Slashing Biomedical Budgets In 2009

• 1. Survivingcorporatemandatesintherecessionof2009 Patrick K. Lynch, CCE, CBET, MBA Biomedical Support Specialist Global Medical Imaging (GMI)

2. Casualforum. Askquestionsatanytime. Pleaseplaceallphonesandpagesonsilent. Morningandafternoonbreaks,butrefillasneeded. g , Restroomsarelocated... Lunchatnoon,providedbyTroff MedicalServices,p y Weshouldbethroughby4PMatthelatest. 3. HospitalemployedBiomeds ISOemployedBiomeds BiomedrelatedbusinesspeopleAllattendeesareimportant.Pleaseaddtothe discussion. If you see this symbol . . . .Important topic wake up and pay attention 4. Problemsbackatthehospital..... Administrationcutourbudget. Administrationcutourbudget Icannottrainmystaff. MybosswontletmehirestaffIneed.y HowcanIdothesameworkwithlessstaff? Administrationcutouttravel. 5. TheEconomicCrisis HowitaffectsHealthcareandHospitals HowBiomedstypicallyrespondtofinancialpressures andwhythesedonotwork. 10WaystoreduceCosts(presentation) W t d C t ( t ti ) Aspongyapproachtocostanalysis Lessonsfromaroundthecountry RoundTable selfhelpfromattendees 6. CBET CCE 34yearsinBiomed 1st PresofNCBA ActiveincertificationofBMETsandCes MemberofallBiomedAssociations Managedlargeinhouse,ISOandcorporateBiomeds Currently,worksforGMIissalesdevelopment,who sponsorsmyactivities. 7. Understandthetrueseverityofthefinancialcrisis,as 1.relatedtohealthcare. l d h l hUnderstandthetraditionalwaysBiomedshavedealtwith 2.costcuttingdirectivesandwhytheydontwork.gy yIdentifyspecificwaysinmyownfacilitytomakea 3.financialimpact.LearnanewwaytoviewBiomedandthewaywe 4. 4contributetothebottomline.Learnfromcompaniespresenthowtoaffectthebottom 5.line.liLearnfromothersintheaudienceaboutthingsthatwork 6.forthem. 8. Leaveherewithmoretoolsinyourbag thanwhenyouarrivedthismorning. thanwhenyouarrivedthismorning 9. TheEconomicCrisis HowitaffectsHealthcareandHospitals HowBiomedstypicallyrespondtofinancialpressures andwhythesedonotwork. 10WaystoreduceCosts(presentation) Aspongyapproachtocostanalysis Lessonsfromaroundthecountry RoundTable selfhelpfromattendees RdT bl lfh l f d 10. TheEconomicCrisis HowitaffectsHealthcareandHospitals HowBiomedstypicallyrespondtofinancialpressures andwhythesedonotwork. 10WaystoreduceCosts(presentation) Aspongyapproachtocostanalysis Lessonsfromaroundthecountry RoundTable selfhelpfromattendees RdT bl lfh l f d 11. TheEconomicCrisis HowitaffectsHealthcareandHospitals HowBiomedstypicallyrespondtofinancialpressures andwhythesedonotwork. 10WaystoreduceCosts(presentation) Aspongyapproachtocostanalysis Lessonsfromaroundthecountry RoundTable selfhelpfromattendees RdT bl lfh l f d 12. Budget Payroll,TechPayroll,MgmtPayroll MgmtPartsContractsOutsideServiceO t id S iTrainingSubscriptionsmisc 13. Budget Payroll,TechPayroll,MgmtPartsContractsOutsideServiceTrainingSubscriptionsmisc 14. NumberofProductiveHours#ofBMETsxnumberofhours3x1240=3720ProductiveBMETHours(7(70%productivity) py) Costanalysis Salaryx1.25(benefits) 3x$40,000x1.25=$150,000peryear CostPerHourofProductiveBMET Totalcost/totalhours=costperhour T t l t/t t lh t h $150,000/3,720=$40.32perhourPerhourcostincreasesasproductivityincreases.Perhourcostincreasesasmgmt.andsec.costsadded. 