This study aims to examine the relationship between the reliability of the anesthesia device and its influence upon the patient outcomes in the 150 public hospitals of a top 20 OECD country. The reliability criteria are measured by using investigation each of; Failure Rate (FR), Mean Time between Failures (MTBF), Mean Time To Repair (MTTR), compared with the total operation time and average usage time per patient. The results obtained by quantitative analysis for the information related to the failure rate and access to alternative devices are highly significant factors that directly affect the patients' treatment and health services. In addition, it has proved there is a strongest significant relationship between the categories of the maintenance system used for the anesthetic device and the level of the risk upon patients `life during providing healthcare services. As a result, this study proposed to adopt the Total Productive Maintenance (TPM) as a safe approach to optimize the anesthetic outcomes due to its efficiency in reducing their sudden breakdown and increasing their performance.