benchmarking biomedical

BENCHMARKING BIOMEDICAL Patriick Lynch plync

Patrick K. Lynch, CCE, CBET

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April 5, 2009MD Expo (www.mdpublishing.com)Phoenix, AZ

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WHY BENCHMARK?

Administration

Patrick L

Prove the value of a departmentcompare to others in your network

Lynch plynch@compare to others in your networkidentify areas for future improvement

Self-assessment

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Self assessmentInternal means for Clinical Engineering to evaluate to others in the field.evaluate to others in the field.

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WHY BENCHMARK? (2)

StaffingProvides an alternative to the old FTE Model

Patrick LProvides an alternative to the old FTE Model

Job Securityd t t d t di f hi h l l

Lynch plynch@

demonstrates understanding of higher level metrics and control of your responsibilities

Pay

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PayValue of more productive employees and operationsoperations. 8

WHO NEEDSTOTOBENCHMARK?

SizeUnder 100 beds100 300 b d? 100 to 300 beds300 to 500 beds500 l b d

Patrick L

500 plus beds

Metro / Rural

Lynch plynch@

Metro / RuralLarge CitySmall city

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Small cityRuralCritical AccessCritical AccessDistance to city of 500,000?

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WHO NEEDSTO

TeachingTOBENCHMARK? (2)

eac gUniversityMedical Schoolnon teaching(2) non-teaching

SystemSIngle hospital

Patrick L

SIngle hospital plus outpatientMultiple hospitals locallyMultiple hospitals, multiple cities

Lynch plynch@Multiple hospitals, multiple citiesSpecialty vs. general hospital

CardiacChild '

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Children'sSurgicalCancerPsych 10

WHO NEEDS TOBENCHMARK? BENCHMARK? (3)

Private vs. publicVeteransPrivate

Patrick LPrivate

County

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THINGS TO CONSIDER

Costcost of biomed program

Customer Satisfactionuptime

Patrick Luptime

incidentsoverall satisfaction

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customersclinical departmentsadministration

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administrationother support departmentsrisk management

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THINGS TO CONSIDER (2)( )

Regulatory Compliance

V l Add dValue Addeduser training

annual required

Patrick L

new employeerefresher operator

special projects

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building / expansiondisaster plans

committees

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EOCInfection ControlCapital EquipmentCapital Equipment

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WHAT TO MEASURE

# of Beds# of Surgeries# of Rad Rooms

Patrick L

# of ICU Beds# of monitored beds

Lynch plynch@

# of medical devicesAdjusted DischargesValue of Equipment

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Value of EquipmentCost of OperationsUptimeUptime

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WHAT TO MEASURE (2)( )

Failure rateFailure rate

# of workorders# of PM workorders

% ti

Patrick L

% on time# of Corrective Workorders# closed

Lynch plynch@

% closed

hospital demographicsSquare Footage

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q ggeographyservicespublic/privatepublic/privateurban/rural

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THE MAIN PROBLEMS

1 We are all different.1. We are all different.2. We ask for information that does not exist.3 We haven’t decided what metrics matter

Patrick L3. We haven t decided what metrics matter.

4. We haven’t decided what is the definition of:

Lynch plynch@of:Unacceptable

Poor

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AdequateGood

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PROBLEMS

Scope of servicesAnesthesiaLaboratoryImaging

Patrick Lg g

CTMRINuclear Medicine

Lynch plynch@Nuclear MedicinePETRadiation TherapyUltrasound

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UltrasoundDialysisSterilizers

C llNurse Call 17

PROBLEMS (2)( )

WhWhereLocation in the US is often cited as a complicator

Patrick L

Contract or in-house

Geography - city or widespread

Leader - BMET, engineer,

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business

Reporting StructureIT

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AdministrationFacilities

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PROBLEMS (3)( )

Data AvailabilityCost of equipment not Cost of equipment not recordedDocumentation of

Patrick L

Biomedical Activities not recorded

easy if all costs are in

Lynch plynch@ya single budget or a single contract

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OTHER THOUGHTS/ FACTORS

Length of time department in businessg pCompare costs to other industriesChargeback Structure

Patrick L

Length of time manager in placeCMMS

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TRADITIONAL BENCHMARK CALCULATIONS:P

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S iTHE ANSWER

Service

Patri

Value

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Ratio

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SERVICE VALUE RATIO

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SERVICE VALUE RATIO

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SERVICE VALUE RATIO IN ACTION

FOR A SINGLE ITEM OF EQUIPMENT

Cost of CT Scanner - $1,000,000Annual Service Contract - $150 000

PatriAnnual Service Contract $150,000

SVR = $150,000/$1,000,000 = 15%

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SERVICE VALUE RATIO IN ACTION

FOR A SINGLE ITEM OF EQUIPMENT

Cost of CT Scanner - $1,000,000Annual Service Contract - $150 000

PatriAnnual Service Contract $150,000

SVR = $150,000/$1,000,000 = 15%

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Cost of a thermometer - $400.00Annual cost of all maintenance = $35 00 m