15. Includesallpersonsnotturningascrewdriverg Supervisors Secretaries PartsClerks P t Cl k Receptionists Allareviewedbyuppermanagementasmuchmore expendablethantechnicalstaff. Mustbeabletojustifytheirneedverywell. j y y 16. Alwaysneeded. Fewoptions. Expensivepartsmakeabigdifference. CTTubes Cryogens UltrasoundProbesandTEEs Oftenusedpartsmakeabigdifference. PMkits Batteries Leadwires 17. Partscontractscanbeevaluatedforcosteffectiveness. ContractsthatincludelaborarealmostalwaysBAD! C h i l d l b l lBAD! 3Componentsofacontract: Certain(100%)need PMs,PMkits. Certain(100%)need PMs PMkits Unknown(??)need repairs(downsideisalways inflated) UnrelatedextrasClinicalsupportforusersClinicaltraining(forusers)Softwareupgrades Greatestopportunitiesforcostsavings Comparebiomedhourlycoststomanufacturerhourly costs. 18. Itemssentoutforrepair Laborcalledtohospitalforserviceneeds. Usedwhen: Specialtechnicalknowledgeisnotpossessedbyin housestaff. Inhousestaffdoesnothavetimetocompleteallwork. Specialtestequipmentisrequired. Manufacturersarethemostexpensive. Mf h i Oftenlocalshopscanbecosteffective. 19. Notthesameasothertravelinthehospital. TechnicaltrainingisnecessaryforBiomeds tobeable toworkontheequipmentasitcomesoutofwarranty. NOTANOPTION! Biomedmustworkhardtomakeadministrationsee thatBiomedTrainingisnotlikeanursegoingtoa th tBidT i i i tlik i t nursingconference. 20. Travelforanurseorresp techmeansgoingtoan annualconvention.l Iftheydontgoforafewyears,theycanstilltakecare ofpatients. ofpatients IfBiomedsdontgotoschool,theysoonbecome obsolete,andareforcedtoputthingsonexpensive contracts. TrainingforaBiomedmeansacquiringnewskillto savemoney. BiomedtravelandtrainingshouldNOTbeevaluated thesameasotherhospitaltravelandtraining. 21. Travelforanurseorresp techmeansgoingtoan gg annualconvention. Iftheydontgoforafewyears,theycanstillpractice theirprofession.h i f i IfBiomedsdontgotoschool,theysoonbecome obsolete,andareforcedtoputthingsonexpensive obsolete andareforcedtoputthingsonexpensive contracts. BiomedtravelandtrainingshouldNOTbeevaluatedg thesameasotherhospitaltravelandtraining. 22. Travelforanurseorresp techmeansgoingtoan gg annualconvention. Iftheydontgoforafewyears,theycanstillpractice theirprofession.h i f i IfBiomedsdontgotoschool,theysoonbecome obsolete,andareforcedtoputthingsonexpensive obsolete andareforcedtoputthingsonexpensive contracts. BiomedtravelandtrainingshouldNOTbeevaluatedg O thesameasotherhospitaltravelandtraining. 23. Travelforanurseorresp techmeansgoingtoan gg annualconvention. Iftheydontgoforafewyears,theycanstillpractice theirprofession.h i f i IfBiomedsdontgotoschool,theysoonbecome obsolete,andareforcedtoputthingsonexpensive obsolete andareforcedtoputthingsonexpensive contracts. BiomedtravelandtrainingshouldNOTbeevaluatedo ed t a e a d t ag s ou d O be e a uated thesameasotherhospitaltravelandtraining. 24. Travelforanurseorresp techmeansgoingtoan gg annualconvention. Iftheydontgoforafewyears,theycanstillpractice theirprofession.h i f i IfBiomedsdontgotoschool,theysoonbecome obsolete,andareforcedtoputthingsonexpensive obsolete andareforcedtoputthingsonexpensive contracts. BiomedtravelandtrainingshouldNOTbeevaluated g thesameasotherhospitaltravelandtraining. 25. Technicalinformationconstantlyemerging.Managementinformationconstantlyemerging.Regulatoryinformationconstantlyemerging.MedicalEquipmentmanagementstrategyconstantly changing. changing 26. TheEconomicCrisis HowitaffectsHealthcareandHospitals HowBiomedstypicallyrespondtofinancialpressures andwhythesedonotwork. 10WaystoreduceCosts(presentation) Aspongyapproachtocostanalysis Lessonsfromaroundthecountry RoundTable selfhelpfromattendees RdT bl lfh l f d 27. Reduceyourspendingby10%! 