Clinical Equipment Life Cycle

Phase III: Disposition

The third and final phase of the equipment life cycle includes all the options for removing a device from a hospital once it is no longer needed. While the goal of proper management and support is to maximize a device’s useful life, at some point, all clinical equipment will reach end of life and need to be retired.

While it is impossible to predict the exact life span of a particular device, there are ways to estimate life expectancy. The American Hospital Organization publishes a guide entitled Estimated Useful Lives of Depreciable Hospital Assets, which can help establish expectations for equipment life. A device may be disposed of because it is exhibiting repetitive failures and repair is no longer a cost-effective option. It may be out of support by the OEM, meaning a hospital can no longer obtain service or parts. Or it may be functioning perfectly, but no longer meets the clinical needs of the facility. Whatever the cause, there are steps to consider to ensure proper disposition.

De-Installation Planning and Coordination

In most cases, when a hospital disposes of one piece of equipment, it replaces it with a new device. This process requires planning to ensure it goes smoothly with minimal down time, especially in the case of more complex equipment. Before any equipment is de-installed, the hospital will have gone through the planning and acquisition stage for replacement equipment (see Phase I of the life cycle).

Repair/Replace Recommendations

Sometimes, malfunctioning equipment costs too much to fix. One of the advantages of having a partner is to help determine the cost-effectiveness of repairing a device versus replacing it. Crothall uses an OTEL (One-Time Expenditure Limit) as a guideline to determine whether the ROI on repairing equipment is sufficient. In addition, Crothall’s TeamTRACE database contains historical data on the thousands of devices we manage, which can help identify a history of problems for a device. Even in cases where repair is included in a service plan, the resulting down time from a recurring problem can reduce revenues for the hospital. And equipment defects can pose safety risks to patients and clinical users.

Decommission & Storage

Retiring a piece of equipment is not as simple as it may seem. For regulatory reasons, there must be documentation showing what happens to equipment that is no longer used. The Joint Commission requires that every device still in service is accounted for and receives preventive maintenance. Any equipment not being serviced must be proven to be decommissioned. Crothall’s TeamTRACE application can keep track of all hospital equipment, whether or not Crothall services it, and produce documentation as needed. In cases where decommissioned equipment is to be stored for potential later use, it should be marked with a notice that Clinical Engineering must inspect it before it can be used.

Resale Market

Decommissioned equipment may still have resale value, even if it is just sold for parts. Crothall’s Technical Resource Center can assist with equipment resale through its many vendor contacts. It can be donated to third-world countries unable to afford new devices. A hospital looking to upgrade its equipment could sell it to a smaller facility or imaging center to help offset the purchase price of the new technology.

Crothall was able to help Adventist Health System find new life for a $950,000 device that was about to be replaced. When Park Ridge Hospital in Fletcher, NC, wanted to upgrade its 8-slice CT to a 64-slice CT unit, it negotiated a trade-in with the OEM. Crothall Regional Manager John Gibson and Unit Manager Rick Padgett realized that fellow Adventist facility Manchester Memorial Hospital in Manchester, KY, was looking to upgrade its single-slice CT at the same time. Crothall coordinated the de-installation and reinstallation of the 8-slice CT over at Manchester, helping Park Ridge offset the cost of its acquisition. The single-slice unit was donated to a clinic in Nepal to help serve the needs of third-world patients.

Park Ridge CFO Kelly Pettijohn appreciates this kind of partnership from a support provider: “Crothall has always been a partner, looking for new ways to improve our processes as well as save money.”

Disposal

Once all avenues have been exhausted, all equipment will eventually be disposed of. Even this relatively straightforward event can benefit from outside expertise. Coordination of recycling, scrap-metal sale, or waste-hauling services requires some knowledge of regulations and process. There is often a better solution to proper equipment disposal than simply tossing everything in the hospital’s dumpster.

Even at the end of equipment’s life, it is useful to have an expert partner to provide guidance. There may still be value in retired equipment, and there are often processes that should be followed to dispose of them properly. Because clinical equipment is part of a cycle, the end of one device means the beginning for a new one. Management and oversight of this continuum is improved with a dependable partner helping every step of the way.