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Annual cost of all maintenance $35.00 SVR = $35 / $400 = 8.75%

SERVICE VALUE RATIO IN ACTION

FOR A SINGLE DEPARTMENT

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Cost of Equipment in Central Supply - $290,000Annual cost of Maintenance - $20,000

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SVR = $20,000/190,000 = 6.90%

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SERVICE VALUE RATIO IN ACTION

FOR A SINGLE CONTRACT

Patri

Cost of Anesthesia Machines = $3,600,000

ick Lynch plyncCost of Anesthesia Machines $3,600,000Cost of Annual Service Contract = $432,000SVR = $432,000/$3,600,000 = 12%

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SERVICE VALUE RATIO IN ACTION

FOR A SINGLE HOSPITAL

Patri

Cost of Equipment = $113,000,000

ick Lynch plyncq pAnnual Biomedical Budget = $5,200,000SVR = $5,200,000/$113,000,000 = 5.13%

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SERVICE VALUE RATIO IN ACTION

FOR A SINGLE VENDOR

Cost of Equipment (Patient Beds) = $12 000 000

PatriCost of Equipment (Patient Beds) = $12,000,000

Annual costs from HillRom (contract + PM + parts) = $2,220,000

ick Lynch plync

SVR = $2,200,000/$12,000,000 = 18.5%

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SERVICE VALUE RATIO IN ACTION

FOR A SINGLE TYPE OF EQUIPMENT

Patri

Cost of all Infusion Pumps = $2,400,000$

ick Lynch plync

Annual sum of Maintenance costs = $264,000SVR = $264,000/$2,400,000 = 11%

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SERVICE VALUE RATIO

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THE MAIN PROBLEMS ANSWERED

1. We are all different. Use Metric that adjusts for variables.

2. We ask for information that does not exist. Use a Metric that uses FEW, easily accessible

Patrick L, y

numbers.3. We haven’t decided what metrics matter.

Always $$$$$$$$$$$

Lynch plynch@Always $$$$$$$$$$$4. We haven’t decided what is the definition of:

Unacceptable SVR greater than 15%Poor SVR greater than 12%

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Poor SVR greater than 12%Adequate SVR less than 12%

Good SVR less than 8%E ll t SVR l th 6%Excellent SVR less than 6% 33

ADVANTAGESAutomatically adjusts for differences in size, scope, contracts, outsourced.

E il ibl b f iliEasily accessible by any facility

Scalable - it applies and compares . . . single item

Item List priceItem Annual cost

single manufacturerManufacturer List PriceManufacturer Annual Cost

Patrick L

single equipment typeEquipment Type List PriceEquipment Type Annual Cost

single department

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single departmentDepartment Equipment List PriceDepartment Annual Cost

single hospitalHospital Equipment List Price

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Hospital Equipment List PriceHospital Annual Cost

single systemSystem Equipment List PriceS A l CSystem Annual Cost 34

1) LIST PRICE OF ALL ASSETS MAINTAINED

Start with estimates and get more specific over time

A li f

Patrick L

Average list of every asset$12,000

Average list of each type

Lynch plynch@Average list of each typeInfusion Pump - $5,000

Specific list of each model

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Specific list of each modelAlaris - $7,000Abbott - $4,000

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2) ANNUAL COST OF MAINTAINING ALL ASSETS)

I l d ALL COSTSInclude ALL COSTS

Include PM, repair, overhead, etc.

Examples-

Patrick L

LaborBenefitsTraining

Lynch plynch@gOn-callTest EquipmentCalibrations

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CalibrationsOutside LaborOutside partsService ContractsService ContractsSecretarial and supervisory costs

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DISADVANTAGES

Examines only costs

Patrick LExamines only costs

Simplicity may cause it to be rejected by

Lynch plynch@it to be rejected by some

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RESULTSP

atrick L

12% 20% M f t C t t

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12% - 20% - Manufacturer Contract9% - 15% - 3rd Party Contract

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8% - 12% - Outsourced In-house4% - 8% - In-house programsp g

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THE NEXT STEPWrite a paper defining Write a paper defining the process.Conduct comparative Conduct comparative studies to validate the methodology.

Patrick Lt e et odology.

Make adjustments as necessary.

Lynch plynch@yPromote to Biomedical field.

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Develop additional metrics for customer satisfaction, etc. 39

SERVICE VALUE RATIO

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MAIN TOPIC Patriick Lynch plyncch@

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A REAL-LIFE EXAMPLE OF THE USE OF SVR TO ANALYZE A GROUP OF EQUIPMENT

Patrick L

Let’s examine all of our

Lynch plynch@Let s examine all of our Warming Blankets to see if we have any lemons. . .

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we have any lemons. . .

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MAIN TOPIC Patriick Lynch plyncch@

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