برنامهریزی جایگزینی تجهیزات پزشکی با استفاده از رویکرد ترکیبی SWOT-ANP-WASPAS
الموضوعات :سهیلا مظلوم واجاری 1 , ایروان مسعودی اصل 2 , کامران حاجی نبی 3 , لیلا ریاحی 4
1 - دانشجوی دکتری مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
2 - دانشیار، گروه مدیریت خدمات بهداشتی و درمانی، دانشگاه علوم پزشکی ایران، تهران، ایران
3 - استادیار، گروه مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
4 - استادیار، گروه مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
الکلمات المفتاحية: SWOT, ANP, WASPAS, جایگزینی تجهیزات پزشکی, مدیریت تجهیزات پزشکی,
ملخص المقالة :
مقدمه : جایگزینی تجهیزات پزشکی به عنوان یکی از ارکان اساسی مدیریت تجهیزات پزشکی نقشی حساس و حیاتی در نظارت بر تجهیزات پزشکی در تشخیص، درمان و پایش بیماران دارد. در جایگزینی تجهیزات پزشکی به دنبال اتخاذ سیاستی هستیم که به جای استفاده از تجهیز برای مدت طولانی با هزینه تعمیر و نگهداری بالاتر، برنامهای مناسب برای جایگزینی تجهیز تعیین گردد. پژوهش حاضر با هدف ارائهی یک سیستم تصمیمگیری جهت تسهیل در فرآیند برنامهریزی جایگزینی تجهیزات پزشکی انجام شده است. روش پژوهش: این پژوهش در تلاش است تا برای نخستین بار با ارائه رویکرد ترکیبی SWOT-ANP-WASPAS یک سیستم تصمیمگیری جهت برنامهریزی جایگزینی تجهیزات پزشکی فراهم آورد. در چارچوب پیشنهادی پژوهش، از ماتریس SWOT به منظور شناسایی معیارها، زیرمعیارها و گزینههای استراتژیک استفاده شده است. در ادامه تکنیک ANP جهت وزندهی به معیارها و زیرمعیارها بکار رفته است. همچنین گزینههای استراتژیک با استفاده از روش WASPAS وزندهی شدهاند.. یافتهها : سیستم تصمیمگیری پیشنهادی در نظر دارد تا با افزایش اعتمادبهنفس تصمیمگیرندگان و ارائه شواهد حمایتی کافی، استراتژیهایی جهت جایگزینی تجهیزات پزشکی تدوین نماید. این سیستم تصمیمگیرنده را قادر میسازد تا ارتباطات پیچیده در مشکل تصمیمگیری را بهتر درک کند؛ که این امر سبب افزایش اعتبار تصمیمات مربوطه میگردد. نتیجهگیری: رویکرد ترکیبی پیشنهادی قابلیت مجتمع شدن به عنوان یک سیستم جامع تصمیمگیری جهت جایگزینی تجهیزات پزشکی در مراکز درمانی موردمطالعه را داراست و اگر پیادهسازی استراتژیهای تدوین شده و رعایت توالی اجرای آنها، مورد حمایت مدیران مربوطه قرار بگیرد؛ شاهد کاهش هزینههای جایگزینی و نیز توسعه فناوری تجهیزات پزشکی خواهیم بود.
1- Gaetano L, Puppato D, Balestra G. Modeling Clinical Engineering Activities to Support Healthcare Technology Management. Chapter 5 in Management Engineering for Effective Healthcare Delivery: Principles and Applications, IGI Global, USA, 2012: 113-131.
2- Wang B, Furst E, Cohen T, Keil O R, Ridgway M, Stiefel R. Medical Equipment Management Strategies. Biomedical Instrumentation & Technology, 2006; 40: 233-237.
3- Dyro J. Clinical Engineering Handbook, Elsevier Press: USA, 2004. eBook ISBN: 9780080476575
4- Saleh N. Comprehensive Frameworks for Decision Making Support in Medical Equipment Management. PHD Thesis Cairo University Giza: Egypt, 2014.
