Purpose: The purpose of this paper is to review maintenance strategies within the healthcare domain and to discuss practical needs as gaps between research and practice.Design/methodology/approach: The paper systematically categorizes the published literature on clinical maintenance optimization and then synthesizes it methodically.Findings: This study highlights the significant issues relevant to the application of dependability analysis in healthcare maintenance, including the quantitative and qualitative criteria taken into account, data collection techniques and applied approaches to find the solution. Within each category, the gaps and further research needs have been discussed with respect to both an academic and industrial perspective.Practical implications: It is worth mentioning that medical devices are becoming more and more numerous, various and complex. Although, they are often affected by environmental disturbances, sharp technological development, stochastic and uncertain nature of operations and degradation and the integrity and interoperability of the supportability system, the associated practices related to asset management and maintenance in healthcare are still lacking. Therefore, the literature review of applied based research on maintenance subject is necessary to reveal the holistic issues and interrelationships of what has been published as categorized specific topics.Originality/value: The paper presents a comprehensive review that will be useful to understand the maintenance problem and solution space within the healthcare context.

Although medical equipment maintenance has been carefully managed for years, very few in-depth studies have been conducted to evaluate the effectiveness and efficiency of these implemented preventive maintenance strategies, especially after the debate about the credibility of manufacturer’s recommendations has increased in the clinical engineering community. Facing the dilemma of merely following manufactures maintenance manual or establishing an evidence-based maintenance, medical equipment maintenance could have exploited an advanced area in operations research which is maintenance optimization research. In this paper, we review and examine carefully the status of application oriented research on preventive maintenance optimization of medical devices. This study addresses preventive healthcare maintenance with a focus on factors influencing the maintenance decision making. The analysis is structured by defining different aspects necessary to construct a maintenance optimization model. We conclusively propose directions to develop suitable tools for better healthcare maintenance management.

A Hybrid Decision-Making Model for Maintenance Prioritization in Health Care Systems

Today, medical equipment become more sophisticated and complex, and hospitals must ensure that their critical devices are safe, accurate, reliable and operational at a required level of performance. For decades, dependability engineering has been applied successfully in many industries to improve the performance of equipment maintenance. Many performance measurement frameworks have been developed and widely used to achieve the excellence of maintenance service, namely the balance of performance, risks and cost. However, the application of all these techniques and models for medical maintenance management remains limited. This study aims to analyse the effectiveness of maintenance management in a healthcare industry. The conceptual framework was designed to scrutinise the relationship between these variables: types of maintenance strategies, dependability criteria, maintenance costs, and risks. The proposed model is illustrated through a reel case study in a healthcare centre to pick up the insufficiencies and propose a roadmap to improve the maintenance management of medical devices.

Purpose: This paper introduces MedMaintBot, an AI chatbot designed to support biomedical technicians and non-expert users like nurses. The study explores the impact of integrating such an AI chatbot into Total Productive Maintenance (TPM) practices in healthcare, aligned with Industry 5.0 (I5.0) principles. Design/methodology/approach: This study adopts a multi-phase methodology, starting with a literature review on technology integration in TPM within healthcare settings. It presents the chatbot development pipeline and conducts a large-scale validation study across 250 queries covering five medical devices (MDs) to demonstrate the chatbot's real-time, context-aware guidance capabilities. Performance analysis further evaluates MedMaintBot's potential to optimize TPM practices and support sustainability goals in healthcare maintenance. Findings: The study reveals that MedMaintBot enhances TPM within healthcare by delivering accurate, context-aware guidance (Accuracy = 0.713, Relevance = 0.810), supporting nurse autonomy in routine maintenance and reducing technician dependency. While clarity and completeness were slightly below ideal for complex tasks, over 80% of autonomy-related queries were validated, showing strong support for first-level interventions. Combined with dynamic Large Language Model (LLM) switching between GPT-4 and MedLLaMA2, MedMaintBot strikes a balance between performance, cost and privacy, positioning it as a scalable and sustainable tool for healthcare maintenance. Research limitations/implications: This research provides valuable insights for practitioners and researchers on enhancing autonomous maintenance (AM) through AI–chatbot integration, offering a scalable framework for integrating AI into TPM practices. It also encourages further studies to address gaps in procedural completeness and contextual continuity and assess scalability across diverse maintenance environments. Practical implications: By providing real-time, context-aware guidance, the chatbot helps reduce user-induced errors, allowing non-expert users, such as nurses, to perform maintenance tasks. This not only reduces the burden on specialized technicians but also ensures better equipment availability, contributing to more streamlined healthcare operations and improved patient care. Social implications: MedMaintBot promotes a more inclusive and resilient healthcare environment by empowering non-expert users with AI-driven support. Its adaptability aligns with the human-centric principles of Industry 5.0, fostering collaboration between technology and healthcare personnel. Originality/value: This research is among the first to examine the integration of innovative AI chatbot with TPM practices within the healthcare sector, particularly in the context of I5.0. It demonstrates how such a system can significantly enhance operational efficiency, empower non-expert users and support sustainability in healthcare, offering a roadmap extending AI-assisted maintenance to broader industrial and resource-constrained environments.

Medical equipment is the biggest capital investment of every healthcare industry and ensuring the reliability and maintenance for critical devices is vital for Patient/user safety and better availability of services. To keep the medical device in a good operational condition, Inspection based maintenance activities have been the most usual means. The purpose of this study is to establish an improved delay time framework to model the two-stage failure process taking into account the influence of the utilization rate on the system’s degradation on the assumption of imperfect maintenance at inspection. This proportional delay time model is seldom considered in DTMs widely used in literature. A complete framework, for Parameters estimation method and the test for goodness of fit is given. To illustrate the model capabilities, a reel case study from the healthcare domain is presented, the model parameters are estimated entirely using the collected maintenance data. Then, the maximum likelihood estimation of the reliability parameters is achieved by Genetic Algorithms.