Download - Benchmarking Biomedical
BENCHMARKING BIOMEDICAL Patriick Lynch plync
Patrick K. Lynch, CCE, CBET
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April 5, 2009MD Expo (www.mdpublishing.com)Phoenix, AZ
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WHY BENCHMARK?
Administration
Patrick L
Prove the value of a departmentcompare to others in your network
Lynch plynch@compare to others in your networkidentify areas for future improvement
Self-assessment
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Self assessmentInternal means for Clinical Engineering to evaluate to others in the field.evaluate to others in the field.
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WHY BENCHMARK? (2)
StaffingProvides an alternative to the old FTE Model
Patrick LProvides an alternative to the old FTE Model
Job Securityd t t d t di f hi h l l
Lynch plynch@
demonstrates understanding of higher level metrics and control of your responsibilities
Pay
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PayValue of more productive employees and operationsoperations. 8
WHO NEEDSTOTOBENCHMARK?
SizeUnder 100 beds100 300 b d? 100 to 300 beds300 to 500 beds500 l b d
Patrick L
500 plus beds
Metro / Rural
Lynch plynch@
Metro / RuralLarge CitySmall city
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Small cityRuralCritical AccessCritical AccessDistance to city of 500,000?
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WHO NEEDSTO
TeachingTOBENCHMARK? (2)
eac gUniversityMedical Schoolnon teaching(2) non-teaching
SystemSIngle hospital
Patrick L
SIngle hospital plus outpatientMultiple hospitals locallyMultiple hospitals, multiple cities
Lynch plynch@Multiple hospitals, multiple citiesSpecialty vs. general hospital
CardiacChild '
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Children'sSurgicalCancerPsych 10
WHO NEEDS TOBENCHMARK? BENCHMARK? (3)
Private vs. publicVeteransPrivate
Patrick LPrivate
County
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THINGS TO CONSIDER
Costcost of biomed program
Customer Satisfactionuptime
Patrick Luptime
incidentsoverall satisfaction
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customersclinical departmentsadministration
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administrationother support departmentsrisk management
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THINGS TO CONSIDER (2)( )
Regulatory Compliance
V l Add dValue Addeduser training
annual required
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new employeerefresher operator
special projects
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building / expansiondisaster plans
committees
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EOCInfection ControlCapital EquipmentCapital Equipment
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WHAT TO MEASURE
# of Beds# of Surgeries# of Rad Rooms
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# of ICU Beds# of monitored beds
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# of medical devicesAdjusted DischargesValue of Equipment
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Value of EquipmentCost of OperationsUptimeUptime
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WHAT TO MEASURE (2)( )
Failure rateFailure rate
# of workorders# of PM workorders
% ti
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% on time# of Corrective Workorders# closed
Lynch plynch@
% closed
hospital demographicsSquare Footage
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q ggeographyservicespublic/privatepublic/privateurban/rural
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THE MAIN PROBLEMS
1 We are all different.1. We are all different.2. We ask for information that does not exist.3 We haven’t decided what metrics matter
Patrick L3. We haven t decided what metrics matter.
4. We haven’t decided what is the definition of:
Lynch plynch@of:Unacceptable
Poor
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AdequateGood
Excellent 16
PROBLEMS
Scope of servicesAnesthesiaLaboratoryImaging
Patrick Lg g
CTMRINuclear Medicine
Lynch plynch@Nuclear MedicinePETRadiation TherapyUltrasound
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UltrasoundDialysisSterilizers
C llNurse Call 17
PROBLEMS (2)( )
WhWhereLocation in the US is often cited as a complicator
Patrick L
Contract or in-house
Geography - city or widespread
Leader - BMET, engineer,
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business
Reporting StructureIT
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AdministrationFacilities
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PROBLEMS (3)( )
Data AvailabilityCost of equipment not Cost of equipment not recordedDocumentation of
Patrick L
Biomedical Activities not recorded
easy if all costs are in
Lynch plynch@ya single budget or a single contract
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OTHER THOUGHTS/ FACTORS
Length of time department in businessg pCompare costs to other industriesChargeback Structure
Patrick L
Length of time manager in placeCMMS
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TRADITIONAL BENCHMARK CALCULATIONS:P
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S iTHE ANSWER
Service
Patri
Value
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Ratio
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SERVICE VALUE RATIO
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SERVICE VALUE RATIO
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SERVICE VALUE RATIO IN ACTION
FOR A SINGLE ITEM OF EQUIPMENT
Cost of CT Scanner - $1,000,000Annual Service Contract - $150 000