5- MHRA, Department of Health, Managing Medical Devices. Medicines and Healthcare products Regulatory Agency Report, V1.1, United Kingdom, Apr. 2015.
6- Oliveir, A J A. Medical Equipment Replacement: Economic Analysis under Deterministic and Uncertain Environments. MS dissertation in Biomedical Engineering, IST, university Tecnica de Lisboa: Lisbon, 2012.
7- WHO (Word Health Organization). Introduction to medical equipment inventory management (Report), 2011. Available at: [http://apps.who.int/medicinedocs/documents/s21565en/s21565en.pdf]
8- Miniati R, Cecconi G, Frosini F, Dori, F, Regolini J, Iadanza E, Biffi Gentili G. Hospital-based expert model for health technology procurement planning in hospitals. Annual International Conference of the IEEE Engineering in Medicine and Biology Society: USA, 2014.
9- Shah S G, Robinsion I. Benefits and barriers to involving users in medical device technology development and evaluation. International journal of Technology Assessment in Healthcare, 2007; 23: 131-137.
10- Porter D. Management of Medical Devices: Areas Requiring Further Strengthening. Proceedings of First WHO Global Forum on Medical Devices, Bangkok, Thailand, Sep. 2010.
11- Cheng M, Dyro J F. Good Management Practice for Medical Equipment. In: Dyro J, editor. Clinical Engineering Handbook, Elsevier: San Diego, 2004: 108-110.
12- Taghipour S. Reliability and Maintenance of Medical Devices. PH.D Thesis, University of Toronto, Toronto, Canada, 2011.
13- Rajasekaran D. Development of an automated medical equipment replacement planning system in hospitals. IEEE 31st Annual Northeast Bioengineering Conference: New Jersey, 2005: 52-53.
14- Ouda B K, Saleh N S K, & Mohamed A S A. The Effect of Useful Life and Vendor Performance on Replacement Decision of Medical Equipment. Cairo International Biomedical Engineering Conference (CIBEC): Cairo, Egypt, December 20-22, 2012.
15- Hartman J C, Tan C H. Equipment Replacement Analysis: A literature Review and Directions for Future Research. The Engineering Economist, 2014; 59: 136-153.
16- Fan W, Machemehl R, Gemar M, Brown L. A Stochastic Dynamic Programming Approach for the Equipment Replacement Optimization under Uncertainty. Journal of Transportation Systems Engineering and Information Technology, 2014; 14: 76-84.
17- Kalavathy S. Operations Research, 4th Edition Kindle Edition. Vikas: New Delhi, 2016. ISBN-13: 978-9325963474.
18- Kelso S. Developing a System to Support Equipment Repair Versus Replacement Decision Making. Proceedings of 41st Conference of the Canadian Medical and Biological Engineering. ACCES23 Charlottetown, Prince Edward Island. 41, 2018.
19- Clark T. A Practicum for Biomedical Engineering and Technology Management Issues by ATLES LESLIE R (Author). Chapter 13 Medical Equipment Replacement: Planning, Factors, Methods and Outcomes, 2008.
20- Taylor K, Jackson S. A Medical Equipment Replacement Score System. Journal of Clinical Engineering, 2005; 30: 37-41.
21- Mkalaf K A. A study of current maintenance strategies and the reliability of critical medical equipment in hospitals in relation to patient outcomes. Doctor of Philosophy thesis, Faculty of Engineering and Information Sciences, University of Wollongong: Australia, 2015.
22- Bryson J M. Strategic Planning for Public and Nonprofit Organizations: A Guide to Strengthening and Sustaining Organizational Achievement (Rev. Ed.). Jossey-Bass: San Francisco, 1995.
23- Wheelen T L, Hunger J D. Strategic management and business policy: achieving sustainability. Upper Saddle River, Prentice-Hall: New Jersey, 2010.
24- David F R, David, F R. Strategic Management: A Competitive Advantage Approach, Concepts (16th Edition), Pearson Education: UK, 2016.
