FMEA) and Reliability-Centered Maintenance (RCM). The findings demonstrate that while traditional maintenance is a necessary foundation, it is insufficient on its own to manage modern technology risk. Proactive methodologies—FMEA for component-level risk prioritization and RCM for the strategic design of function-oriented maintenance programs—provide a demonstrably more robust framework for prospectively identifying and mitigating equipment-related risks before they cause patient harm. Importantly, the ultimate success of any technical strategy is profoundly moderated by non-technical, organizational factors, including a strong, non-punitive safety culture, visible leadership support, and the strategic allocation of resources. Therefore, the most effective approach is an integrated one, which synergistically combines the predictive power of analytical tools like FMEA and RCM with robust operational practices, all underpinned by a committed organizational safety culture, reframing equipment management as a strategic imperative central to ensuring patient safety and quality of care.