Introduction

The Ohio State University (OSU) Medical Center (Columbus, OH) was selected as a finalist for the inaugural Health Devices Achievement Award, announced in June 2006, for its efforts to boost IPM completion rates by using a performance-based service-contract model.

The Health Devices Achievement Award recognizes outstanding initiatives undertaken by member healthcare institutions to improve patient safety, reduce costs, or otherwise facilitate better strategic management of health technology. Learn about the other submissions that achieved recognition.

ECRI congratulates the applicants: Robert Howard, Duane Hart, and Robert Andrews. 

Discussion

Under OSU's traditional fee-for-service arrangement for the medical center's 915 infusion pumps, IPM completion rates were running at about 85%, significantly below the 95% target specified in the center's Medical Equipment Management Plan. In addition, pump IPM work orders that were closed with an "Unable to Locate" notice were averaging about 15% per year, and these "lost" pumps had drug libraries that were out of date.

Reflecting the organization's desire to "Do It Better and Do It Different," OSU Clinical Engineering Services developed a request for proposal (RFP) that specified a sliding scale for IPM completion, as well as premiums for inventory additions and updating drug libraries. That is, the agreement was structured so that after the end of the service period (in this case 90 days), the service provider would receive a monetary premium (e.g., an extra $2.50 per pump) if the total IPM completion rate exceeded 95%. Similarly, additional premiums would be paid in the following circumstances: if a 100% rate was achieved, if the service provider found a pump that had not been in the inventory (these pumps were then tagged, tested, and added to the inventory), or if the service provider found and updated a pump with an out-of-date drug library.

The effect of the incentive program was clear: The service provider completed the requisite IPM for 101% of the current inventory (several previously untagged pumps were located and added). Furthermore, a retrospective analysis of the IPM completion data for infusion pumps showed that during this service period, 69 corrections were made to the inventory, and 100% of the pumps inspected had drug libraries that were verified or updated.

Our members at the OSU Medical Center also reported an interesting human response to the initiative: Whereas previous service providers were content to remain at a fixed location, waiting for supply staff to bring devices to the technician for IPM, the service provider operating under the incentive agreement took a more proactive approach. The provider went to the clinical locations to swap newly serviced equipment for equipment that was due for service. It also conducted routine sweeps in all storage locations to find equipment. And it engaged clinical care managers in the process, rewarding their efforts with a simple thank-you or sometimes even providing breakfast treats in the lounge to recognize extra effort.

With the type of service contract implemented by the OSU Medical Center, the service professionals knew that their company's payment was tied to performance. This encouraged creative solutions to the difficult task of finding nearly a thousand infusion pumps in a large facility.