25- Bisbe J, Malagueno R. Using strategic performance measurement systems for strategy formulation: Does it work in dynamic environments? Management Accounting Research, 2012; 23: 296-311.
26- Houben G, Lenie K, Vanhoof K. A knowledge-based SWOT-analysis system as an instrument for strategic planning in small and medium sized enterprises. Decision Support Systems, 1999; 26: 125-135.
27- Yuan H. A SWOT analysis of successful construction waste management. Journal of Cleaner Production, 2013; 39: 1-8.
28- Yuksel I, Dagdeviren M. Using the analytic network process (ANP) in a SWOT analysis-A case study for a textile firm. Information Sciences, 2007; 177: 3364-3382.
29- Shafieyan M, Homayounfar M, Fadaei M. Identification of Strategies for Sustainable Development of Rice Production in Guilan Province Using SWOT Analysis. International Journal of Agricultural Management and Development, 2017; 7: 141-153.
30- Lin Y H, Chiu C C, Tsai, C H. The study of applying ANP model to assess dispatching rules for wafer fabrication. Expert Systems with Applications, 2008; 34: 2148-2163.
31- Lee Y H. Application of a SWOT-FANP method. Technological and Economic Development of Economy, 2013; 19: 570-592.
32- Saaty T L. Decision Making with Dependence and Feedback: The Analytic Network Process. RWS Publications: Pittsburgh, 1996.
33- Chung S H, Lee A H L, Pearn W L. Analytic network process (ANP) approach for product mix planning in semiconductor fabricator. International Journal of Production Economics, 2005; 96: 15-36.
34- Meade L M, Sarkis J. Analyzing organizational project alternatives for agile manufacturing processes: an analytical network approach. International Journal of Production Research, 1999; 37: 241-261.
25- Zavadskas E K, Kalibatas D, Kalibatiene D. A multi-attribute assessment using WASPAS for choosing an optimal indoor environment. Archives of Civil and Mechanical Engineering, 2016; 16: 76-85.
26- Zavadskas E K, Antucheviciene J, Razavi Hajiagha, S H, Hashemi S S. Extension of weighted aggregated sum product assessment with interval-valued intuitionistic fuzzy numbers (WASPAS-IVIF). Applied Soft Computing, 2014; 24: 1013-1021.
27- Zavadskas E K, Turskis Z, Antucheviciene J, Zakarevicius A. Optimization of weighted aggregated sum product assessment. Electronics and Electrical Engineering, 2012; 122: 3-6.
28- Mardani A, Zavadskas E K, Govindan K, Amat Senin A, Jusoh A. VIKOR Technique: A Systematic Review of the State of the Art Literature on Methodologies and Applications. Sustainability, 2016; 8: 37.
29- Apostolakis I, Tsantis S. Medical Imaging equipment assessment at Public Health Sector of Greece. Risk-based maintenance: A Decision Support Model. International Journal of Caring Sciences, 2014; 7: 24-31.
30- Chien C, Haung Y, Chong F. A Framework of Medical Equipment Management System for In-House Clinical Engineering. Proceedings of 32nd Annual International Conference of the IEEE EMBS, Buenos Aires, Argentine, Aug.31-Sep.4, 2010: 6054-6057.
31- Bahadori M, Sadeghifar J, Ravangard R, Salimi M, Mehrabian F. Priority of Determinants Influencing the Behavior of Purchasing the Capital Medical Equipments Using AHP Model. World Journal of medical Science, 2012; 7: 131-136.
32- Khalaf A, Djouani K, Hamam Y, Alayli Y. Maintenance Strategies and Failure‐Cost Model for Medical Equipment. Quality and Reliability Engineering International, 2014; 31: 935-947.
33- Horenbeek AV, Pintelon L. Development of a maintenance performance measurement framework using the analytic network process (ANP) for maintenance performance indicator selection. Omega, 2014; 42: 33-46.
34- Faisall M, Sharawi A. Prioritize Medical Equipment Replacement Using Analytical Hierarchy Process. IOSR Journal of Electrical and Electronics Engineering, 2015; 10: 55-63.
