Infection
Connection
SPDs demand more from repair, maintenance service providers
by
Julie E. Williamson
When it comes to maintaining and repairing instruments, sterile processing departments are becoming increasingly proactive and willing to explore a range of options in an effort to increase device effectiveness, sustain inventories and curb unnecessary expenses.
That should come as no surprise given the lofty price tags of surgical instrument trays, which can run as high as $20,000 or more, and the fact that replacing even one instrument can easily run several hundred dollars. Add to that increasingly tight budgets and stringent requirements from operating room staff and it becomes clear why so many central service departments are taking a more active interest in pre-ventive maintenance programs.
CS departments aren’t shy about their needs, either. Regardless of the service route they take – be it from mobile repair companies, original equipment manufacturers, freestanding repair facilities or even a hospital’s own biomedical and engineering department – today’s SPDs demand faster turnaround times, extended hours of operation and more specialized instrument care options. Eager for business in a competitive market, repair and maintenance service providers are working hard to meet those demands, sources told
Healthcare Purchasing News.
“Customers are asking for more because they have to be able to meet the needs of their facilities,” said Alex Vrancich, general manager, Spectrum Surgical Instruments, Stowe, OH. “Because the customer is controlling the market, companies are realizing that if they fail to meet customer needs, they will lose business to a competitor that will. It’s that healthy competition that has ultimately led to even greater services for the customer.”
Mobilizing maintenance
To generate added efficiency and convenience, a growing number of central service departments are seeking the services of quality mobile repair and maintenance companies.
The Cleveland Clinic Foundation, for example, recently awarded a contract with a repair company that offers both on- and offsite service and handles approximately 90 percent of repairs for the 13-hospital system. According to Richard Schule, surgical processing manager for the Cleveland Clinic, the health system expects approximately 20 percent savings and along the way is also “turning more instrument trays.”
Not only can mobile providers handle routine repair and maintenance requests quickly and
cost-effectively, they can also help eliminate the hassle of shipping items to the OEM or a remote, stationary facility operated by an independent servicer. Unlike years ago when many healthcare facilities avoided mobile repair companies for fear of poor quality and limited service, today’s CS departments are enjoying the freedom the mobile operations allow and finding that quality and levels of service are exceeding their expectations.
They are also finding some companies that perform mobile repairs are upgrading their service capabilities. Although a substantial portion of the mobile market still revolves around routine preventive maintenance, such as sharpening and adjusting of scissors, knives, bone cutters and other commonly used surgical instruments, some companies are ramping up their offerings by deploying larger, better equipped service vans that can accommodate more equipment and tackle jobs once reserved for full-blown repair facilities.
Mobile Instrument Service and Repair Inc., which is based in Bellefontaine, OH, northwest of Columbus, features state-of-the-art mobile service “labs” that can tackle minor scope repairs, for instance. The company anticipates that within a few years, it will have the capability of onsite repairs and reinsulation of 5mm and 10mm laparoscopic instruments.
“It’s a difficult myth to dispel, but mobile services are no longer just about sharpening instruments,” said Beverly Young, Mobile Instrument’s marketing manager. “More fully extensive [service vehicles] have brought greater repair and maintenance options, which is really helping to change the landscape of the business.”
The surge in volume of minimally invasive surgical procedures has also driven the onsite repair and maintenance market. According to Toby Lees, vice president of marketing and business development for Cardinal Health’s Equipment Management Services, McGaw Park, IL, facilities have “a greater need to manage those instruments” and appreciate companies that can provide onsite service and preclude the necessity for sending out some of these devices. Cardinal’s OnSite service provides inspection and repair of a broad range of instruments, from the most basic surgical tools to advanced microsurgical and laparoscopic instruments.
SPDs can also expect onsite repairs and maintenance of needleholders and orthopedic hand tools — items frequently excluded from mobile servicing in the past, added Spectrum’s
Vrancich.
“All companies that offer onsite service should now be doing needleholders on location,” he said, adding that vehicle size and space restrictions are no longer acceptable excuses for not providing the service. “The customers have spoken and expressed a need, so companies need to be meeting that need. The same can be said for orthopedic hand tools. Because there are a lot of sharp edges involved, these items should be serviced regularly – and should be able to be done so onsite.” Larger, more complicated items such as power equipment typically must be serviced at the repair facility, however.
Further, many companies offering onsite services are extending their hours of operation to better meet their customers’ demands. Spectrum’s onsite and mobile repair labs now operate seven days a week, and the company has added more service assistants in the regional market to help pick up and deliver instruments.
“Gone are the days of bread truck routes where trucks come only at a set time and date every month,” Vrancich explained. “Increased service has been driven out of necessity because hospitals are doing more cases than in the past and need their instrumentation turned around more frequently – and quickly.”
