Managing Medical Devices --- Guidance for healthcare and social services organisations
DB2006(05) November 2006

The Management of Medical Equipment in NHS Acute Trusts in England
by National Audit Office 10 June 1999

Medical Technical Officer (MTO) Definition

EBME (Electronic Biomedical Equipment) Department (设备科）

The Growth of Technology in the NHS
An Insight into the Inter-relational Nature of Buying, Using and Maintaining Medical Devices

Selecting and Buying
When selecting and buying equipment it is important to consider the impact on users, support staff, the procedure that the equipment is used for (the patient), consumables and durables storage, risk, costs, length of time on the market etc.

To ensure this is done properly it is advisable to have a standard method for reviewing and proposing the procurement. One suggested methodology is available from: http://www.ebme.co.uk/arts/iso/business_case.htm

Hospital Standardisation
Devices need to be fit for purpose and economical. We must consider life costs and need. When considering durables (more than one use) and consumables (single use), also consider the available storage space and "Do we have room"?

Is the supplier safe? Can we ensure that they will be around in 5 years time? Check the suppliers history and references - visit other sites and speak to the users.

Who manages the devices? It is not always EBME that should manage the devices. It may be better to bring in a managed service option and manage the managed service. An example might be 'Rigid Scopes' Most EBME departments are unable to maintain these devices and can only manage the repairs. Another option would be to ask the supplier to supply, repair, and manage the scopes. This frees up time for EBME, reduces costs, and improves the service to the patient.

It is also possible to have a single supplier for a device type. For example, all lamps could be bought from one supplier at wholesale prices. This procurement model could also apply to blood pressure cuffs, cables, sensors, etc. with the benefits of cost reduction, reduced downtime on devices, and improved safety/care delivery for the patient.

Regional and National Considerations:
Many regions now have Purchasing hubs or confederations. We can use the knowledge of these hubs to develop improvements within our organisations. They will have conducted many trials across many Hospitals. This information can then be used in your case for improvement. Get involved!

Using new devices safely:
To ensure user training is delivered, we need to reduce the number of equipment models within the organisation (and reduce the quantity held by increasing utilisation). This is vital for patient safety and reduces corporate risk. Most NHS hospitals have between 5 to 10 times the number of equipment models they actually require. If the Hospital equipment asset was analysed it could be shown (in the majority of cases) that investing in equipment and standardising to single supplier/single model would benefit the Hospital. It would make substantial cost savings, reduce risk, increase storage space, increase utilisation and reduce the maintenance burden. If the investment could be made at the start of the financial year there could be 'in year savings' which would cancel out the investment and achieve substantial ongoing operational and cost benefits.

Organisational Efficiency:
Using technology is vital to the organisations ability to run in a safe and efficient manner. Technology can and should be used to improve efficiency and reduce costs. To achieve this is difficult unless the Hospital has taken on-board the EBME recommendations relating to management of equipment.

The impact on EBME:
The impact on EBME generally includes budgetary responsibility for service contracts, parts, consumables and durables. When assisting in the delivery of improvements it is important to ensure you have sufficient resources to deliver the promises you make to the Hospital.

Support
Don't be left high and dry.

Prepare strong business cases, be prepared for difficulties, Present your case for improvement, Get it right, Check all the benefits, Consult key stakeholders, and Present a strong case.

Don't let yourselves get out manoeuvred…or you might end up feeling like the matador to the left "Why did I ever get into this?"

A successful example:
The Hospital needs to reduce non-staffing (non-pay) costs…EBME need more resources to do the job professionally. By standardising on devices, suppliers, consumables and canceling service contracts the Hospital made recurrent saving of £1Million (non-pay savings) for a £400K investment, (this included a new EBME workshop, training room and offices), thereby .improving safety, reducing costs, and delivering a better service for the patients.