根本原因分析法在Elekta Precise直线加速器维修管理中的应用

Application of root cause analysis in maintenance management of Elekta Precise linear accelerator

目的:探讨Elekta Precise直线加速器管理中引入根本原因分析(RCA)法的应用效果,提高开机率。方法:采用RCA法分析2012年6月至2019年9月医院临床在用的Elekta Precise直线加速器故障原因、处理方法和维修保养计划等,统计分析直线加速器故障频次、不同系统故障发生比率、故障与季节及使用年限的相关性,绘制故障因素鱼骨图及时修订维修保养计划,优化设备管理策略。结果:直线加速器故障频次共计174次,其中多叶准直器(MLC)故障占比最高(占55.75%),床运动、充气系统、水冷系统、磁控管、闸流管、机械运动、低剂量率、剂量监测和控制系统故障率分别占6.32%、5.17%、4.60%、3.45%、4.60%、3.45%、10.34%、2.87%和3.45%。夏季发生故障率较高;2012-2014年故障次数较多且维修时间较长。修订维修保养计划后故障率逐年下降;直线加速器开机率逐年上升,由2012年开机率的90%提升至2018年和2019年的99%。结论:Elekta Precise直线加速器维修管理中运用RCA法分析数据,及时制定和修改维修保养管理计划、优化设备管理策略,可提高直线加速器的开机率,降低故障发生率。

Objective:To discuss the application effect of the introduction of root cause analysis(RCA)method in the management of Elekta Precise linear accelerator to improve the operating rate.Methods:RCA method was used to analyze the failure causes,treatment methods and maintenance plans of Elekta Precise linear accelerator used in clinical practice from June 2012 to September 2019.Failure frequency of linear accelerators,fault occurrence rates of different systems and relativity between fault and season and service life were shown with pie charts and histograms,and fishbone chart on failure factors was drawn to revise maintenance plan in time and optimize equipment management strategy.Results:A total of 174 failures occurred in the linear accelerator,failures of multi-leaf collimator(MLC)has the highest proportion of failures(accounting for 55.75%),bed movement,inflation system,water cooling system,magnetron,thyratron,mechanical movement,low dose rate,dose monitoring and control system failure rate accounted for 6.32%,5.17%,4.60%,3.45%,4.60%,3.45%,10.34%,2.87%and 3.45%;the failure rate was higher in summer;the number of failures was large and the maintenance time was long during 2012-2014.The failure rate was decreasing year by year after revision of maintenance plan;and the linear accelerator operating rate was increasing from 90%in 2012 to 99%in 2018 and 2019.Conclusion:The application of the RCA method in the maintenance and repair management of Elekta Precise linear accelerators,the timely development and amendment of maintenance and repair management plans,and the optimization of equipment management strategies could increase the operating rate and reduce the failure rate of linear accelerators.