Items that require more specialized repairs and must be sent out to service centers are also getting extra attention with speedy turnaround times and substantial cost savings. Mobile Instrument, for example, offers a two- to four-day turnaround on items sent to their main repair labs. What’s more, the company says its customers can expect to save between 50 percent and 75 percent over replacement costs, which are substantially less than OEM prices. According to Young, flexible scope repairs performed by Mobile Instrument Service cost $3,600 on average, versus $7,000 from an OEM.
“Even scopes deemed ‘non-repairable’ by OEMs and some other third party repair companies can many times be fixed,” she continued, adding that more than 90 percent of such scopes sent to Mobile Instrument are repairable.
Making the most of warranties
Although many CS departments are using third-party repair and maintenance companies, that doesn’t mean they are tossing OEMs aside completely. Despite some common complaints, such as slower service, many hospitals still find equipment manufacturers useful for repairing items under warranty.
Anderson Hospital, Maryville, IL, sends virtually every instrument to Aesculap, the hospital’s primary instrument vendor. According to sterile processing manager Lisa Huber, the service has worked well, even though items have to be sent out for repair.
“They come every Friday to pick up our instruments. They do the repairs in St. Louis over the weekend and then have them back to us Monday morning, so the turnaround time is pretty good,” she said.
Some large healthcare organizations, such as Intermountain Health Care, a big integrated delivery network based in Salt Lake City, have enormous volume and so tap into nearly all available repair and preventive maintenance options. The six-hospital system prefers to have its own in-house clinical engineers maintain and repair equipment such as tables and warming cabinets, but uses OEMs for almost every item under warranty. To help offset repair and maintenance fees, the organization has also been creative with its requests to OEMs at the time of purchase. For arthroscopy items, for example, IHC negotiated a deal with the primary vendor to perform all minor repairs free of charge. IHC has even been known to negotiate OEM training programs for its engineers and request repair maintenance manuals so some maintenance service can be performed in-house.
“It really is a partnership, so it’s give and take. They work with us and we work with them, and that works quite well for us here,” said Bruce Bird, manager of central processing and IHC’s Urban Central Region Hospital. IHC also inks service contracts with the OEM for more specialized equipment, such as lasers.
For non-warrantied items, the health system commonly uses third-party repair facilities. Bird said scopes are sent out for repairs to a local repair company, while more routine instrument repairs and preventive maintenance needs are handled by a smaller local third-party company that offers mobile service.
“Our in-house [team] does not do preventative maintenance on handheld instruments, so we contracted with a company that could do the work onsite and handle more volume,” he noted, adding that the bulk of IHC’s general instruments are manufactured by Pilling Surgical, Horsham, PA, and that the third-party repair company was trained by the manufacturer.
Value-added service
While quality and price are the primary considerations when sorting out repair options, sources agreed that those points often aren’t enough to capture a healthcare facility’s business. Today’s sterile processing departments are often just as interested in a service provider’s educational offerings with an eye toward helping staff do a better job of managing their instrumentation and detecting small problems before they become larger, more costly ones.
One CS manager in the Midwest admitted her facility is “falling short” on preventive maintenance and frequently sees worn needleholders and scissors that cut poorly. Although the hospital does contract with a repair facility, she said the facility is stuck in a rut of only sending instruments out that require immediate – and often extensive – repair.
“We need more help from our repair company to educate our facility on the importance of preventive maintenance and keeping our instruments working properly between service pick-ups,” she said.
Many companies, including both Spectrum Surgical and Mobile Instrument, are filling a need by providing customers free inspections to catch potential problems before they have a chance to grow worse. Some also provide free in-service sessions to educate staff on proper instrument care to keep items working optimally.
“We’ve developed software to log serial numbers and track history,” explains Mobile’s Young. “If we start seeing a negative trend where the same instruments keep coming in for repair, we then we will call and suggest an in-service session to educate staff. Some people may not realize how delicate these instruments are and may be handling them improperly or even using improper sterilization techniques, which can erode them. It’s extremely important to educate staff and help hospitals get the most out of their instrumentation.”
Some companies have taken repair and maintenance a step further by investing in ways of providing more comprehensive equipment management services. Cardinal’s Equipment Management Services, for example, range from simple instrument repairs to the direct maintenance and management of facilities’ surgical equipment. The company has stationed repair specialists within approximately 100 healthcare institutions nationwide to maintain instrumentation. Cardinal works with facilities to determine which type of tray maintenance is required and then actually purchases those instruments and manages the recovery process.
“Customers are asking us to go places we haven’t gone before,” says Cardinal’s Lees. “There’s a [greater emphasis] on preventive maintenance. They want us to do more than repair and we are trying to [respond to] those needs.”
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