How better equipment management offers time and money savings

The management of hospital equipment is under scrutiny as NHS trusts review all operational areas in the drive for efficiency and productivity savings.

Having the right equipment is vital to the smooth running of a hospital. One study in 2008 estimated that nurses waste 36 minutes per shift looking for and retrieving essential kit. In extreme cases, patients have been put at risk when equipment meant for single use is used more than once and not cleaned properly between patients. There are examples of staff hoarding equipment because they cannot rely on stocks being quickly replenished.

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Universal Hospital Services is a provider of medical equipment management and service solutions in the US. The organisation has completed some research across 80 hospitals in the US which has yielded lessons for hospital facilities departments in the NHS.

Timothy Kuck, UHS executive vice president explains: “Management of large-volume medical equipment is often overlooked and typically is inefficient, which can lead to higher costs and significant clinical risk to patients. 

“Hospitals should look for consistency across the facility including oversight of management, maintenance and deployment. A dedicated equipment management programme is a great way to overcome challenges operationally, clinically and financially.”

UHS manages more than 585,000 pieces of medical equipment across 8,675 hospital facilities in all 50 US states. Their approach is end-to-end equipment management programmes which encompass almost all medical equipment across a hospital, ranging from small disposables for infusion pumps to large pieces such as patient beds. The programme has a central team based on-site who co-ordinate activity across as big of scale as possible - often at the multiple hospital system level.

All logistics around equipment movement including delivery and pick-up, cleaning, maintenance, repair and regulation documentation are completed by on-site staff. In addition, a pooled purchasing function across a number of hospitals provides the latest technology on a variable spending model only charging on a pay-per-use basis, which means the hospital is charged only when a piece of equipment is in use on a patient.

The company’s research found that up to 10 per cent of large-volume equipment is broken or lost each year, creating a backlog and equipment shortage for clinical staff. The cost of resources to maintain the fleet and fix broken equipment significantly increases a hospital’s total cost of ownership, while manufacturers or regulatory recalls of medical equipment can disrupt equipment availability and patient care. The administrative time to manage recalls is significant to hospital staff especially if they struggle to locate the potentially faulty equipment.  

Standardisation of equipment is another important facet for a smooth operational process.  Non-standard products is also a problem, staff have to use unfamiliar equipment and time is wasted as they get to grips with unusual buttons or dials or even struggle to open packaging.

A recurring clinical challenge is accessing the right equipment. If nurses are losing over 36 minutes per shift looking for and retrieving kit, this loss of valuable time detracts from patient care, and impact staff satisfaction and morale. As a result, it is not unusual for scarce equipment to be hoarded when available, potentially putting patient safety and equipment integrity at risk.

UHS has worked with about 75 hospitals in the US to introduce such programmes and a recent audit has demonstrated improved outcomes in the following areas:

• Access to the right product which is sanitised and ready for use:

Equipment management programmes increase the chances of having clean and functional equipment more readily available.  In a study of 52 facilities with a dedicated programme and 80 without one in place, there was an 86 per cent improvement of delivery of sanitised equipment for those with a programme.

In addition, the 52 facilities showed a 68 per cent improvement in the delivery of non-functional equipment over facilities with a dedicated programme.

• Speedy access to equipment

Formal management of day-to-day equipment by a dedicated team helps nursing staff focus on their core competency of providing optimal patient care. 87 per cent of caregivers surveyed in hospitals with a dedicated equipment management programme reported that they received patient-ready equipment in 30 minutes or less, compared to only 38 per cent in the ‘non-asset facilities.’ This prompt access reduces therapy delays and allows more time treating patients.

• Increased utilisation

By standardising equipment and increasing equipment productivity, the 52 facilities with a dedicated programme typically experienced better utilisation rates.  They averaged 70 per cent utilisation, 75 per cent better than the group who do not yet have such programmes.

Hospitals must start to think differently when approaching the financial challenges. Firstly, how to access capital for the latest technology. The expense of buying new equipment can strain the finances of even the best-run hospital. As a result, equipment upgrades are often delayed until absolutely necessary and equipment is used past its useful life. Owning and maintaining medical equipment is both costly and time-intensive for hospitals. Equipment management programmes can help predict the changes in volume minimising inappropriate localised purchasing, resulting in lessening equipment that sits idle for the remainder of the year. Equipment not utilised can also take up valuable resources and storage space.