New Equipment Maintenance Rules Will Require More Hospital Time, Money and Staff
By Stephen Grimes
New regulations and standards for medical equipment maintenance were recently announced by the Joint Commission (TJC), aligning TJC’s accreditation standards with updated regulations from the Centers for Medicare and Medicaid Services (CMS) issued on December 20, 2013. The new regulations mandate substantial changes in the ways most hospitals conduct medical equipment maintenance – and these new requirements mean administrators will spend considerably more time, money and staff to maintain their medical equipment.
To ensure compliance, hospital administrators must, among other steps, overhaul their medical equipment maintenance plans, compile full inventories, follow manufacturer maintenance recommendations to the letter, identify high-risk equipment, revise their policies and procedures and closely monitor the credentials of those who maintain the equipment.
Not only will compliance likely mean more financial expenditures to maintain medical
equipment, it will also require more attention and time from the individuals tasked with maintenance, compliance and record-keeping. In short, the new standards will require immediate attention from hospital leaders and more money, time and personnel dedicated to the medical equipment maintenance process.
Until these latest regulations were implemented, hospitals were given a great deal of flexibility in their medical equipment maintenance practices. During the past 25 years, TJC and CMS permitted hospitals to use a popular, risk-based approach, enabling administrators to streamline scheduled maintenance and minimize associated costs so long as patient and staff safety were not compromised.
This approach encouraged hospitals to focus scheduled maintenance primarily on the most critical medical equipment whose service histories provided evidence that replacing worn components and maintaining regular testing was effective combating equipment failure. Many hospitals were able to reduce or eliminate scheduled maintenance for low risk equipment when service history evidence showed little or no benefit from the more extensive maintenance.
For more than two decades, this evidence-based approach allowed hospitals to focus their limited resources on medical equipment maintenance issues that had the greatest effect on patient safety and care. Under the new regulations, hundreds to thousands of additional pieces of medical equipment will be added to hospital inventories, with administrators required to track and ensure that manufacturers’ recommended maintenance procedures are followed.
Hospital leaders must ensure that their existing clinical engineering services – whether in-house or contracted through a vendor such as ABM Healthcare Support Services – have sufficient expertise and personnel to develop and implement an aggressive and complex compliance plan.
Also worth noting is that even when equipment is serviced by the manufacturer, evidence suggests that those manufacturers often do not follow their own published recommendations, primarily because those recommendations are based on worst-case environments not applicable to most hospitals. Until manufacturers provide more nuanced maintenance recommendations, hospitals will be required to comply and ensure that maintenance strictly abides by the published recommendations.
Compliance with these new standards will require considerably more time, money and human resources than what hospitals typically spend on medical equipment maintenance, but the new regulations must be addressed. Hospital leaders, compliance officers and risk managers must be kept informed about these new requirements. They need to understand the issue and work with those responsible for medical equipment management in their organizations to ensure they develop a robust plan to achieve and maintain compliance.
Stephen L Grimes, FACCE FHIMSS FAIMBE is Chief Technology Officer of ABM Healthcare Support Services.