While meeting The Joint Commission’s (TJC) new standards on medical device maintenance may not be easy for some hospitals, it is doable. This was the main message delivered by George Mills, TJC’s director of engineering, and Stephen Grimes, managing partner and principal consultant for Strategic Healthcare Technology Associations, LLC, during a webinar hosted by AAMI in early January.
TJC has moved to a “much more aggressive, ‘see it—cite it’ practice,” according to Mills. Under the new elements of performance (EPs), hospitals are expected to complete all planned maintenance activities in line with manufacturer recommendations or an alternative equipment management (AEM) program 100 percent of the time.
Previously, TJC had drawn a distinction between high-risk and non-high-risk equipment in terms of the 100 percent rule. But following efforts to streamline its standards and input from the Centers for Medicare & Medicaid Services, the federal agency that administers several government health insurance programs, the expectation for all equipment – regardless of risk – is now the same.
During the webinar, which was attended by nearly 1,000 healthcare technology management (HTM) professionals, Mills provided the example of changing the oil in a pump, saying that you have to do all the steps to complete the job. “You’ve got to do those. No negotiation there,” he said.
The leeway comes in crafting an AEM program and departmental policies, as well as in determining the frequency of the required maintenance activities. Mills stressed the need to start with the recommendations from the device manufacturer and then use real-world evidence to decide if deviations can be made without reducing the safety of the equipment. He repeatedly underscored the need to create a comprehensive program that reflects an understanding of possible questions and challenges down the road.
“It does take some thought and time,” Mills said of developing a strong AEM program. He added that it is vital that HTM staff can explain and defend their policies when asked about them. “It always goes back to: ‘Can you defend the decision you make?’” Mills said.
Mills and Grimes emphasized that maintenance activities covered by the new 100 percent rule don’t apply to equipment that is either in use with a patient or missing. The key point, the two men indicated, is having the ability to document that:
• HTM staff did indeed determine the equipment was either in use or could not be located.
• There is a clear policy in place that details what will be done once the equipment becomes available or remains missing for a specified period of time.
For large health care systems with multiple facilities, both men said there is a need to recognize that some adjustments are likely necessary in AEM programs and policies to best meet the needs of each individual facility. “One size doesn’t fit all in this case,” Grimes said.
A recording of the one-hour webinar and PDF versions of the slides are available in the AAMI Store, www.aami.org/store. On-demand access is free for AAMI members and $85 for non-members.
AAMI Foundation to Tackle Purchase and Use of Complex Healthcare Technology
With a recognition of the increasing complexity of modern medicine – and all the challenges that go with that – the AAMI Foundation is poised to launch its newest patient safety initiative: building a repository of best practices to guide health care facilities and clinicians in the procurement and use of medical devices and healthcare technology.
The Foundation is assembling a diverse group of experts to serve on the National Coalition to Promote the Safe Use of Complex Healthcare Technology, which kicks off April 12-13 in Annapolis, Maryland.
Given the inherent risks involved in using complex technologies to diagnose, monitor, and treat patients, the primary goal of the coalition is to build a repository of best practices that addresses:
• Selecting and purchasing complex technology
• Educating and training clinical users of healthcare technology
• Assessing proficiency of use
Those best practices will apply across care settings and units, as well as device types and brands. This will be the Foundation’s fifth patient safety initiative.
“We believe that bringing the right people together from across the health care and medical device community is the best way to address the complicated challenges that hospitals and clinicians face today,” said Marilyn Neder Flack, executive director of the AAMI Foundation and senior vice president of patient safety initiatives at AAMI. “All stakeholders should join this effort because as devices become increasingly complex, the probability that clinicians will lack some vital knowledge of when, why, or how to use these products with patients grows, and positive patient outcomes are at risk.”
Healthcare technology management professionals interested in learning more or sharing best practices from their hospitals can contact Jim Piepenbrink, the AAMI Foundation’s deputy executive director, at firstname.lastname@example.org.
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