by
Loren Bonner, DOTmed News Online Editor | May 29, 2014
From the May 2014 issue of HealthCare Business News magazine
“We’ve been doing this for a long time and we don’t see patient safety issues. In other words, where we do use our experience and we back off manufacturers’ requests, it hasn’t caused any additional hazard for patients,” says Matt Baretich, president of Baretich Engineering in DOTmed’s original story about the maintenance directive back in 2012.
A brief history
For several years, there was built-in conflict between what CMS and the Joint Commission required as far as medical equipment maintenance. When CMS clarified its standing in 2011, asking hospitals to strictly adhere to manufacturers’ recommendations, the clinical engineering community reacted strongly because it went against their long-established practices.
But there was more: It also created the potential for more work and an even greater financial burden to hospital budgets, and with that, the issue of patient safety.
“Hospitals are under big budget constraints so if a department has to do more work, they probably won’t get a budget increase to hire more people. So that means something else won’t get done and that’s what we’re afraid of. Those other things have more impact on patient safety than some of the maintenance activity,” says Gaev.
We still have questions
Experts say that many parts of the December 2013 clarification from CMS need further clarification. On that priority list is how CMS defines “critical equipment.”
“The problem is that if you take any piece of medical equipment, you can come up with a reason that it’s critical,” says Gaev. Clinical engineers are asking for a list of critical equipment from CMS that would hopefully clear up the confusion.
Besides clearly defining critical equipment, professionals in the field would also like CMS to explain what they mean when they say “a sufficient” amount of information. For example, one device category was excluded from being put on an alternative equipment management program because new equipment without “a sufficient” amount of maintenance history had been acquired.
And even bigger-picture questions remain, for instance, does the evidence-based risk assessment for preventive maintenance have to be knowledge from within a certain hospital or can a facility get its knowledge from other hospitals?
The clinical engineering community will be trying to find answers to these questions and more in the months ahead.
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