28. Reduceyourspendingby10%! What they really mean is: yy 29. Reduceyourspendingby10%! What they really mean is: yy Reduce your spending b 10%! Rddi by 30. Reduce your spending b 10%! Rddi by NOW! 31. No 32. NoandYes 33. No...... becausethepainisreal.b h i i l Anditwillgetworse.Wehaventseenanythingyet.Weallhavetotightenanythingyet Weallhavetotightenourbelts. 34. Yes..... Yes ...becausethebiggergoalisnottojustreduceBiomed costs butto costs,buttoreduceHOSPITAL costs. 35. TheEconomicCrisis HowitaffectsHealthcareandHospitals HowBiomedstypicallyrespondtofinancialpressures andwhythesedonotwork. 10WaystoreduceCosts(presentation) Aspongyapproachtocostanalysis Lessonsfromaroundthecountry RoundTable selfhelpfromattendees RdT bl lfh l f d 36. WhatifEVERYpieceoftechnologyinahospital wereseenasasponge? SizeofSponge=valueofequipment Amountofwaterinthesponge=MONEYto maintain 37. Servers Lab MRICTCopiers SterilizersAneses GeneralUltrasound Biomedical EquipmentCad Access Linear Accelerators 38. = 39. = 40. Servers Lab MRI CT Copiers SterilizersAnesesGeneralUltrasoundBiomedicalEquipmentCard Access Linear Accelerators 41. Reduceyourspendingby10%.BiomedResponse: pHow?Where? 42. TypicalBiomedApproachestocostreductionReducePMs CutOvertime Reduceservicestocustomers Shiftcostsbacktocustomercostcenters 43. WhattheCsuitereallywants....Findawaytoreducecostsasmuchaspossible,butthe minimumshouldbeanamountequalto10%ofyour ii h ldb l % f currentyearsbudget. 44. Thekeytoremember:ThewayforBiomedtoincreasevaluetothehospitalis to,notcontract.BiomedicalEngineeringspecializesinwringingthe costoutofmedicalequipmentservice,while maintaining(orincreasing)thereliability,safetyandi t i i ( i i )th li bilit f t d accuracyfortheoverallgoodofthepatientand caregivers. g 45. TheEconomicCrisis HowitaffectsHealthcareandHospitals HowBiomedstypicallyrespondtofinancialpressures andwhythesedonotwork. 10WaystoreduceCosts(presentation) Aspongyapproachtocostanalysis Lessonsfromaroundthecountry RoundTable selfhelpfromattendees RdT bl lfh l f d 46. UltrasoundMachinesMUSEsystemLinearAcceleratorSterilizerService 47. OldState:(phase1 totalOEMcontracts) Manufacturercontract $250,000/year TransitionState:(gottrained,usethirdparties,begindoingPMs) TrainBMET,waitforcontracttoexpire T i BMET itf t tt i FinalState:(phase4) Inhouseservice ouse se v ce Savings: $180,000peryear Addedbenefit firststepintoImagingService. 48. OldState:ManufacturerContract $44,000peryear(hardware,software,upgrades)(Costofactualservicedelivered,ifboughtatmarketprices(Costofactualservicedelivered ifboughtatmarketpriceswas$15,000peryear.) TransitionState:TrainBMET FinalState:ServiceIn houseServiceInhouse Savings:$30,000peryearlesscostofsoftwareupgrades 49. OldState:ManufacturerContract $425,000peryear TransitionState:SwitchtoISO,contract$250,000peryearS it ht ISO t t$AgreedtotraininhouseBMET FinalState:InhouseservicePromotionforBMET Savings: Si$300,000peryear 50. OldState:ManufacturerContract $125,000plusparts TransitionState:Biomedmanagesoutsidecontract FinalState:BiomedhiresFacilites Eng,cancells contract Savings: Si$75,000peryearHiredpersonfromengineering. 51. Bestideasfromaroundthecountry: Keependoflifeequipmentoperationalaslongas financiallyandtechnologicallyfeasible.Buyusedequipmentforspares,parts,backups.Buyusedequipmentforspares parts backups 52. Bestideasfromaroundthecountry: Keependoflifeequipmentoperationalaslongas financiallyandtechnologicallyfeasible.Buyusedequipmentforspares,parts,backups.Buyusedequipmentforspares parts backups Removeunusedmedicaldevicesfromservice,retire, adjuststaffingandcostsaccordingly. 