35- Jamshidi A, Abbasgholizadeh S, AitKadi D, Ruiz A. A Comprehensive Fuzzy risked – based Framework for Replacement of Medical Devices. 11 Congres International De Genie Industriel – CIGI2015 Quebec, Canada. 2015: 26-28.
36- Dehayem Nodem F I, Kenne J P, Gharbi A. Preventive Maintenance and Replacement Policies for Deteriorating Manufacturing Systems. International Journal of Production Research, 2011; 49: 3543-3563.
37- Than T M, et al. Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?. BMC Health Services Research, 2017; 17: 669.
38- Quezada L, López-Ospina H A, Palominos P I, Oddershede A M. Identifying causal relationships in strategy maps using ANP and DEMATEL. Computers & Industrial Engineering, 2018; 118: 170-179.
39- Hafezalkotob A, Hafezalkotob A, Liao H, Herrera F. An overview of MULTIMOORA for multi-criteria decision-making: Theory, developments, applications, and challenges. Information Fusion, 2019; 51: 145-177.
40- Zheng Y, Xu Z, He Y, Liao H. Severity assessment of chronic obstructive pulmonary disease based on hesitant fuzzy linguistic COPRAS method. Applied Soft Computing, 2018; 69: 60-71.
41- Zarbakhshnia N, Soleimani H, Ghaderi H. Sustainable third-party reverse logistics provider evaluation and selection using fuzzy SWARA and developed fuzzy COPRAS in the presence of risk criteria. Applied Soft Computing, 2018; 65: 307-319.
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1- Gaetano L, Puppato D, Balestra G. Modeling Clinical Engineering Activities to Support Healthcare Technology Management. Chapter 5 in Management Engineering for Effective Healthcare Delivery: Principles and Applications, IGI Global, USA, 2012: 113-131.
2- Wang B, Furst E, Cohen T, Keil O R, Ridgway M, Stiefel R. Medical Equipment Management Strategies. Biomedical Instrumentation & Technology, 2006; 40: 233-237.
3- Dyro J. Clinical Engineering Handbook, Elsevier Press: USA, 2004. eBook ISBN: 9780080476575
4- Saleh N. Comprehensive Frameworks for Decision Making Support in Medical Equipment Management. PHD Thesis Cairo University Giza: Egypt, 2014.
5- MHRA, Department of Health, Managing Medical Devices. Medicines and Healthcare products Regulatory Agency Report, V1.1, United Kingdom, Apr. 2015.
6- Oliveir, A J A. Medical Equipment Replacement: Economic Analysis under Deterministic and Uncertain Environments. MS dissertation in Biomedical Engineering, IST, university Tecnica de Lisboa: Lisbon, 2012.
7- WHO (Word Health Organization). Introduction to medical equipment inventory management (Report), 2011. Available at: [http://apps.who.int/medicinedocs/documents/s21565en/s21565en.pdf]
8- Miniati R, Cecconi G, Frosini F, Dori, F, Regolini J, Iadanza E, Biffi Gentili G. Hospital-based expert model for health technology procurement planning in hospitals. Annual International Conference of the IEEE Engineering in Medicine and Biology Society: USA, 2014.
9- Shah S G, Robinsion I. Benefits and barriers to involving users in medical device technology development and evaluation. International journal of Technology Assessment in Healthcare, 2007; 23: 131-137.
10- Porter D. Management of Medical Devices: Areas Requiring Further Strengthening. Proceedings of First WHO Global Forum on Medical Devices, Bangkok, Thailand, Sep. 2010.
11- Cheng M, Dyro J F. Good Management Practice for Medical Equipment. In: Dyro J, editor. Clinical Engineering Handbook, Elsevier: San Diego, 2004: 108-110.
12- Taghipour S. Reliability and Maintenance of Medical Devices. PH.D Thesis, University of Toronto, Toronto, Canada, 2011.
