Evaluating and Selecting Video Equipment for the OR - operating room

AORN Journal, Dec, 1999 by Jean Workman, Cheryl Vrabel

Purchasing video equipment for an OR can be a tremendous venture. Standardization is a simple process that can resolve many of the problems associated with purchasing video equipment for minimally invasive procedures. Standardization is rarely undertaken, however, because it often is viewed as an unattainable goal when dealing with physicians of multiple specialties.

Many questions arise when considering standardization. Where should we begin? What goals need to be met? What process should be followed? Which company's equipment should be evaluated? How much will it cost? Who should be involved in the selection process? How long should the evaluation last?

Recently, the surgery department of Morton Plant Hospital, Clearwater, Fla, was faced with the challenge of replacing video equipment. It was here that we set out to answer these questions.

Morton Plant Hospital is one of four community hospitals in the Morton Plant Mease Health Care Alliance and part of the Baycare Health System. The surgery department of the 697-licensed bed, not-for-profit hospital consists of 19 ORs, in which approximately 16,500 procedures are performed per year, including general, gynecologic, orthopedic, urologic, neurological, retinal, ophthalmologic, otorhinolaryngologic, plastic, podiatric, thoracic, vascular, and cardiac services. Twenty percent of the total surgeries performed each year are minimally invasive--a technique that has affected virtually every surgical service and that is constantly expanding its applications.

DETERMINING THE BEST PEOPLE FOR THE JOB

As the purchase of video equipment was a large capital expenditure, members of the purchasing department and senior management of Morton Plant Hospital typically would make this type of decision. Many facilities are accustomed to basing major purchases primarily on cost instead of individual department needs, and purchasing agents often are trained to focus on pricing. As a result, the evaluation and selection process of a vendor frequently becomes an auction, and the job goes to the lowest bidder rather than to the company that best meets the needs of the customer.

We questioned, however, whether purchasing agents and senior managers were the best people to make this type of decision or whether their decision making was just a tradition. We suggested that the people who regularly use the video equipment have the best knowledge and understanding of the needs of the department and, therefore, could best conduct the selection process. We proposed that purchasing agents work with a vendor after it had been selected by facilitating purchase orders and equipment delivery and meeting any follow-up needs of the department.

Empowering the users. One of the philosophies of the Baycare Health System is total quality management, which includes meeting the needs of the customers, process focus, and continuous process improvement. The personnel involved in a process (ie, the users) are encouraged to identify the needs of the customers and are empowered to improve the process.

As level three clinical nurses of general, gynecologic, and orthopedic surgery, we were entrusted with the responsibility of evaluating and selecting the video equipment. The majority of procedures that require video equipment occur in these three services, making the level three clinical nurses the most qualified to handle the process. Our involvement also allowed impartial gathering of information without influence by other products a company offered, last minute lowering of prices, or other factors that can sway a decision maker who is not familiar with the use and handling of equipment.

Senior managers empowered us to negotiate, serve as a point of contact with the product representatives, and make the decisions on how to conduct the evaluation and selection process. Our goals were to

* standardize video equipment to one company and

* develop physician ownership of the equipment, based on the fact that the physicians were the consumers.

PREPARING THE PROPOSAL

Approximately one year before the actual purchase could be made, we needed to justify the request for new equipment to the medical capital equipment committee. This was accomplished by developing a service, outcome, and cost proposal, which is necessary for any capital request.

Service. Service is defined as meeting the customer's expectations. As procedures were becoming more advanced, the hospital's video equipment clearly was not meeting the expectations of the physicians in all procedures. We proposed that providing newer, more advanced technology would better support the physicians and their patients and better meet their expectations.

We emphasized the many advantages to standardizing video systems throughout all surgical services, including more flexibility with scheduling and staffing. As the facility has approximately 100 staff members, standardization creates an opportunity to cross-train among the specialties, providing staff members a greater working knowledge of the equipment. All equipment is interchangeable; thus, having a component out for repair is not crucial, and there is no need for loaner equipment.