Matt Baretich: Falling in Love with AEM

I am writing this blog post while flying back from Indianapolis, where Frank Painter and I recently finished a day-long, AAMI-sponsored alternative equipment maintenance (AEM) workshop at the Indiana Biomedical Society conference. There were 30 enthusiastic attendees. It’s clear that there continues to be a lot of interest in AEM programs, albeit tempered by trepidation about exactly how to implement one.

In my AEM Program Guide: Alternative PM for Patient Safety, I wrote that the objectives of an AEM program are to:

  1. Save time (and money) on PM (planned maintenance) without compromising on Objectives 2 and 3.
  2. Achieve the same level of “equipment safety” for medical devices in the AEM program as for medical devices that follow manufacturer recommendations.
  3. Be in full compliance with regulations from the Centers for Medicare & Medicaid Services (CMS) and accrediting organizations such as The Joint Commission (TJC).

Frank and I have now run nine AEM workshops across the country, and we’re scheduling more of them (the next one is March 14 in Tampa, FL). The slide deck I use is updated continuously, but I always start out with those three objectives. Later in the workshop, we talk about what words to actually use in our AEM policies and I suggest “optimizing the use of maintenance resources” as more appropriate than “saving money” as an objective. We don’t want to make it sound like we’re just trying to cut corners and save a couple of bucks.

I hope that the healthcare technology management professionals who attend these workshops go home fully prepared to kickstart their AEM programs and start saving money—I mean, optimizing resources. We’ve been getting favorable feedback from attendees, who seem to be happy with what they’ve learned. However, I’m here to tell you that I’m the person who has learned the most from the workshops. My thinking has evolved.

When I first started thinking about AEM programs a few years ago, I was—to put it bluntly—not impressed. CMS said that AEM stood for “Alternate Equipment Management.” TJC said AEM stood for “Alternative Equipment Maintenance.” That’s two words of disagreement in a three-word phrase. I did some presentations with titles like, “What are those people thinking?” I could go on (and have).

When Steve Campbell, AAMI’s chief operating officer, asked me to write what became the AEM Program Guide, I agreed because I like the idea of trying to make sense out of nonsense. The purpose of the publication was to provide interim guidance while a formal AEM standard was being written.

Then I fell in love. Not head-over-heels in love, but step by step. I read everything I could about AEM programs. There’s a lot out there and much (but not all) of it is good stuff. I talked to everyone who would talk to me. I heard many good ideas, a few overly elaborate ideas, and some pretty darned bad ideas. Creativity was rampant, as it should be.

What I fell in love with was the idea that sound AEM principles, carefully considered, really do give us tools for evidence-based maintenance, that holy grail we’ve been seeking lo these many years. That’s not just rhetoric; it’s an opportunity to do smarter HTM. Let me know how goes the quest!

To find more AEM training events, visit www.aami.org/events.

Matt Baretich is president and CEO of Baretich Engineering based in Fort Collins, CO.

2 thoughts on “Matt Baretich: Falling in Love with AEM

  1. Interesting that Hospital Based programs are looking to “optimize” (Save Money) and Manufactures continue to “Maximize Profits” (Rip us off with limiting service policies). The main issue we run into is Manufactures who are not willing to “share” their Technical Service Manuals (TSM) that meet NFPA 99 2012. See, we as Hospital’s have to meet the CMS and TJC (now NFPA 99 2012) requirements, while the Manufactures do not have any accountability to these standards. I have seen multiple examples of Manufactures who restrict access to TSM and actually create a Service Monopoly from a Sales Monopoly (see violation of Sherman Anti-Trust Act and Clayton Act). Until the FDA is able to create rules to mandate the TSM be provided, we are left spend our “maintenance resources” on proprietary service contracts.

  2. While I am surely one to play word games, I am not sure that “optimizing the use of maintenance resources” as a euphemism for “saving money” really makes any difference. Are we trying to fool ourselves or someone else? If AEM is linked to an event (which it hardly ever is) the issue remains that you did something different from (and usually less than) what the manufacturer recommended. This, of course, may or may not be related to causation.

    Note also in #3 that state law may address the subject.

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