From the May 2018 issue of HealthCare Business News magazine

Fortunately, another exception was created: Alternative Equipment Maintenance/Management (AEM). Because of AEM, the clinical engineering department can potentially reduce costs associated with staff overtime and/or on contracted services for PM assistance, in order to meet regulatory compliance.

AEM and what It can mean to your hospital
AEM, when executed properly, can ease the burden on an HTM department’s budget while continuing to assure patient safety.

Of course, implementing an AEM program is not as easy as it first appears, since it has many rules and restrictions set forth by both the Joint Commission and CMS (Centers for Medicare and Medicaid Services). In fact, the exceptions are one of the easier aspects of an AEM program.

For instance, medical device lasers, imaging devices, and radiologic devices are all prohibited from being on an AEM program. Thus, these medical device categories must have the manufacturers’ PM performed on them always, and at a 100 percent completion rate. In addition to the three taboo device types, HTM is not allowed to place medical devices that are new to them on an AEM program without a sufficient history (PM history or device years). New devices are defined as equipment types that are new to the organization and not just another infusion pump from the same manufacturer. In order to determine a medical device history that would be considered to be sufficient, HTM departments can set a policy as to a required amount of PM history, or a set level of device years. For example, if you have five equivalent devices for eight years, you have 40 device years for that device type. If your policy states that the number of device years required is 35, then this type is eligible for your AEM program.

Likewise, you may specify a PM history of 6 PMs before a device is placed into an AEM program. Other factors include setting a specified limit on failure rate (e.g., < 2%) and/or having backup devices available for use (e.g., > 5). Furthermore, AEM devices must also be maintained at 100 percent compliance.

AEM policies and acceptable equipment types
To implement an AEM program at your facility, HTM leadership must develop a clearly written plan in their department policies, and these policies will be presented to regulatory agencies when requested. Equally, your AEM program must not reduce the risk to patient safety as you modify your PM procedures.

For instance, you may increase the interval between inspections (say every two years versus annually), but you will perform the manufacturer’s steps completely during the 2-year inspection interval. On the other hand, you may choose to modify a step to inspect a component and replace if necessary, as opposed to replacement-only method on a PM task. Likewise, your history might determine that you want to perform a unique additional step to the manufacturer’s PM procedure that will improve patient safety and reduce the failure rate. Again, implementing an AEM program requires additional work and planning, along with a continual monitoring of the program: monthly, quarterly, etc.

With your AEM policies in place, you can begin to evaluate which equipment types you are going to place into your AEM program. Knowing the rules of AEM, you can easily eliminate the taboo devices from the inventory, along with unfamiliar device types that are new to you or your organization. But what about high-risk medical devices that are not on the taboo list and you have a documented history for?

May 2018 Magazine

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