Failures, service, cost

Cynthia would like to implement a new service that would manage the medications taken by the HMO s heart failure patients. The questions that the HMO is asking include How much will the service cost and Will the interventions conducted by the pharmacist reduce hospitalizations and emergency department visits Cynthia has additional questions Will the interventions I conduct increase my patients health-related... 

Breakdown maintenance is suitable for equipment whose failure does not threaten production, safety or the environment, and where the cost of preventing failure would be greater than the consequence of failure. In this case, the equipment would be repaired either on location or in a workshop. Even with this policy, it is assumed that the recommended lubrication and minor servicing is performed, just as with a motor car. 

Preventive maintenance includes inspection, servicing and adjustment with the objective of preventing breakdown of equipment. This is appropriate for highly critical equipment where the cost of failure is high, or where failure implies a significant negative impact on safety or the environment. This form of maintenance can be scheduled on a calendar basis (e.g. every six months) or on a service hour basis (e.g. every 5,000 running hours). 

Risk-Based Inspection. Inspection programs developed using risk analysis methods are becoming increasingly popular (15,16) (see Hazard ANALYSIS AND RISK ASSESSMENT). In this approach, the frequency and type of in-service inspection (IS I) is determined by the probabiUstic risk assessment (PRA) of the inspection results. Here, the results might be a false acceptance of a part that will fail as well as the false rejection of a part that will not fail. Whether a plant or a consumer product, false acceptance of a defective part could lead to catastrophic failure and considerable cost. Also, the false rejection of parts may lead to unjustified, and sometimes exorbitant, costs of operation (2). Risk is defined as follows ... 

Customer complaints Warranty claims Failure analysis reports Process capability studies Service reports Concessions Change requests Subcontractor assessments Performance analysis Deviations and waivers Contract change records Quality cost data External Quality Audit records... 

The service life of a rupture disk is difficult to predict, since corrosion, cycling pressures, temperature and other process conditions can all affect the useful life and cause premature failure. A graphite-type disk is shown in Figure 7-9. In some processes it is safer to replace disks on a schedule after the life factor has been established, as a planned shut-down is certainly less costly than an emergency one. 

The golden rule, therefore, is to deal only with consultants, contractors, plant suppliers and water-conditioning experts whose experience and standing are known to be good. If there is any doubt, references should be sought and followed up. Water and effluent installations are a relatively minor cost item in any plant, but their failure can be disastrous. It is foolish to make false economies on so essential a service. 

The ideal method would be that all plant or equipment units have a duplicate or redundant standby that on failure would automatically be brought into service. This is satisfactory when considering small, less expensive units, which are installed to ensure that the services they are providing are not disrupted (this could also include auxiliary items on major plant and equipment). However, due to the capital costs of the major unit itself, it would be... 

A failure to install a necessary softener is ultimately reflected in higher bills for maintenance, repairs, and water treatment chemical products and services. Scaling can still occur with soft, lean waters, and the cost of additional fuel over a year probably would pay for several water softeners. In addition, the control of internal water chemistry becomes more difficult than it might otherwise be, which places an additional operational burden upon the facility. 

The major disadvantage of large plants is their vulnerability to large losses. In 1967 an explosion and tire in a Cities Service oil refinery at Lake Charles killed 7 employees and injured 14.6 The damage and business interruption costs exceeded 30,000,000. Usually the losses are not this large. However, in 1966 there were 20 fires in the chemical and petroleum industry, which caused damages in excess of 250,000.7 Even if there is no fire, the failure of a bearing on an ammonia compressor can cause the plant to shut down for a number of days two days for cool down, one day for repairs, two days for startup. The loss in sales from this interruption alone could exceed 50,000 per day, or a total of 250,000. ... 

Recently, a method for predicting the remanent life of a reinforcing geotextile was proposed [1] in which the strain to failure of a sacrificial sample was divided by the current creep rate. This requires verification. However, very few methods have so far been proposed or used for monitoring plastics in service and at the same time providing a numerical prediction of their remaining life. The reason for this is not just that the methods are likely to be expensive and complicated, but that there are few applications of plastics which can compete in risk and replacement cost with a high temperature boiler or aircraft structure. 

Pacific Environmental Service, Inc., 231 Paint, ozone damage to, 12, 691 economic cost of, 655-58 from failure of paint film, 652-55 PAN. See Peroxyacetylnitrate Paper chromatography, 68, 69 Paraffins, 58,59... 

Conservative estimates of direct and indirect costs of major depression in the United States resulting from the associated morbidity and mortality exceed 30 billion. Most of this cost is due to indirect expenses to society, such as decreased productivity and increased need for social services because of disability. In addition, there is the cost to family caregivers, the failure to advance in one s career or education, lost leisure time, and the pain and suffering endured by depressed patients and their families (54, 55). The societal cost of depressive disorders is estimated to be approximately 45 billion annually ( 56). 

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