13- Rajasekaran D. Development of an automated medical equipment replacement planning system in hospitals. IEEE 31st Annual Northeast Bioengineering Conference: New Jersey, 2005: 52-53.
14- Ouda B K, Saleh N S K, & Mohamed A S A. The Effect of Useful Life and Vendor Performance on Replacement Decision of Medical Equipment. Cairo International Biomedical Engineering Conference (CIBEC): Cairo, Egypt, December 20-22, 2012.
15- Hartman J C, Tan C H. Equipment Replacement Analysis: A literature Review and Directions for Future Research. The Engineering Economist, 2014; 59: 136-153.
16- Fan W, Machemehl R, Gemar M, Brown L. A Stochastic Dynamic Programming Approach for the Equipment Replacement Optimization under Uncertainty. Journal of Transportation Systems Engineering and Information Technology, 2014; 14: 76-84.
17- Kalavathy S. Operations Research, 4th Edition Kindle Edition. Vikas: New Delhi, 2016. ISBN-13: 978-9325963474.
18- Kelso S. Developing a System to Support Equipment Repair Versus Replacement Decision Making. Proceedings of 41st Conference of the Canadian Medical and Biological Engineering. ACCES23 Charlottetown, Prince Edward Island. 41, 2018.
19- Clark T. A Practicum for Biomedical Engineering and Technology Management Issues by ATLES LESLIE R (Author). Chapter 13 Medical Equipment Replacement: Planning, Factors, Methods and Outcomes, 2008.
20- Taylor K, Jackson S. A Medical Equipment Replacement Score System. Journal of Clinical Engineering, 2005; 30: 37-41.
21- Mkalaf K A. A study of current maintenance strategies and the reliability of critical medical equipment in hospitals in relation to patient outcomes. Doctor of Philosophy thesis, Faculty of Engineering and Information Sciences, University of Wollongong: Australia, 2015.
22- Bryson J M. Strategic Planning for Public and Nonprofit Organizations: A Guide to Strengthening and Sustaining Organizational Achievement (Rev. Ed.). Jossey-Bass: San Francisco, 1995.
23- Wheelen T L, Hunger J D. Strategic management and business policy: achieving sustainability. Upper Saddle River, Prentice-Hall: New Jersey, 2010.
24- David F R, David, F R. Strategic Management: A Competitive Advantage Approach, Concepts (16th Edition), Pearson Education: UK, 2016.
25- Bisbe J, Malagueno R. Using strategic performance measurement systems for strategy formulation: Does it work in dynamic environments? Management Accounting Research, 2012; 23: 296-311.
26- Houben G, Lenie K, Vanhoof K. A knowledge-based SWOT-analysis system as an instrument for strategic planning in small and medium sized enterprises. Decision Support Systems, 1999; 26: 125-135.
27- Yuan H. A SWOT analysis of successful construction waste management. Journal of Cleaner Production, 2013; 39: 1-8.
28- Yuksel I, Dagdeviren M. Using the analytic network process (ANP) in a SWOT analysis-A case study for a textile firm. Information Sciences, 2007; 177: 3364-3382.
29- Shafieyan M, Homayounfar M, Fadaei M. Identification of Strategies for Sustainable Development of Rice Production in Guilan Province Using SWOT Analysis. International Journal of Agricultural Management and Development, 2017; 7: 141-153.
30- Lin Y H, Chiu C C, Tsai, C H. The study of applying ANP model to assess dispatching rules for wafer fabrication. Expert Systems with Applications, 2008; 34: 2148-2163.
31- Lee Y H. Application of a SWOT-FANP method. Technological and Economic Development of Economy, 2013; 19: 570-592.
32- Saaty T L. Decision Making with Dependence and Feedback: The Analytic Network Process. RWS Publications: Pittsburgh, 1996.
33- Chung S H, Lee A H L, Pearn W L. Analytic network process (ANP) approach for product mix planning in semiconductor fabricator. International Journal of Production Economics, 2005; 96: 15-36.
