Multitude of tips for saving on equipment

(Editor's note: This is the first part of a two-part series on saving money. This month we cover how to save on equipment and give you information on how adding surgeons results in cost savings. Next month, we'll cover how to stop throwing away money on supplies.)

To cut costs for your outpatient surgery equipment, establish and enforce protocols for new product entry, advises Peggy Camp, RN, BSN, MSN, clinical resource director at HCA Supply Chain, Continental Division, in Denver.

"Control the flow of new technology," she advises.

Set up a purchasing decision-making hierarchy, suggests Roger Pence, president of FWI Healthcare, an Edgarton, OH-based consulting firm primarily for ambulatory health care providers. "Let team leaders make decisions on limited-dollar purchases, then supervisors at the next price level, then managers for greater amounts, and so on," Pence says. The lower the decision is made, the greater the probability of nonpurchase, because they'll think, "we really don't need it," he says. "The higher a low-dollar purchase is made, the greater likelihood it will be acquired — 'it's a small amount; buy it.'"

Only buy equipment when it has been justified by the requestor and approved by most or all of the users, he advises.

When you aren't using a piece of equipment, get rid of it, Pence suggests. "I hear all the nurses saying, 'What if the other one breaks?' Right. When was the last time it happened?"

Potential sales outlets include ads with the state surgery center/hospital association's newsletter or web site, fliers to other providers in the area, contacts with the original manufacturer, or an ad on eBay or your web site, he says. Be careful that the ad doesn't imply to patients that their care might have been provided with out-of-date equipment, he says. "There are also numerous 'refurbished' equipment firms that buy used equipment," Pence says. "Or ask your medical staff," he adds. "They may have a contact that would be interested."

Also, you can give it to an organization that accepts equipment donations to take to third-world countries, which might give you a tax deduction. (Editor's note: For information on an organization that links donors of medical equipment and supplies with charities, go to

Purchase products considered environmentally friendly, Pence advises. The initial price might be higher, but long-term electric, water, and supply use is much less, he says.

Most of Pence's centers use a main medical gas shutoff valve. "If you leave the gas lines open — especially to anesthesia machines — they bleed a lot of gas out overnight and over the weekend," he says. "Installing the main shutoff near the supply tanks — and the last one out at night shuts it off and the first one in turns it on — saves dollars and potentially a delayed start by having an empty tank."

For older facilities that need to replace their heating, ventilating, and air conditioning (HVAC) systems, know that the less efficient/lower purchase price systems use much more energy, Pence says. "The efficient ones tend to be higher priced, but save operating expenses for the rest of their lives," he says. The sales company or installer can help calculate savings, Pence says.

Add new doctors, or lose money

When was the newest surgeon added to your center's staff?

"If it is more than one year, you are losing money now or definitely will be in the near future," says Roger Pence, president of FWI Healthcare, an Edgarton, OH-based consulting firm primarily for ambulatory health care providers.

The reason? "New physicians have new skills, new ways of doing procedures, use new equipment that can be faster," Pence says. Doing cases efficiently and faster is better and saves dollars, he adds.

Also, new surgeons bring new ideas, new techniques, and quicker ways to do treatments, he says. "It keeps the 'established' doctors on their toes, Pence says. As the existing practitioners age and eventually retire, you'll have built-in replacements, he says. "By being there, the new physician is developing a desire to use the center and will be ready to buy in as soon as possible," Pence says. "What is easier and less time-consuming: hunting up new doctors in town, or proposing to an existing utilizer the availability of ownership shares?"