As HTM professionals continue to take on a more important role in overseeing hospital technology and devices, alternative equipment maintenance (AEM) programs provide a unique opportunity for them to take matters into their own hands.
HealthCare Business News spoke to Shane Kearney, senior business analyst for corporate imaging business services at Fairview Health Services in Minnesota, to find out what AEM programs entail, what their limitations are, and what advantages they can offer over manufacturer maintenance protocols.
HCB News: Alternative equipment maintenance seems to be a growing trend in the biomedical engineering space. For people who don't know, how did all this AEM talk get started?
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Back in 2011, CMS and Joint Commission expressed some concern around inconsistency in the way that in-house and third-party maintenance programs were supporting medical equipment. In an effort to standardize these programs they announced their expectation that hospitals should follow manufacturers’ preventive maintenance requirements when caring for medical equipment.
The biomedical engineering and Healthcare Technology Management community had largely not been following manufacturer recommendations, based on their experience and professional judgement. Adopting the CMS practice would have caused a significant shift in the resources needed and the effectiveness of hospital maintenance programs. AAMI and ASHE released a response that provided evidence that alternatives to the manufacturer's maintenance recommendations would have not caused harm to patients, and in 2012 the agencies took a step back to solicit feedback and discuss. In 2014, CMS released "S&C 14-07", allowing hospital equipment support groups to employ alternative equipment maintenance (AEM) programs, with some exceptions.
HCB News: What are some of the basic rules that all AEM policies must adhere to?
To paraphrase CMS 42 CF 482.41(c)(2) a bit, if a hospital chooses to employ a deviation to the preventive maintenance frequency or procedure dictated by the original equipment manufacturer, the hospital must develop, implement, and maintain a documented AEM program. This is to ensure that risks to patients and others in the hospital are minimized when using the facility or medical equipment. In an effort to unpack that a bit we can take it step by step:
1. Developing an AEM involves a few key foundations, such as recognizing a definition of medical equipment, defining what is critical equipment, identifying who is qualified to make the decisions, establishing a risk scoring method, and constructing a policy that clearly states the approach. Taking it a step further involves establishing your AEM review cycle and what metrics would be measured to indicate the success or need for reevaluation. Some of the key indicators you would want to look at in the future may not be in place today and would have to be established. If you plan on having an alternative to the procedure, regardless if the frequency will be adjusted or not, document this procedure for communication during implementation.