Imaging Equipment Audit

• Salesforce Opportunity.

• Audit Title

• Hospital Trust

• Conducted on

  Date

• Prepared by

• Audit Team Names

• Trust Image

  Media

• Opportunity Title

• Opportunity Type

  Select Managed Maintenance Muanaged Equipment Service Multi-Vendor Service Bio-Med Med Physics

  • Managed Maintenance
  • Muanaged Equipment Service
  • Multi-Vendor Service
  • Bio-Med
  • Med Physics

• Opportunity Plan - Key Dates for this Opportunity

• Audit Plan - Include dates, locations, departments etc

• Tender Team Members (including their roles)

• Trust Information - Values, Mission etc

• Key Audit Questions

• Hospital

Hospital Location
• Hospital Name and Address
  Address

• Hospital Image

  Media

• Date of Site Audit

  Date

• Department

Department Number

• Department Name i.e. Radiology, A&E, Theatres

• Location Information - Wing/Building/Floor

• Clinical Lead Name

• Clinical Lead Contact Phone Number

• Clinical Lead email address

• Department Access i.e. Opening Hours, Security etc

• Additional Notes on Department

• Room

Room Number

• Room Name Or Number

• Room Image

  Media

• Equipment

Equipment Number

• Equipment Image

  Media

• Modality

  Select X-Ray - Fixed Analogue X-Ray - Fixed CR X-Ray - Fixed DR X-Ray - Mobile Mammo Dental Interventional X-Ray Fluoroscopy Surgery Computed Tomography Magnetic Resonance Nuclear Medicine Healthcare Infomatics - CR Reader Healthcare Infomatics -

  • X-Ray - Fixed Analogue
  • X-Ray - Fixed CR
  • X-Ray - Fixed DR
  • X-Ray - Mobile
  • Mammo
  • Dental
  • Interventional X-Ray
  • Fluoroscopy
  • Surgery
  • Computed Tomography
  • Magnetic Resonance
  • Nuclear Medicine
  • Healthcare Infomatics - CR Reader
  • Healthcare Infomatics -

• Manufacturer

• Model

• System Serial Number

• Serial Number Plate Image

  Media

• Local Identifier

• Current Service Provider

  OEM - Contract

  ISO - Contract

  T&M

  Biomed

• Current Service Provider - Company Name

• Current Service Provider Reference

Technical Information

• Year Of Manufacture (If known)

• DXR/iXR/Surgery Flatplate Detectors

  N/A

  Single - Fixed

  Dual - Fixed

  Portable

• DXR/iXR/CT - Tube Manufacture / Replacement Date (If known)

  Date

• DXR/iXR/CT - Tube Origin - Is the Tube OEM or non OEM?

  OEM - New

  OEM - Remanufactured

  OEM - Used

  Non - OEM

• US Only - Condition Of Probes - What is the condition of Probes including Specialist Probes?

  Good

  Minor Wear and Tear Visible To Cables

  Damage Visible - Still In Use

  Some Coils Faulty

• MR Only - Coil Condition - What is the condition of MR coils - Are they all functioning?

  Good

  Minor Wear and Tear Visible To Cables

  Damage Visible - Still In Use

  Some Coils Faulty

• All Modalities - Cosmetic Condition - What is the cosmwetic quality of the Equipment including Missing, Broken, Cracked Covers, Infection Control Risk?

  Excellent Condition Considering Age

  Minor Wear And Tear Visible

  Some Damage Visible - Potential Infection Risk

  Infection Risk - Immediate Replacement of Parts Required

• All - System Operation - Does System Perform All Clinical Functions According To Specification? (Refer to Clinical Staff)

  System Performs All Functions Within Specification

  Some Features No Longer Work But Accepted Clinically

  Major Features Not Working Clinically

• All Modalities - Service History - Is the Service History Available?

  Yes

  No

  N/A