FEATURE


If you are going to be taking on the burden of a large purchase and, with it, a large monthly payment, you need to have the cases to justify and then support that payment.”


—Jennifer Butterfield, RN, CASC, Lakes Surgery Center


physicians performing cases at facilities using older technology.” At Summit Surgical Center, capi- tal purchase requests are closely scru- tinized and ranked by their impor- tance, Schmidt says. “As part of our annual budget process, we determine how much money we can spend in a year on capital purchases, which tells us whether we can only purchase high-priority items or if there is room for ‘wish list’ items. We consider the benefits to patient safety and whether equipment will become standard of care in the community as more impor- tant than potential financial returns.”


Research Options Whether a physician is requesting the newest C-arm model or it is time to replace old stretchers, ASCs should identify different vendors that can pro- vide the capital equipment they are con- sidering, advises Wziontka. “I always prefer to get three good quotes on pieces of equipment to gauge their range of prices. I will see if there are any vendors


16 ASC FOCUS APRIL 2016


contracted with our group purchasing organization that might be able to sell me the equipment. I will also look into whether I could purchase the equipment used from a reputable company.” Schmidt’s ASC works with a bio- medical company that


informs her


when equipment is approaching its “end of life” or has required numerous repairs to help determine what may need to be replaced and when. ASCs would be wise to involve their


physicians in the research and in the negotiation process, Butterfield says. “Physicians can be really helpful if they are willing to seriously consider multiple vendors rather than just commit com- pletely to a single vendor or product.”


Conduct Trials An important step to take before com- mitting to a capital equipment pur- chase is to provide your physicians with an opportunity to use the equip- ment, Schmidt says. “We bring in everything for trial so the physicians can confirm whether what they saw


at a tradeshow actually works the way they thought it did.” Let your physicians sample the equipment for a few days, especially if it is brand new, cutting-edge technol- ogy that they have not used, Wziontka adds. “You want your physicians to see how the equipment actually feels and determine whether it operates the way they expect it to.” Sometimes it may not be possible to trial a piece of equipment in your ASC but that is not necessarily a reason to bypass the live demonstration, Butterfield says. “You can work with the vendor to send your physician to a non-competing facil- ity that has the equipment you are con- sidering to see in use or you might be able to arrange for your physician to try using the equipment at a conference.”


Saying No As much as an ASC’s leadership team might want to give its physicians every- thing they ask for, sometimes the bud- get will not allow for a capital purchase. “You need to be direct about why the purchase was not approved,” Schmidt says. “If it is wish list item that does not fit in the plan for the year or the return on investment analysis did not justify the purchase, explain the reason to the physician asking for the equipment.” And if that happens, “you want the backing of your governing board so physicians know it is not the admin- istrator against them when a pur- chase request is not approved,” Butter- field says. “It is a group decision for or against, which is helpful when you have to deliver the bad news.” If there is the possibility that a capi- tal purchase request might be honored in the future, this should be shared with the physician and staff, Cornwall says. “Encourage them to continue to research and gain knowledge on the reasons that would support a decision for capital purchases, and continue to plan for the time when it proves to be a wise investment.”


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