34- Meade L M, Sarkis J. Analyzing organizational project alternatives for agile manufacturing processes: an analytical network approach. International Journal of Production Research, 1999; 37: 241-261.
25- Zavadskas E K, Kalibatas D, Kalibatiene D. A multi-attribute assessment using WASPAS for choosing an optimal indoor environment. Archives of Civil and Mechanical Engineering, 2016; 16: 76-85.
26- Zavadskas E K, Antucheviciene J, Razavi Hajiagha, S H, Hashemi S S. Extension of weighted aggregated sum product assessment with interval-valued intuitionistic fuzzy numbers (WASPAS-IVIF). Applied Soft Computing, 2014; 24: 1013-1021.
27- Zavadskas E K, Turskis Z, Antucheviciene J, Zakarevicius A. Optimization of weighted aggregated sum product assessment. Electronics and Electrical Engineering, 2012; 122: 3-6.
28- Mardani A, Zavadskas E K, Govindan K, Amat Senin A, Jusoh A. VIKOR Technique: A Systematic Review of the State of the Art Literature on Methodologies and Applications. Sustainability, 2016; 8: 37.
29- Apostolakis I, Tsantis S. Medical Imaging equipment assessment at Public Health Sector of Greece. Risk-based maintenance: A Decision Support Model. International Journal of Caring Sciences, 2014; 7: 24-31.
30- Chien C, Haung Y, Chong F. A Framework of Medical Equipment Management System for In-House Clinical Engineering. Proceedings of 32nd Annual International Conference of the IEEE EMBS, Buenos Aires, Argentine, Aug.31-Sep.4, 2010: 6054-6057.
31- Bahadori M, Sadeghifar J, Ravangard R, Salimi M, Mehrabian F. Priority of Determinants Influencing the Behavior of Purchasing the Capital Medical Equipments Using AHP Model. World Journal of medical Science, 2012; 7: 131-136.
32- Khalaf A, Djouani K, Hamam Y, Alayli Y. Maintenance Strategies and Failure‐Cost Model for Medical Equipment. Quality and Reliability Engineering International, 2014; 31: 935-947.
33- Horenbeek AV, Pintelon L. Development of a maintenance performance measurement framework using the analytic network process (ANP) for maintenance performance indicator selection. Omega, 2014; 42: 33-46.
34- Faisall M, Sharawi A. Prioritize Medical Equipment Replacement Using Analytical Hierarchy Process. IOSR Journal of Electrical and Electronics Engineering, 2015; 10: 55-63.
35- Jamshidi A, Abbasgholizadeh S, AitKadi D, Ruiz A. A Comprehensive Fuzzy risked – based Framework for Replacement of Medical Devices. 11 Congres International De Genie Industriel – CIGI2015 Quebec, Canada. 2015: 26-28.
36- Dehayem Nodem F I, Kenne J P, Gharbi A. Preventive Maintenance and Replacement Policies for Deteriorating Manufacturing Systems. International Journal of Production Research, 2011; 49: 3543-3563.
37- Than T M, et al. Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?. BMC Health Services Research, 2017; 17: 669.
38- Quezada L, López-Ospina H A, Palominos P I, Oddershede A M. Identifying causal relationships in strategy maps using ANP and DEMATEL. Computers & Industrial Engineering, 2018; 118: 170-179.
39- Hafezalkotob A, Hafezalkotob A, Liao H, Herrera F. An overview of MULTIMOORA for multi-criteria decision-making: Theory, developments, applications, and challenges. Information Fusion, 2019; 51: 145-177.
40- Zheng Y, Xu Z, He Y, Liao H. Severity assessment of chronic obstructive pulmonary disease based on hesitant fuzzy linguistic COPRAS method. Applied Soft Computing, 2018; 69: 60-71.
41- Zarbakhshnia N, Soleimani H, Ghaderi H. Sustainable third-party reverse logistics provider evaluation and selection using fuzzy SWARA and developed fuzzy COPRAS in the presence of risk criteria. Applied Soft Computing, 2018; 65: 307-319.