PatriAnnual Service Contract $150,000
SVR = $150,000/$1,000,000 = 15%
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SERVICE VALUE RATIO IN ACTION
FOR A SINGLE ITEM OF EQUIPMENT
Cost of CT Scanner - $1,000,000Annual Service Contract - $150 000
PatriAnnual Service Contract $150,000
SVR = $150,000/$1,000,000 = 15%
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Cost of a thermometer - $400.00Annual cost of all maintenance = $35 00 m
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Annual cost of all maintenance $35.00 SVR = $35 / $400 = 8.75%
SERVICE VALUE RATIO IN ACTION
FOR A SINGLE DEPARTMENT
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Cost of Equipment in Central Supply - $290,000Annual cost of Maintenance - $20,000
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SVR = $20,000/190,000 = 6.90%
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SERVICE VALUE RATIO IN ACTION
FOR A SINGLE CONTRACT
Patri
Cost of Anesthesia Machines = $3,600,000
ick Lynch plyncCost of Anesthesia Machines $3,600,000Cost of Annual Service Contract = $432,000SVR = $432,000/$3,600,000 = 12%
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SERVICE VALUE RATIO IN ACTION
FOR A SINGLE HOSPITAL
Patri
Cost of Equipment = $113,000,000
ick Lynch plyncq pAnnual Biomedical Budget = $5,200,000SVR = $5,200,000/$113,000,000 = 5.13%
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SERVICE VALUE RATIO IN ACTION
FOR A SINGLE VENDOR
Cost of Equipment (Patient Beds) = $12 000 000
PatriCost of Equipment (Patient Beds) = $12,000,000
Annual costs from HillRom (contract + PM + parts) = $2,220,000
ick Lynch plync
SVR = $2,200,000/$12,000,000 = 18.5%
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SERVICE VALUE RATIO IN ACTION
FOR A SINGLE TYPE OF EQUIPMENT
Patri
Cost of all Infusion Pumps = $2,400,000$
ick Lynch plync
Annual sum of Maintenance costs = $264,000SVR = $264,000/$2,400,000 = 11%
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SERVICE VALUE RATIO
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THE MAIN PROBLEMS ANSWERED
1. We are all different. Use Metric that adjusts for variables.
2. We ask for information that does not exist. Use a Metric that uses FEW, easily accessible
Patrick L, y
numbers.3. We haven’t decided what metrics matter.
Always $$$$$$$$$$$
Lynch plynch@Always $$$$$$$$$$$4. We haven’t decided what is the definition of:
Unacceptable SVR greater than 15%Poor SVR greater than 12%
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Poor SVR greater than 12%Adequate SVR less than 12%
Good SVR less than 8%E ll t SVR l th 6%Excellent SVR less than 6% 33
ADVANTAGESAutomatically adjusts for differences in size, scope, contracts, outsourced.
E il ibl b f iliEasily accessible by any facility
Scalable - it applies and compares . . . single item
Item List priceItem Annual cost
single manufacturerManufacturer List PriceManufacturer Annual Cost
Patrick L
single equipment typeEquipment Type List PriceEquipment Type Annual Cost
single department
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single departmentDepartment Equipment List PriceDepartment Annual Cost
single hospitalHospital Equipment List Price
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Hospital Equipment List PriceHospital Annual Cost
single systemSystem Equipment List PriceS A l CSystem Annual Cost 34
1) LIST PRICE OF ALL ASSETS MAINTAINED
Start with estimates and get more specific over time
A li f
Patrick L
Average list of every asset$12,000
Average list of each type
Lynch plynch@Average list of each typeInfusion Pump - $5,000
Specific list of each model
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Specific list of each modelAlaris - $7,000Abbott - $4,000
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2) ANNUAL COST OF MAINTAINING ALL ASSETS)
I l d ALL COSTSInclude ALL COSTS
Include PM, repair, overhead, etc.
Examples-
Patrick L
LaborBenefitsTraining
Lynch plynch@gOn-callTest EquipmentCalibrations
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CalibrationsOutside LaborOutside partsService ContractsService ContractsSecretarial and supervisory costs
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DISADVANTAGES
Examines only costs
Patrick LExamines only costs
Simplicity may cause it to be rejected by
Lynch plynch@it to be rejected by some
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RESULTSP
atrick L
12% 20% M f t C t t
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12% - 20% - Manufacturer Contract9% - 15% - 3rd Party Contract
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8% - 12% - Outsourced In-house4% - 8% - In-house programsp g
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THE NEXT STEPWrite a paper defining Write a paper defining the process.Conduct comparative Conduct comparative studies to validate the methodology.
Patrick Lt e et odology.
Make adjustments as necessary.
Lynch plynch@yPromote to Biomedical field.
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Develop additional metrics for customer satisfaction, etc. 39
SERVICE VALUE RATIO
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MAIN TOPIC Patriick Lynch plyncch@
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A REAL-LIFE EXAMPLE OF THE USE OF SVR TO ANALYZE A GROUP OF EQUIPMENT
Patrick L
Let’s examine all of our
Lynch plynch@Let s examine all of our Warming Blankets to see if we have any lemons. . .
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we have any lemons. . .
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MAIN TOPIC Patriick Lynch plyncch@
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