Posted by Nick - Biomed Australia, 3/16/2009 2:56:38 PM

Very interesting topic, but at the end of the day as biomeds we can only do so much, if the manufacturer no longer supports the product and parts cannot be sourced, I would always make the suggestion that the hospital replaces equipment.

I normally run off the system that most equipment has a 7-10 year life span, after that it should be replaced. Of course somethings slip through the cracks, but you just need to ensure the people running the place are constantly made aware that they are using old/unsupported equipment.

Posted by VSarmiento, 3/17/2009 7:44:12 AM

I agree with Nick from Australia on his views and approach on this topic.  Also, there is another way one can approach to address such issues. Not only to address the safety aspects involved in maintaining inventories of older medical devices, but also to be used as an economic and budgeting tool for hospital administrators.

There is a need to establish an ongoing equipment replacement program to ensure and enhance the patients safety. This effort should be spearheaded by the local Biomed dept., justified and supported by the Risk Management Dept.  Risk Management people can be used as a very good source of support for this joint endeavor, since the risk exposures for the hospital is and will be greatly minimized as the program is implemented. At the same time lowering overall hospital insurance premiums when new medical devices are bought and put into use by the hospital. Beside being a key hospital dept. in the hospital, Risk management people are very much aware of this requirement, as they too must passed the JCAHO accreditation processes.  

Posted by VSarmiento, 3/17/2009 7:52:18 AM

Training issues for both Nursing staff, (for proper equipment use) and Biomed Staff (for equipment maintenance), not only as an accreditation requirement but to extend equipment useful life thus further lowering overall hospital risk exposures.  

Posted by Art Bartosch, 3/17/2009 4:29:40 PM

Replacement of technology in an institution is driven by many factors. Obviously financial has a huge impact on the procurement process. Capital committee is very reluctant to spend $$ where the need is not there. But WHO determines that need ? As a Director of Biomed, I constantly scan my inventory and device histories to help prioritize the need. A washer constantly breaking down in CSP stagnates the process flow for instrumentation throughput. Down cath lab rooms don't make revenue. Is just a high/low heart rate alarm good enough for patient care or should that patient have the benefit of a modern arthymia detection platform. How about the Docs...those who work in surrounding institutions will tell you what the other facilities can offer them in the form of technology and why. You may have to pick and choose only a handful of equipment to capitalize..but present a long term plan of replacement.Your job is to demonstrate the value of replacing technolgy on a regular basis. It is the finace guy who has to figure out how to get it done. Seek that person out and make your case. You will be surprised how much you can get replaced if you help in negotiating finance terms and conditions. COMPANIES WILL BE VERY CREATIVE IN THIS ENVIRONMENT TO MAKE A DEAL...Now is the best time to make those deals. You do your team and your patients a disservice by keeping devices operational long past their useful life.

Posted by Amaury Agoncillo, 3/24/2009 7:02:33 AM

This is common in smaller hospitals,and I can relate to your experience.First and foremost any equipment whether its a handheld thermometer or a fully equiped monitoring equipment has its useful life, depending on the manufacturer typically its (8-10 years). With this type of economy it is hard to lobby for a full replacement but you should consider your options. Here are the things you should consider. 1. Are there any parts available in the used marketplace? 2. Is the value to repair exceeds its current market value? 3. Run a history report to find out how much you have spent on your equipment repairs. Normally in a hospital if you present them with visual tools such as figures and graphs it is easier for you to make your case for a capital purchase. Remember you are the expert, show them what you can do by doing something about it. Good luck

Amaury

Posted by William von Rentzell, 3/24/2009 7:42:45 AM

It's simple really. Make official unequivocal documented statement to management that the equipment in question is totaly unreliable due to, in the sited case, decade(s) of lack of vendor support, extreme likelihood of failure from extreme age, and certain unavailability of replacement parts from any source. I assume the institution relies somewhat on JCAHO and other bodies' certification. However possible I'd make the connection with related standards for technology management in the statement.

Posted by Fred Servillon, 4/4/2009 5:28:34 AM

The comments I read in this topics are true facts facing the real equipment management in healthcare institutions. In some patient care depts, speaking in my experience as a former biomed tech, if you look in their storage area of equipment, you'll find machines that are old, seldom used or were never used for months. Since, the equipment management software generates preventive maintanance schedule periodically for these machines, we, in the biomed department are obliged to comply with regulation to perform rigorous PM task to make sure that they are safe to use. Six 6 months later, these machines are still in the same positions buried behind the other machines and never been touched. The most common answer you get when you ask the question why they are till keeping these machine is "just in case we have to use it, or we needed a backup"
It's very hard to convince the owning department to get rid of out-dated, non-supported machines, specially if you have good biomed technicians who can always fix them when they are broken.
One solution to hit the department "where it hurts" as they saying goes and that would be their service expense budget. Some biomed management shifted to charging the users by the quantity of PM they perform for the department. This means, if they don't want to be charged for PM performed for these machines that they never used, then they should get rid of them. This will give the users to pay more attention to what they owned and eventually keep only the onces that are cost effective.
The biomed management can start giving the inventory list periodically to the owners and how much they are charged for the time and parts to maintain them periodically. When it's time to cut expenses specially mandatory, these owning managements have the supporting documents on hand.

Posted by Fred Servillon, 4/4/2009 5:35:25 AM

http://www.24x7mag.com/joltnews/2007-11-13_09.asp

Posted by Daryl Anderson, 4/7/2009 8:39:55 AM

As long as you are able to keep fixing the equipment it is not going anywhere. We have some Mennen monitors, vintage 1986, that are no longer supported by Mennen and no parts are available anywhere. As they fail, we remove them from the units and notify the department manager, who has been budgeting for replacements for years and is continually turned down, that they have to find a replacement. A sucky modus operandi, but one that we have found ourselves in with 3-4% operating margins. Once upon a time, before the DRA, money was available and replacing equipment was proactive. The 21st Century apparently is going to have a reactive approach.

Posted by Insurance in Cincinnati, 5/12/2011 4:33:40 PM

Medical technology is advancing so quickly it's probably worse than how frequently people change their smartphones.

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