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Ingeniería clínica en una edad de la reforma

por Brendon Nafziger, DOTmed News Associate Editor | May 30, 2013
From the May 2013 issue of HealthCare Business News magazine

If I have to go back to performing preventative maintenance on all of our IV pumps twice a year as opposed to once a year, that’s a lot more work, and that means more manpower. To get it all done and done across the board, you probably have to add staff at a time when everybody wants to cut staff.

Dale Hockel: As we all know, it caused quite a stir. Clearly, what it can do is have an impact by increasing the frequency of the PMs. If you are in a risk management program today and you follow the PM schedule of the manufacturer, you could increase your PMs. We’ve been cautious and our regulatory team has been communicating back with the Centers for Medicare and Medicaid Services to work through our concerns and recommendations.

The main concern is that it’s driving unnecessary PMs. What is the rationale for some of the PMs, when we have historical data based on service records that some of these PMs are not necessary, even though it differs from the OEM recommendation? I think the Joint Commission embraced early on that risk management was an acceptable management strategy.

It can drive costs up, your labor costs, but [cost increases] also if it requires a PM kit or parts that you replace. You’ve got labor and parts costs that can be artificially inflated, and that clearly serves the manufacturer well.

Heidi Horn: As soon as CMS came out with this requirement, Joint Commission and organizations like AAMI disputed it very openly. Subsequent reports seemed to infer that CMS was taking the arguments against this requirement under consideration and there was a possibility they would reverse it. This created some confusion in the industry and most I have talked to have taken a “wait and see” approach to see whether CMS will change the requirement again before completely changing their policies and procedures. In my organization, we did adopt the CMS policy but have not noticed any improvement in safety or downtime.

Steve Vanderzee: One of the things our industry tends to do is a knee-jerk reaction. Now you have to follow manufacture requirements, and we automatically assume it’s going to increase the workload. What we are finding at Advocate is that’s not necessarily so. For monitors, for example, we have them set up for PMs on a semi-annual basis, and it’s actually an annual requirement. While there are things we might have to make adjustments on and shift frequency, I think there will be an offset. Those other things we’ve been overdoing, we’ll offset the things we need to do more of. In our organization, we’ve done the tip of the iceberg, aligning our maintenance strategies with the CMS recommendations, but we haven’t seen a dramatic impact.

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