摘要:

The past decade has seen the restriction of reimbursement and increasing pressures for cost-containment mandate vast improvements in technology assessment. Because no single source of evaluative data exists, individual hospitals must develop their own assessment programs. Medical, monetary, legal and supplier issues must all be considered in response to any request for the acquisition of technology. This can be accomplished through a coordinated effort by a diverse grouping of the medical and technical talent found in any hospital. This paper reviews the important issues described in the literature and offers background and guidance for assessment concerns, in an attempt to assist the individual hospital in becoming a successful technology evaluator.

ISSN:0363-8855    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A simple mathematical model has been developed to identify and prioritize medical equipment in need of replacement. The model contains a total of ten attributes addressing four primary replacement issues: equipment service and support; equipment function; cost benefits; and clinical efficacy. Sensitivity to incomplete or subjective data is significantly reduced through the use of a “yes-no” (0,1) scoring scheme. Decision-making validity does not appear to be compromised with such a technique. When tested on a sample of 146 medical devices in five different categories, the model recommended that two devices be replaced within the existing fiscal year and eight in the following year, and that fifteen devices be placed in an advisory category. The model's recommendations appear to be compatible with existing subjective criteria.

ISSN:0363-8855    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0363-8855    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This paper outlines one hospital's response to the changing needs for: quality of care; risk management; cost control; and regulatory agency requirements. All recall, update, and product safety alerts are now routed to the office of The Director of Materials Management. The director notifies the appropriate department manager, who must reply in writing. The Clinical Engineering Department maintains ahistorical data filefor medical equipment, which includes service costs information. New purchasing forms and terms have been developed for use in purchasing equipment and service. Maintenance of accurate historical data for medical devices begins at purchase, and continues to installation and through ongoing service. This requires the cooperation of the manufacturer, the service vendor, and the clinical department using the device. Because technology management can improve the quality of care and reduce risk, it is worth doing and can also reduce costs.

ISSN:0363-8855    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Failure modes and effects analysis (FMEA) is a proactive quality assurance procedure that has been commonly used to address potential design flaws and product misuses during the design stage of a product's life. FMEA is becoming commonplace among manufacturing companies but is relatively unknown outside of manufacturing circles. One potential new application of FMEA is by medical device end-users who could address design or functional concerns specific to their situation. The continued increase in the amount and complexity of medical instrumentation necessitates an aggressive stance towards safety in each hospital, such as is recommended in this paper.

ISSN:0363-8855    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Recent changes in attitudes concerning medical equipment maintenance place more responsibility for planning appropriate levels of maintenance on the clinical engineer and biomedical equipment technician. A system is described in which maintenance decisions are based on the effects of equipment failure on quality of patient care and potential for injury to patients and staff. It is hoped that development of an acceptable classification scheme will simplify maintenance decisions. Such a system will provide levels of maintenance appropriate to the equipment function in patient care.

ISSN:0363-8855    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Commercially available electronic muscle stimulators (EMS) are used for functional electrical stimulation (FES) and are interfaced with the reciprocating gait orthoses (RGO). The new system that results is described with both individual electrodes and an electrode garment. Various advantages of the system include: (a) commercially available subsystems from various manufacturers, and (b) subsystems that may be individually prescribed by a physician. The system itself currently employs two EMS units worn on a belt, controlled by remote switches and interfacing to electrodes placed over hamstring and gluteal muscle groups of each leg. Two EMS units (for stimulation of the hip extensors) function primarily for ambulation. The system has been evaluated on four spinal-cord-injured individuals (two paraplegic and two quadriplegic) who are five or more years post-injury. Each EMS unit is powered by a nine-volt alkaline transistor battery. All subjects utilized individual carbon-rubber electrodes, and one subject also utilized a Transcutaneous Transducer Garment (TTG). It is emphasized that successful EMS-RGO walking exercise is one of three modalities in a program of active physical therapy. The paper gives an overview of the operational, design and material considerations that are important for technology transfer.

ISSN:0363-8855    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

When delivering several intravenous drug doses from a single bag, it is generally necessary to throw away any drug that remains in the bag, if the amount is insufficient to deliver the next dose. An algorithm has been developed to allow all of the drug in a bag to be used. Based on standard pharmacokinetic equations, the algorithm calculates the time when the remainder should be given, so that a desired peak serum drug concentration is achieved on the next dose. The algorithm requires as inputs the time limit on the bag, the dosing interval and the size of the dose. This algorithm applies only to drugs that obey single compartment, first-order linear kinetics (e.g. aminoglycosides), but is easily modified for other situations. In conjunction with computer- assisted infusion, use of the algorithm may potentially reduce the cost of aminoglycoside administration by reducing clinical drug waste.

ISSN:0363-8855    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0363-8855    

出版商:OVID    

年代:1992

数据来源: OVID