According to The Joint Commission (TJC) requirements, “The hospital evaluates new types of equipment before initial use to determine whether they should be included in the inventory. Before initial use of medical equipment on the medical equipment inventory, the hospital performs safety, operational, and functional checks. In addition, the hospital maintains a written inventory of all medical equipment.” Because of these mandates, our department’s standard operating procedure calls for inspections on all medical equipment brought into the medical center for clinical use. These incoming inspections must be performed by clinical engineering or healthcare technology management (HTM) personnel prior to the equipment being put into use.
During an incoming inspection, the equipment is examined visually, and an electrical safety check is conducted. In addition, there is a performance check to ensure that the equipment meets manufacturer and purchase specifications. The criticality of the equipment also is assessed to determine its inclusion in the preventive maintenance (PM) program. If the criticality assessment is missed, it would be difficult to meet TJC standard that ”the hospital identifies the activities and associated frequencies, in writing, for maintaining, inspecting, and testing all medical equipment on the inventory.”
Sometimes, a new piece of medical equipment is brought into the medical center for evaluation, loan, or demonstration without notifying all stakeholders, including HTM. This equipment, not owned by the medical center, still must be fully documented. The equipment may be entered in the PM program, especially if it stays on station longer than six months.
How can we ensure that all new medical equipment is inspected by HTM before being put into use? To begin with, HTM should be involved with all aspects of equipment procurement—from the initial discussions of new or replacement equipment to the actual implementation of the equipment. If such involvement can be achieved, HTM can reduce the number of surprises that arise when unexpected medical equipment is delivered. This involvement also creates a higher reliability system to mitigate future failures. The discovery of undocumented equipment during rounds will also decrease as HTM gets more involved in the cradle-to-grave management of equipment acquisitions.
Many medical centers have a standard, designated equipment procurement process. The process should include a review by HTM, which should be asked to literally sign off on any procurement decision. A cost analysis also is crucial so that the organization can understand the short- and long-term resource implications of supporting that equipment. In addition, clinical staff should be educated on the equipment procurement process, along with the process to obtain a loaner device or have a device brought into the hospital for demonstration. This education should stress the importance of equipment inspection and documentation to safe and effective maintenance.
In short, when HTM knows early on about new medical equipment coming into the medical center, the potential risks to patients and clinical staff are reduced, along with possible violations of regulatory compliance.
Hillary Groff, MSBME, is a biomedical engineer with the Central Arkansas Veterans Healthcare System.