TechNation reached out to industry professionals to find the latest information regarding sterilizers. The basic concept for sterilization has not changed too much over the years, however new technology has impacted the controls and capabilities of these devices.
Mediquip Parts Plus Inc. Vice President David French, Honor Health Biomedical Equipment Technician Chris Mrazek and Prohealth Care Senior Biomed Tech Steve Pries shared their insights on these valuable medical devices. Also participating in this roundtable on sterilizers is a trio of professionals from BayCare Health System in Regional Manager J.R. Richardson, Field Service Specialist-Sterilization Christopher Wilson and Field Service Specialist-Sterilization Germaine Kinder.
Q: What are the latest advances in sterilizers?
BayCare: Today’s sterilization equipment, similar to most medical equipment devices today, now have the capability to network to an event management database through the hospital network. Where in the past cybersecurity concerns were exempt from sterilization equipment, this is no longer the case. Additionally, today’s technology provides more options as it relates to the number and types of cycles provided by the sterilization equipment.
French: Sterilization time and load sizes. Quicker cycles and bigger loads. Traceability and remote monitoring are improving.
Mrazek: Over the last few decades, there have been major advancements in that just the doors alone have undergone major upgrades from manual locking to pneumatic and hydraulic doors. Now, we can even have the units hooked up to a computer system to follow the loads from OR to the sterilizers. Manufacturers can even log into systems to do remote diagnostics for reduced downtimes.
Pries: While the basic sterilization process remains the same, the addition of more sensors and the increasing sophistication of the programming have made this equipment more efficient and more foolproof from a user perspective. There also continues to be a steady increase in the use of low-temperature sterilization, such as hydrogen peroxide.
Q: Has new technology and/or cybersecurity concerns impacted sterilizers? If yes, how?
BayCare: Yes. The latest sterilization equipment in the market today will connect to your network and provide alerts as well as cycle count data. Now that the sterilizer/washer connects to the network, the same cybersecurity concerns apply as they do with any other medical device.
French: Anytime you have remote access there are concerns.
Mrazek: There is always a risk, but as long as IT has a good firewall there should be no problems.
Pries: Regarding cybersecurity, most sterilization equipment now has the ability to be connected to the net. However, this also opens the equipment up to cyber-attack, so adequate protections must first be put in to place. Our sterilization equipment is intentionally not connected to the net, so cyber-attack is not a concern. The only exception we have made are the scope washers, which are quite complex, and require frequent remote troubleshooting by the vendor. New technology would mainly pertain to the addition of an ever increasing number of sensors within the equipment, as well as the increasing sophistication of the controls and programs that run these units. These additions are meant to make the equipment as foolproof as possible for the user. However, the downside is that it also leads to more frequent problems.
Q: What are the pros and cons of buying brand new versus buying refurbished sterilizers?
BayCare: Sterilization equipment consumers today primarily look for improved efficiency or productivity, when selecting new equipment. Although there may be other determining factors, the following attributes are the most common for sterilization equipment consumers: efficiency/throughput (Can we increase our productivity?), cost, chamber size, standardization and utility requirements. If the refurbished systems are competitive in these areas, or if cost containment becomes the number one emphasis of the facility, then buying a refurbished unit may make sense.
French: Everything is about quality and will the company stand behind their product. Price is important, but with new or refurbished equipment if the quality is not there the price makes no difference.
Mrazek: Always depends on the facility; for small rural hospitals and outpatient surgery centers refurbished is always the better option for cost effectiveness. Hospitals, I would suggest, should always buy new for the latest and greatest software and warranties – not to mention longer lifespan.
Pries: Unless the budget is really tight, we will always opt for a new unit, rather than a refurbished unit. Our experience with refurbished units, whether from the OEM or a third party, has generally been negative. The OEM will stand behind their equipment, whether new or used. Third-party refurbished units are generally lower cost, but we have had problems with warranty coverage, and have also had quality problems with the refurbishing that was done. While buying a new unit is initially more costly, we believe it pays for itself with far fewer breakdowns and a much longer lifespan.
Q: How can a facility with a limited budget meet its sterilizer needs?
BayCare: Facilities with a limited budget may be able to meet their sterilization needs by either using more disposable inventory that do not require sterilization, using centralized sterilization methods or sub-contract the facility’s sterilization needs.
French: Refurbished sterilizers are less expensive than new. A facility must do their due diligence when selecting a refurbishing company. Know what questions to ask.
Mrazek: This, again, goes back to new or refurbished? How big of a unit is needed? How much are they sterilizing? Places on limited budgets have many options such as used or refurbished units. There are lots of companies out there offering sterilizers and washers rebuilt at half the cost of new.
Pries: When there is a limited budget, this usually means refurbished equipment will be purchased from a third party or the OEM. This may be cheaper in the short run, but our experience is that it usually costs us big in the long run – both in repair costs and shorter equipment lifespan. If at all possible, first choice is to purchase new from the OEM, second choice is refurbished from the OEM and third choice is refurbished from a third party.
Q: What are the most important things to look for when deciding to use in-house or external service providers?
BayCare: Cost of service, response time and historical uptime statistics from the OEM/vendor.
French: Qualifications first and price second.
Mrazek: Always up front costs. In-house repairs will cost the hospital an extra FTE, but reduces downtime and costly contracts.
Pries: You must do a very careful cost comparison between a vendor contract and the cost of having someone in-house. The vendor contract needs to be gone over thoroughly to verify what is actually being covered. There are always exclusions that can be very costly and are not always spelled out. If you have enough equipment, it can be very cost effective to do it in-house. However, you must take into account the cost of training, having adequate parts on hand and whether you are going to train a second person as a backup or call in the OEM when your in-house person is not available. Also, be aware that some OEMs are trying to discourage having in-house people through two methods. First, by raising the cost of parts sky high. Second, by saying that the training is only good for a certain number of years. After that, you must take another test. If you fail, you must be retrained, which is always costly.
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