Another would be items that are simply so low-risk that there would be next to no risk for an incident if they failed, such as thermometers, fingertip oximeters, otoscopes, etc. These are “low-hanging fruit” items, simply due to freeing up resources that would otherwise be spent performing the preventive maintenance. Less obvious candidates are devices that might undergo undue stress with repeated preventive maintenance or devices that have part of their scheduled maintenance already performed by other hospital staff during regular, documented rounding. These devices differ between hospitals but can include devices such as gas machines or defibrillators.

Prohibited items include imaging/radiology equipment (used for diagnostic or therapeutic purposes), medical laser devices, new equipment, and critical equipment. Equipment maintenance must also comply with any other state or federal agency laws. If one of these governing bodies requires maintenance according to manufacturer's recommendation it must be followed, even if an AEM is allowed under CMS guidelines.

HCB News: When successful, what benefits does AEM bring to maintenance?
SK: If implemented effectively and correctly an AEM program can lead to cost savings through reduced equipment downtime and more effective resource management. It also gives the department and care facility a standard approach to measuring and mitigating risk. An AEM can also prolong the life of an asset and prevent failures if done successfully.

If a manufacturer's procedure calls for having something like a gasket or filter removed, inspected, cleaned, and replaced on a regular basis, that handling could shorten the lifespan of that component significantly. Altering the procedure to remove that task, or reduce the frequency with which it takes place, could maintain the integrity of the part and reduce the number of times it, and the device, fails. It also shows a level of involvement that goes beyond the manufacturer. Developing an AEM program should take into consideration the manufacturer's maintenance recommendations and layer on top another level of objective data on how the device handles all the real-world interactions in a hospital environment. Coupled with a regular review it solidifies the focus on maintaining the highest possible level of safety for patients and staff.

HCB News: Can HTM departments implement AEM policies developed at other hospitals?
SK: In short, yes. Policies can be adopted from other organizations, either hospitals or third party healthcare support organizations. The decision to place something on an AEM can only be adopted from other hospitals by sharing the underlying data that supports the AEM. It's not enough to say "hospital X does an AEM on these, so we are too," you have to be able to have the information on hand that shows your due diligence in assessing the risk mitigation and decision to apply maintenance procedures or frequency in a way that differs from manufacturer's recommendation. This is a space where professional organizations like the NCBA can provide incredible opportunity, helping facilitate the discussion and exchange of ideas and information that can help biomed and HTM leaders make confident decisions quicker than if they were left to their individual healthcare facility's data and expertise.

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