In the field of medical equipment maintenance management, there is no single and standard checklist that includes all hospitals in the country. The only available checklists include accreditation measures that generally assess the tasks and activities of the medical engineering unit. Since the issue of maintenance management includes a wide variety of topics, and in the low- and middle-income countries, there is major weakness in this regard, so we decided to design a checklist for uniformity and accurate and comprehensive assessment using Iranian context. The Departments of Medical Equipment of some provinces in Iran have designed a checklist natively for its affiliated hospitals, the dimension and method of which are different. For example, the maintenance management evaluation checklist of Tabriz Medical Equipment Office includes 15 indicators (technical force, medical engineering unit, medical equipment ID, quality control tests, PM, training, medical equipment and spare parts storage, service and maintenance contract, the existence of purchase process, the existence of decommissioning process, the existence of recall system and reporting of adverse events, ensuring sound electricity, implementing a continuous maintenance improvement process, familiarizing with the general administration’s rules and website, management and allocating a separate budget for maintenance).
According to the medical equipment maintenance management criteria of the MOHME, some of these dimensions can be merged into one dimension and some can be separated. In addition, each of the indicators and sub-indicators can be expanded. That is, not all maintenance management issues are addressed. The scoring and classification of dimensions in this checklist does not have a specific standard and does not include all dimensions of maintenance according to the maintenance criteria of the MOHME and is generally designed.
Herrera-Galán  evaluated the performance of the maintenance function through management audits and their implementation in five hospitals. The aspects evaluated include equipment availability, response to a service request, monitoring and control of biomedical equipment, staff training, quality of work executed by the maintenance technicians, the workload of maintenance technicians, control of the work executed by the maintenance technicians, the effectiveness of annual maintenance planning and department performance. The results of this research show that the audit technique is a valuable checklist in the performance assessment of a hospitals. The application of the proposed method evidenced that the most critical component in the results of a management audit is the human resource .
An effective medical equipment maintenance program consists of three main elements. (1) Identifying the medical devices that need to maintenance program by the Ministry of Health. (2) Financial management, personal management, performance monitoring, operational management and performance improvement. (3) Proper implementation of the maintenance program. These three elements are also considered in the designed checklists in different dimensions such as resources, designing and implementation .
The maintenance and its management constitute a checklist that ensures the equipment performance. There exist four criteria in which the hospitals coincide that they should improve, even though each of them in different measure and sub-criterion. These criteria are an organization of maintenance; human resources; planning, programming and control of the maintenance and corrective maintenance. These criteria are among the sub-categories of maintenance management assessment checklists .
Amerion et al.  identified effective factors on the MEMM in a military hospital. Among effective factors on the MEMM, 26 components were extracted. User training components, human resources, commitment and the experience of users, the foreign exchange market, periodic visits, and trade name were the most important components which had more than 75% of the relative abundance. According to the results, factors with high importance on the management of medical equipment maintenance should be supported by the center’s directors. Attention to the use of these components can reduce maintenance costs, and therefore, increase the life of medical equipment. User training and human resources are the two main dimensions of this checklist .
According to the current results, documentation and service are two dimensions of MEMM. The problems of some hospitals in MEMM were introduced from the aspects of maintenance time, maintenance record, maintenance service and self-maintenance. Some measures were proposed including simplifying maintenance process through PDCA, information maintenance record, cooperating with the third-party maintainer and establishing self-maintenance team, so that precision and information medical equipment management can be realized to maximize the benefit of medical equipment management .
The medical equipment requires maintenance (both scheduled and unscheduled) during its useful life. The medical equipment maintenance process should be planned, implemented, monitored, and improved continually. This process requires careful supervision by healthcare administrators, many of whom may not have the technical background to understand all of the relevant factors. Maintenance management is the most important function in overall medical equipment management. In this regard, implementation of appropriate maintenance strategies requires the following types of resources: human resources, material resources, financial resources and documentation. Our findings also point to the importance of these resources .
We need a comprehensive assessment checklist that covers all aspects of medical equipment maintenance management in hospitals. In this regard, the identification of influential factors is essential. Eighty-nine factors were identified that affect MEMM. Five of the factors were found related to resources item, 12 factors related to service, 4 factors related to education, 15 of these factors regarding quality control, 19 factors related to inspection, 12 factors related to information bank and 22 factors were dedicated to management. These factors are implicated in decision-making in support of selection, purchase, repair and maintenance of medical equipment, especially for capital equipment managers and medical engineers in hospitals and also for the assessment of this process. Identification and classification of influential factors can be of help for raising critical alerts about the types of equipment more prone to maintenance problems .