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International Physician Update
| HOSPITAL MANAGEMENT |
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| NOVEMBER 2002 |
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The Art of Buying Medical Equipment
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| Medical equipment purchasing experts Rick Kruelle, left, and John Sdanowich. |
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Johns Hopkins Hospital’s John Sdanowich and Rick Kruelle have years of experience in the ever-changing world of capital equipment purchasing. The key to their success? In a word, teamwork.
“Often, the decision to purchase is strictly clinical and this leads to conflicts because the financial, business, or legal components are left behind,” explains Sdanowich, an administrator in the Department of Radiology.
“A health system team should be unanimous in its desire to make the best decision in the interest of the whole system. The only competition that exists should be between vendors and their competitors in the marketplace.”
Kruelle, assistant director of corporate purchasing for the Johns Hopkins Health System, recommends that a purchasing team include the following: a rotating clinical member who can bring in department specialists as needed, a permanent financial member in charge of administering all capital equipment, a permanent member of the legal staff, and an experienced senior buyer skilled in capital procurement, leases and outside services. The editors of International Physician Update recently met with Sdanowich and Kruelle to discuss some of the issues hospital administrators face when purchasing medical equipment.
Question: In your experience, what are the common mistakes health systems make when purchasing medical equipment?
Sdanowich: The purchase of medical equipment requires clinical, financial, business and legal expertise. Often, the health system approaches the purchase without taking into account one of these areas of expertise. For example, if the purchasing decision is made from only the clinical perspective, and not the legal, business or financial views, then the result almost always fails.
Kruelle: That’s why we always recommend a team approach in which experts in these four areas work together to ensure that the decisions made are in the best interests of the entire organization. It’s also very important to create a purchasing system that is standard and cost-efficient.
Question: What are the advantages of integrating this multi-disciplinary team?
Kruelle: The team serves as a point of contact for the evaluation of all purchases. When there is a centralized unit with knowledge about the details of the entire system, the institution’s negotiating power is greatly increased. Having a multi-disciplinary central point of contact with final authority over decisions can eliminate a lot of frustrations. Also, working in a coordinated way can significantly shorten the time it takes to negotiate and sign off on these purchases.
Sdanowich: The central purchasing team also examines other equally important aspects, such as the life of the equipment, institutional standardization, return on investment, the minutiae of contracting, and whether technical assistance, services and training, are needed.
Question: Today, many health systems are under great pressures to contain costs. Any advice?
Sdanowich: Asset management is a key to maximizing investments that have already been made on behalf of the institution. This means that we know what we have, where it is, and how it is being used. A lot of money can be saved by maximizing equipment we already have.
Kruelle: In large-scale projects or in a new hospital, it is vitally important to define, at the earliest possible time, the clinical services that will be offered, as well as data on how much each piece of equipment will be utilized. A global vision of institutional needs can help create great savings. There are times when one piece of equipment can be used by two different departments or clinical teams. In other cases, we’ve found that some departments request equipment that is too expensive compared to its projected use.
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