“Get to the clinical side” was the sales motto of a company where I once did business. It served as a reminder to salespeople that physicians and nurses are responsible for making most of the product decisions in hospitals. The motto reminded salespeople that if they wanted to be more effective, they should spend less time talking to members of the biomedical and purchasing staffs and more time attempting to influence physicians and nurses in the clinical areas of the hospital.
Members of the purchasing and biomedical engineering departments frequently complain that that the doctors and nurses always seem to get the products they want, and that they are often bypassed in the equipment selection process. Those who complain must remember that physicians and nurses are responsible for outlining the courses of treatment and assuring the best possible outcomes for their patients. Within their specialties, they are the best people to make equipment decisions. For example, neonatologists and NICU nurse specialists are the most appropriate people to decide which infusion pumps are best suited for use on premature infants.
Allowing people to choose the devices that enable them to do their best work is not new. We would not expect the equipment manager of a major league baseball team to decide which bat or glove each ballplayer should use because we know that a player’s peak performance depends on their bats or gloves feeling just right for them. Professional golfers and tennis players would never allow someone else to choose the brand or model of clubs and racquets they use. While we accept that athletes should be allowed to select their own equipment, we seem unwilling to give physicians and nurses the same freedom. We need to remember that athletes only have to worry about winning or losing games while physicians and nurses must worry about losing human lives.
Accepting the premise that physicians and nurses have the right to select the equipment that best suits their needs does not mean that the biomedical and purchasing departments should not be involved in the selection process. There are still important roles they can play. Biomedical departments can assist physicians and nurses by helping them validate their choices. They can use their networking abilities to communicate with other hospitals to find reliability data, user error rates, and background information on equipment quality and factory support. They can provide bench testing to measure the device’s performance against the manufacturer’s written specifications. For example; with infusion pumps they can test battery life, accuracy, and resolution of flow at various flow rates. Purchasing personnel can provide important budgeting information relative to price, accessories and cost of ownership. The ultimate decision however will always be on “the clinical side” in the hands of the clinicians who use the devices.
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