ELECTRICAL SAFETY transformer overloading, and temperature alarms.


n The line controller monitors the continuity of the floating IT network’s protective earth (P/E wire).


n The fault locator unit locates any insulation faults in the floating IT network.


It is also worth investing in usability, facilitating staff workflows, and speeding up operations, with a cloud service that enables remote operation, alarm transfer, and storage with statistics. A remote monitoring station might typically be located at the nurses’ counter or break room. Electronic devices should be used only in sockets intended for them, with the sockets clearly marked. Electric cabling should be arranged safely, and no unnecessary wires or other items be on the floor. At PPO-Elektroniikka we have noticed a current trend


An outlet with a broken PE wire.


factors are slowing the introduction of new advanced safety solutions: a diversity of attitudes, cultural factors, lack of compliance with safety norms, laxity in surveillance and control, the apathy of top management, and a reliance on unskilled and short-term workers. Insulation monitoring would help to transmit the alarms to permanent skilled staff who could react immediately to the problem.


n Small steps forward Healthcare technology is constantly evolving, and large- scale hospitals are often eager to adopt new technologies that enhance patient care and safety. The critical issues are efficiency, ease of implementation, and cost-effectiveness. The private sector in India has generally been quicker to adopt new technologies due to more significant financial resources and autonomy. They want to benefit from safety, reliability, and operational efficiency. In contrast, public sector hospitals often have budget constraints, and may require more time to allocate resources for new technologies.


India is a popular destination for medical tourism,


Timo Ohtonen


Timo Ohtonen is the managing director and owner of the Finnish health tech company, PPO-Elektroniikka Oy, having been one of the founders in 1981. He has developed five generations of the MEV Insulation Monitoring System with his team. He has ‘vast experience’ in professional electronics and electrical safety. PPO-Elektroniikka Oy is a member of the Association of Finnish Hospital Engineering.


with hospitals offering high-quality healthcare services at competitive prices. Healthcare tourists greatly value hospitals that follow European safety norms where insulation monitoring is mandatory. India is an excellent example of what kind of situation many other countries are currently in. Development is happening slowly.


Enhancing staff’s understanding Proper guidance and investment in training are beneficial for the usability and efficiency of the new technology equipment. The optimal results are achieved when staff have a proper understanding of, and familiarity with, the operation of the equipment. Regular training provides the necessary skills and knowledge, and ensures the safe use of electronic medical devices. The existing hazards should be discussed using real examples. A medical isolation transformer separates the operating


theatre’s electrical network from the national grid. There needs to be sufficient insulation monitoring with alarms within the network so that: n The insulation level monitoring device monitors the insulation of the floating IT network (leakage current), transformer load (current A), and temperature (°C).


n The system monitoring panel indicates any insulation level alarms, line controller alarms, test lead faults,


42 Health Estate Journal November 2024


for the entire medical IT system to be installed within the operating theatre itself. However, it would be wise to consider both the consequences of malfunctions and access to maintenance, and whether perhaps it would be make sense to keep some of the medical IT equipment elsewhere, so that a malfunction/maintenance doesn’t interrupt surgery when engineering staff have to attend the operating room to resolve any issues. A technical cabinet in the hallway could be a good solution to facilitate access for electrical maintenance and help to minimise downtime for maintenance, or repairs. In the event of a problem, the healthcare engineering or biomedical engineering team can then be informed immediately, and the faulty device quickly replaced, and sent off for repair.


Summary We are now at the point where global safety measures are being developed due to constantly increasing awareness and prioritisation of patient safety, with international legislation being implemented in different countries to meet the current requirements. Implementation and use of electrical equipment in healthcare facilities needs to be sufficiently well controlled, and sanctions for negligent practice determined. In addition to saving human lives, this will help minimise operating theatre outages, resulting in greater efficiency and cost reductions. Before these critical premises are used, the relevant bodies should, during their commissioning inspections, pay special attention to ensuring that all electrical installations are in accordance with laws, regulations, and standards, and that Group 2 medical facilities have undertaken power and equipotential measurements. In Finland, the commissioning inspection is always carried out before a new installation is implemented, or any additions or changes are made to an existing building. Maintenance is a topic that needs far more attention and detailed discussion. If this single issue is handled correctly, it will resolve many problems in healthcare applications. Electricity can be an invisible killer that may not even leave a trace, but with properly installed and maintained advanced safety equipment and adequate training, it is possible to counter these hazards. The cost is minimal in comparison to the benefit; the lifecycle of an insulation monitoring system can be over 30 years.


n The author would like to thank Ranjit D Deshmukh (India), Mohd Farez (Malaysia), and Gary Mcilvain (UK) for their country-specific reviews.


Acknowledgment n This article first appeared in the IFHE Digest 2024, titled


‘Raising safety standards in healthcare facilities’. HEJ thanks the article’s author, the IFHE, and the Digest’s editor, Matt Seex, for allowing its re-publication here.


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