53. Bestideasfromaroundthecountry: Keependoflifeequipmentoperationalaslongas financiallyandtechnologicallyfeasible.Buyusedequipmentforspares,parts,backups.Buyusedequipmentforspares parts backups Removeunusedmedicaldevicesfromservice,retire, adjuststaffingandcostsaccordingly. Purchaseused,refurbishedequipmenttostretchcapital dollars. . 54. Bestideasfromaroundthecountry: Keependoflifeequipmentoperationalaslongas financiallyandtechnologicallyfeasible.Buyusedequipmentforspares,parts,backups.Buyusedequipmentforspares parts backups Removeunusedmedicaldevicesfromservice,retire, adjuststaffingandcostsaccordingly. Purchaseused,refurbishedequipmenttostretchcapital dollars. Barter tradeservicewithareahospitals,insteadof Barter tradeservicewithareahospitals insteadof duplicatingtraining. 55. A:Insteadofthis,wehaverepeatedlyshownthemwhere wecanreducethebudgetsofotherdepartments,as therepaircostsarenotinourbudget.Theyarereallyjustlookingforabottomlinereduction,andonceyoushowittothem,itsnotimportantwhichd h itt th it tit t hi hdepartmentbudgetlinereallyhits.KarenWaninger 56. EncouragepeopletousetheirPTO. Whileitdoesnotshow upanydifferentinouractualbudgets,itdoesreducethe pyg, debtliabilityforthehospital. Theyhavealreadyaccrued theexpenses,soifpeopleactuallyusethePTO,theyreduce thebalanceintheaccrualaccount. Stretchoutthecalibrationontestequipment,doitevery2 yearsinsteadofeveryyear,unlessyoustarttoseedriftwith specificdevices. Justmakesureyourpoliciesareupdated toreflectwhatyouaredoingthere. toreflectwhatyouaredoingthere Seeifyoucansellanyofyouroldtestequipment(NOT medicalequipment)oneBayandusethatmoneyfornew tools,etc. tools etc Makesurethatyourhospitalhasapprovedthat approach,though,andthateverythingisaboveboardwith trackingtheassets. KarenWaninger Director,ClinicalEngineering CommunityHealthNetwork 57. TheEconomicCrisis HowitaffectsHealthcareandHospitals HowBiomedstypicallyrespondtofinancialpressures andwhythesedonotwork. 10WaystoreduceCosts(presentation) Aspongyapproachtocostanalysis Lessonsfromaroundthecountry RoundTable selfhelpfromattendees RdT bl lfh l f d 58. AlanKoreneff CorporateDirectorofClinical Engineering,Novant Health,Charlotte SonnyWhite 59. Whatworksforyou? WhathasNOTworkedforyou? Areyouwillingtolookinnontraditionalplacesfor expansionopportunities? Whyareyouhere? 60. Itllbeworsebeforeitisbetter. 1.Everybodyisinthesamesituation. 2.Expandyourvisionbeyondpatientcare. 3.TheBiomedistheleastcostlywaytomaintainTh Bidi h l l i i 4.medicalequipment.Tosavemore,Biomedmustexpand. 5.TravelandtrainingbudgetsforBiomedaredifferent 6.thanfortherestofthehospital.Usethespongeanalogytoidentifyyoursponges. 7.UseSVRandtheparfaitslidetoidentifyfatsponges 8.whichneedsqueezing.whichneedsqueezingNETWORK useyourfriendsforideas. 9. 61. Whydidyoucomeheretoday?Didyoufindsomeanswerstoyourproblems?Whatisthenextstep?WhatcantheNCBAdoforyou?Suggestionsandcomments(alwayswelcome)S ti dt ( ll) Pleasereturnevaluationform. Plt l ti f 62. Foracopyofthispresentation, f hi iemailplynch@GMI3.comFor assistance with a plan to move safely into imaging service, contact plynch@GMI3.coml h@GMI3If you would like this py presentation made for yyour organization, contact plynch@GMI3.com or patrick@plynch.us