Consequentially yours

Jan. 24, 2023

Many of us favor and prefer choice. Those of us who don’t, either find comfort in being told what to do, or simply don’t want the hassle of making decisions that interfere with whatever else interests us.

However, the privilege (or right in some cases) of choice, as well as the compliance to edict, lead to a similar outcome: Consequences. Whether we make a choice or a choice is made for us, we must deal with the consequences – good or bad, attractive or ugly, healthy or sick.

Healthcare workers, managers and leaders deal with choices daily that result in administrative, clinical, financial and operational repercussions. Whether it’s to offer, continue or cease a clinical service line; whether it’s to hire, lay off or fire a person or product- or service-related business; whether it’s to contract with this supplier or vendor or another; whether it’s to pursue diversity, equity, sustainability; whether it’s to invest in reusable or disposable/single-use only products; whether it’s to work with original equipment manufacturers (OEMs) or third-party independent service organizations (ISOs) to maintain and repair costly devices and equipment. All those decisions bear consequences.

Healthcare Purchasing News has explored the reusable vs. disposable and the OEM vs. ISO debates for decades, acknowledging the controversies, passions, personalities and points of view of proponents and opponents of either “side.” Where choice may be preferred and demanded, accountability and responsibility must be accepted.

Healthcare organizations can, do and should have the choice to invest in reusable and/or disposable/single-use only items. They can, do and should have the choice to contract with OEMs and/or ISOs for maintenance and repair of costly devices and equipment.

But adjustments must be made to budgets, processes, strategies, tactics and techniques. Disposables affect the waste stream; reusables involve sterile processing, maintenance and repair cycles. OEMs intimately know how to maintain and repair their own devices and equipment; ISOs offer similar quality services with a caveat … the customer understands that the OEM may/will void any warranty on a product on which service is performed by an unauthorized third party. OEMs don’t want to be liable for a product serviced by someone else that may not function properly and that may lead to patient harm.

Most everyone agrees that one incident – patient harm/injury stemming from malfunction or misdiagnosis (including missed diagnosis) – is too many.

Amid all the clinical, corporate, legislative and regulatory clamor, three tenets may make a difference.

Limited access. OEM-authorized, certified and contracted ISOs should be granted access to sections of product manuals so that they can provide necessary repairs when and where the OEM cannot or will not for whatever reason. In this regard, the approved ISO partner functions like a physician assistant or nurse practitioner – patient-treating “subcontractors” in retail outlets. Think of it as choosing between the car dealership for an oil change or a lube shop franchise. But OEMs should not be forced by government decree to “open source” their product manuals for all ISOs any more than Coca-Cola should be coerced to share its soft drink formula with beverage distributors.

Universal quality. The application of quality service and system standards should apply to all OEMs and all ISOs alike. Everyone who wants to participate in the maintenance and repair game should be able to play, but by the same rules and standards for complete or component service.

Responsible liability. If an OEM or an OEM-endorsed ISO is determined to be responsible for some problem, then either or both should be held accountable. If an ISO not affiliated with or endorsed by an OEM is found to be responsible for some problem, then that ISO alone should be held accountable. This will prevent capital budgets from being diverted to legal expenses.

If this issue truly revolves around patient safety, then it’s paramount for clinical and corporate common ground on quality – not conundrum – to be achieved. 

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