Sunday, March 30, 2014
Your preceptor, excited to have a Baylor resident, tells you their hospital has had a high rate of Hospital Associated Infections, and needs a solution quick. He tells you he has heard of a robot designed to kill micro organisms and reduce HAI; the vendor is ready to give a discount price of $70K per robot to the hospital if the hospital acts now. Your preceptor asks for your Baylor expertise and recommendation. How would you go about determining whether or not this would be a 'good buy' for the hospital?
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First I would meet with Infection Control, most likely a seasoned nurse to discuss the full scope of the situation and historical attempts/processes aimed at fighting infection in the hospital.
ReplyDeleteI would then shoot a copy of the quote to the Director of the Clinical Engineering department so that they could initiate a technology assessment.
Although in the preliminary stages, I would also give a heads up/"just so you know" email to Logistics or whoever was in charge of executing hurry-up acquisitions, just so it would be on their radar. I would also ask them for any background given the present budget situation/constraints on the fiscal year -- and see if there was anything that could be done to proactively in case this did move forward.
I would meet with the head of Environmental Services/Housekeeping, the actual ones most likely responsible for cleaning/sterilizing/controlling infection -- and see what the current costs of preventing/combating infection really are.
I would meet with Clinical Engineering to discuss the technology assessment, which would give me peace of mind. I would now know such things as: Is this proven technology? What do the white papers say? What have other hospitals found regarding efficacy/effectiveness? What are the true costs of ownership (warranties, service schools, disposables/reusables, etc). Is this a reputable manufacturer? Is this a good model? Is it the best fit for our problem?
Clinical Engineering could also indicate whether there were any IT considerations, and if the equipment was capable of integrating with our enterprise network/IT infrastructure. If there were IT considerations, I would meet with the Chief Information Officer (CIO) to discuss the feasibility of the purchase and integration of robots.
I would then get a copy of the quote and use it to create a cost-benefit analysis. The acquisition cost would be my present value outflow, and the rest of the cash stream would be shaped by inflows (savings as a result of deploying the robots) and outflows (maintenance, warranties, other costs of ownership). I would compare this to the costs associated with Infection Control using non-robot solutions and see which was more attractive. I would also see if Leasing was a good option.
If deciding to move forward, I would meet with my preceptor to present the cost-benefit analysis, along with comprehensive qualitative and quantitative costs/factors, and present the case in a thorough fashion, answering any questions that would help facilitate timely decision making.
I would not be allured/wowed by the sexiness of new technology. I would communicate with relevant stakeholders. I would balance the qualitative costs/benefits with quantitative costs/benefits.