Disinvestment. Utilization indexes for medical equipment a pilot model.

U. Nocco1, G. Lolli Ceroni2, E. Lettieri2, S. del Torchio1

1 Clinical Engineering Department, Varese Town and University Hospital, Varese – Italy2 Politecnico di Milano School of Engineering, Milan - Italy

UTILIZATION INDEXES FOR MEDICAL EQUIPMENT UTILIZATION INDEXES FOR MEDICAL EQUIPMENT A PILOT MODELA PILOT MODEL

Corresponding author:

eng. Umberto NoccoClinical Engineering DepartmentAOU Ospedale di Circolo e Fondazione MacchiViale Borri, 57 – 21100 Varese – ItalyTel +39 0332 278301 - mobile: +39 335 7882671e-mail: [email protected]

BACKGRO

UN

DMedical Equipment

To a Healthcare Institution medical equipment represents:

-investment;

-source for clinical information;

-stakeholder to process definition;

What we don’t know…

- How much is each device used?- Can we define theoretical productivity?- Which devices are eligible for utilization

assessment?- Can utilization assessment be used in a

disinvestment process?

But, first of all- Do we have data?

2U. Nocco et al. - Utilization indexes for medical equipment. A pilot model

BACKGRO

UN

DWhich devices are eligible for evaluation?

Mandatory:Mandatory:

There are devices that are needed in each ward:

-defibrillators

-ekg machines

-….

due to regulation

Strategic:Strategic:

Other devices are needed “just in case”: a pediatric bed in a ICU is needed although it might be used once a year

Eligible devices Eligible devices are those related to a specific procedure, those that require a high investment (US machines), or those who have little cost but big numbers (infusion pumps).

The more complete an IT scheduling and reporting system the better.


OBJECTIVES

Purpose

Main objectives of the project are:

1.1. Propose a model to define productivity indexes for medical Propose a model to define productivity indexes for medical equipmentequipment;

2.2. verify whether they can be calculated easilyverify whether they can be calculated easily

3.3. verify which stakeholders are to be considered during data verify which stakeholders are to be considered during data analisysanalisys

U. Nocco et al. - Utilization indexes for medical equipment. A pilot model 4

METH

OD

SConcept approach

-Yearly number of exams- Daily number of exams- Asset daily productivity

-Yearly exam index (Y)- Daily exam index (D)

-Asset utilization index (S)

- Clinical- Organizational- Demand- etc.

Theore

tica

l

Actu

al

METH

OD

SIndex definition and calculation


Phase Index name Index

Theoretical

Annual theoretical exam Number

Daily Theoretical Exam Number (NTd)

Assett daily productivity (S) and

Real

Acutal Yearly Exam Index (Y)

Actual Daily Exam Index (D)

Assett Utilization Index (S)

50 wY EE

G

EN WTd

100Y

a

E

EY

Ew weekly exams per scheduleG=weekdays in schedule

100

50

Td

a

N

GED

M

NS Td

M

NS AdR

*

** 50ˆ

S

MGES a

METH

OD

SIndex evaluation

Given that the main hypothesis to the model is that daily schedule is determined considering epidemiology, resources and assett availability, index evalutation is being carried out as follows:

Saturation indexes (Y and D):

Index value judgementY and D >90% ok (10% mortality on booked exams is acceptable)

75%< Y and D <90% actions needed, expecially referred to production analysis

Y and D <75% Heavy activity is needed on organization, device condivision ect.

RESULTS AN

D D

ISCUSSIO

NUltrasound machines

US machines were analyzed in Pediatric Cardiology

Entry data:

Ew=19 G=3 M=2 Ea=661 working weeks: 50


%71ˆ

%94,693,6350

661

%5,69100950

661

2,2

1,3

4,4150661

3,6

9505019

S

D

Y

S

S

N

N

E

R

Ad

Td

Y

Saturation index is quite good both for yearly exams and device utilizationBUTHospital administration should verifiy why only 70% of available schedule is used by patients.

Is this number of exams/day or (worse) this number of exams/day/device sustainable?Which actions should be implemented? Device condivision

RESULTS AN

D D

ISCUSSIO

NGastroscopes


Gastroscopes

Entry data:

Ew=100 G=5 M=14 Ea=5000working weeks: 50

4,1

42,1

88,102504900

20

500050100

R

Ad

Td

Y

S

S

N

N

E

%98ˆ

%98202504900

%981005000

4900

S

D

Y

Can such a small number of exams/day/instrument can be acceptable?

RESULTS AN

D D

ISCUSSIO

NGastroscopes


Gastroscopes

4,1RS

%98ˆ SAs far as endoscopes are concerned, not only do we need to consider the exam time, but also disinfection time

If we consider disinfection time, 14 endoscopes are needed to cover daily schedule

CON

CLUSIO

NS

Did we get to the point?

- Proposed indexes seem to be easy to determine and provide valuable entry data for further discussion;

- The problem is by all means hard to model, since there are many variables that need to be considered at different points of the analysis;

- Entry data need to be present and read correctly. A multidisciplinary approach is needed.

Further work

- Indexes need to be tested outside the proposing facility (at the moment being on the run);

- Stakeholders should be modeled and introduced in the core model at fixed points to standardize the process.


U. Nocco1, G. Lolli Ceroni2, E. Lettieri2, S. del Torchio1

1 Clinical Engineering Department, Varese Town and University Hospital, Varese – Italy2 Politecnico di Milano School of Engineering, Milan - Italy

UTILIZATION INDEXES FOR MEDICAL EQUIPMENT – A PILOT MODELUTILIZATION INDEXES FOR MEDICAL EQUIPMENT – A PILOT MODEL

Corresponding author:

eng. Umberto NoccoClinical Engineering DepartmentAOU Ospedale di Circolo e Fondazione MacchiViale Borri, 57 – 21100 Varese – ItalyTel +39 0332 278301 - mobile: +39 335 7882671e-mail: [email protected]

THANK YOU FOR YOUR ATTENTION

Disinvestment. Utilization indexes for medical equipment a pilot model.

Health & Medicine

Transcript of Disinvestment. Utilization indexes for medical equipment a pilot model.