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Disinvestment. Utilization indexes for medical equipment a pilot model. U. Nocco1, G. Lolli Ceroni2, E. Lettieri2, S. del Torchio1
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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: umberto.nocco@ospedale.varese.it
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.
3U. Nocco et al. - Utilization indexes for medical equipment. A pilot model
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
U. Nocco et al. - Utilization indexes for medical equipment. A pilot model 6
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
U. Nocco et al. - Utilization indexes for medical equipment. A pilot model 8
%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
U. Nocco et al. - Utilization indexes for medical equipment. A pilot model 9
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
U. Nocco et al. - Utilization indexes for medical equipment. A pilot model 10
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.
11U. Nocco et al. - 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 – 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: umberto.nocco@ospedale.varese.it
THANK YOU FOR YOUR ATTENTION
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