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Disclaimer/Transparency
I do have a biased opinion! 30+ years managing in-house clinical engineering inprograms
15+ years clinical engineering consulting (Medical Technology Management., Inc.) www.mtminc.org
Practice area focus is in creating and/or expansion of CE programs Conversion of out-sourced programs to in-house outin-
Having been in this profession for my entire career, I know a lot of CE professionals that have gone both ways, switching back and forth as needed
I do agree
OutOut-sourced programs may make sense for smaller hospitals, < 100-150 beds, especially if they are not part of a 100larger system with internal CE resources Not all in-house, or out-sourced, programs are created inoutequal Common factors that impact degree of success
Quality and education of the staff Resources Administrative support Fix it shop vs. a professional servicewhat are the needs? Either type of program is doomed for failure if the program delivered does not fit the needs and expectations of the organization! Neither are free
Parts credits contribute to vendor's bottom line* *if the hospital purchased the asset, then, technically, the parts credit belongs to them!
No conflict of interest
Hospital in control over parts and labor sources, and can easily switch if quality becomes an issue.
Provider in control over parts and labor sources. Hospital have to fight for change.
If inventory is $290,000,000 COSR = 4.7% Budget is then $13,630,000 Outsource to a provide that has 20% profit margin, cost now becomes $16,356,000 (COSR now 5.6%) If hospitals net annual operating margin is 2%, the additional $s paid needs to be made up by the hospital collection of 100% on $13,630,000 of patient charges!
Software CMMS and data conversions Test equipment and tools Manuals Over due PMs and CMs wip credits Staffing and ability to hire providers staff Contracts and OEM discounts Policies and procedures Clerical and call center support Clinical engineering expertise Three to six months lead time
Develop a business plan (three years), based on cost and quality Set realistic goals and expectations Consolidate all service budgets into one Include contract/vendor management services Start with general biomedical equipment support Plan for expansion into service of ultrasound; sterilization; imaging; cath lab; clinical lab; radiation oncology; surgical instrument mgt.
Perform bi-annual assessment of equipment actually serviced, PM or biCM, and remove from inventory items never seen, to lower your program contract cost Read your contract and verify deliverables are being delivered Negotiate the margin, full disclosure of all costs If vendor gets credits for parts returned, it should be credited back to the hospital Mandate full staffing levels. If not met, get credit Mandate credits for PMs not done on time Obtain quarterly downloads (Excel format) of inventory and work histories Consider getting helpcall me when you are ready to save money! (daved@mtminc.org)