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Thursday, 09 March 2017
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As described in our previous blog post, Is Your Medical Facility Haunted by Ghost Assets?, a healthcare asset listing containing items that do not actually exist at your facility is problematic. So once you have had a healthcare asset inventory and reconciliation to remove those pesky ghost assets, you’ll want to keep your asset listing clean. This can be challenging because maintaining the integrity of your asset listing is a collaborative effort, but these tips can help.

First, ensure that you set up clearly defined policy and procedures for tangible personal property and that the appropriate parties at your healthcare facility are aware of and fully understand them. This is the foundation of successful healthcare asset management.

Your healthcare asset policy and procedures should be written and made available either in print and/or through an easily accessible, shared location such as your intranet. Begin this document with an explanation of its objectives along with some examples of why it is important to properly track assets, such as insurance purposes or government regulations.

Next, set forth your definitions. For capital assets, explain that the items must have had an acquisition cost, regardless of their current value, equal to or above your capitalization threshold (include the actual dollar amount) for this classification. Include any other terms you will reference throughout the document.

Outline responsibilities. If you expect that department directors or managers will perform the work of reporting asset transfers and disposals and that Receiving will report asset acquisitions, ensure that they understand this responsibility and that they know who to report this information to and how to do so. By requiring that new items are tagged upon receipt by a single entity, it will be easier to ensure only assets within capital threshold will be tagged and that the tags will be placed in the appropriate position on each item.

Associating each asset with unique tag numbers can make asset tracking easier. These tags will serve only to maintain an accurate asset log and will be a different and separate type of tag than the kind used by Biomedical Engineering, which are used for equipment maintenance purposes. Note that while it is possible to simply record serial numbers instead of tagging, that method can make routine audits more difficult, as serial numbers are often located on hard to see surfaces of equipment. If you plan to record both serial numbers and tag numbers, be sure to establish which type of information will be the primary component by which each asset will be identified. If tags will be used, describe tagging in full; include an explanation of:

  • What to tag and what not to tag, some examples are:

    • IT items like computers may have a different tag, and many items will also have a BioMed tag. Do not cover these tags; they are used for other types of tracking. Some of these items will fall beneath the capital threshold and do not require an asset tag, while some will need an asset tag – carefully review the acquisition cost of the item against the capital threshold to determine whether to apply an asset tag.

    • A tag number should be recorded for some items, like endoscopes, but cannot have a tag physically applied because of the cleaning process or other reason (explain what to do with the tag itself, perhaps require it be turned in to Accounting so that its unique number is not accidently reused, etc)

    • Include a list of examples of items that should receive an asset tag

    • Provide a point of contact to resolve any uncertainty over whether something should be tagged

  • When to tag: all items should be tagged immediately upon receipt by (insert responsible party here)

  • Where to tag so that the numbers can easily be seen when the item is in use

    • Example: do not tag a bed on the back of the headboard as it will be completely out of view when a patient is in it; instead, place the tag at the footboard end.

    • Set a rule of thumb as to the general location a tag should be placed on any item. For example, instruct that a tag should be placed at the top right side of any piece of equipment whenever possible. (Exceptions to this rule may be caused by insufficient surface area to apply the tag there, or there could already be a logo or other information there.) Consistently tagging items in the same spot will make it easier to find the tag number information in the future.

  • How to record asset tags for each situation (acquisition, transfer, disposal)

    • Create a standardized form that includes all required information to be completed for any of these asset activities and information on where to send the completed forms.

      • A standardized nomenclature for consistent equipment description is fundamental to maintaining an accurate asset listing. Include an exhaustive list of asset types that should be used verbatim to describe items on the form.

(Here’s an example of why standardized descriptions are important. Imagine Intensive Care has a monitor in each patient room by ABC Company, and the model is Cardio Scope 700. Meanwhile, on patient floors there are monitors by XYZ Company called Mega Vitals 5. It is very likely that these two monitors will be described differently even though they are the same type of equipment. Examples might be: ICU Monitor and Vitals Monitor, ABC Monitor and XYZ Monitor, or Cardio Scope Monitor and Mega Vitals Monitor. In fact, it is even possible, especially if additional monitors are purchased after some time, that two of the same exact model of monitors could be described differently. Such variances will make it difficult to sort your data to view every monitor at your facility. It is better, therefore, to standardize on a description such as Monitor, Patient or Monitor: Physiologic because the manufacturer and model information will still be recorded in their respective fields and can serve as additional filters, if needed, without limiting the initial sort.)

  • This is a good place to outline transfer and disposal policies

Finally, you may also want to include information on your physical inventory procedures and policy and even a record page to list the month and year each time an asset inventory and reconciliation is completed. Inventories should be performed at regular intervals to ensure tagging procedures are being followed appropriately, and the reconciliations will clean up any ghost assets that may have formed on your asset listing.

A well-organized and detailed document containing your tangible personal property policies and procedures is the first step to successful healthcare asset management. Other asset management tools, such as the standardized form for tracking asset activity mentioned above, will also make keeping up with assets much easier for everyone involved. Stay tuned to our blog for a post with more on that coming soon.

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Posted on 03/09/2017 10:56 AM by Karen Dino
Wednesday, 08 February 2017
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An LED, or Light-Emitting Diode, works by electroluminescence – its material emits light in response to an electric current or field. By contrast, incandescence works by visible light being emitted as a result of the high temperature of its material, while fluorescence is the emission of light by a substance (phosphorus in fluorescent bulbs) that has absorbed light. Incandescent bulbs were developed as far back as the late 1800s. Fluorescents took off in the 1930s, and LEDs had their start in the 1960s. As the technology continues to develop, LEDs have recently become more affordable and have been found in a wider variety of applications. For healthcare, this allows for more durable, efficient, and environmentally sound lighting for exams and surgeries.

The benefits of LED lights are many. There is no warm-up time as with incandescent bulbs, so an LED will reach full brightness much quicker. Because LEDs do not rely on high temperatures to produce light, they generate much less heat than incandescent lights, which results in a more comfortable working environment. Although they are smaller, LEDs consume less energy than halogen bulbs at the same intensity of light; in fact, LEDs produce more lumens per watt than incandescent bulbs. LED light can be dimmed and focused, and color can be achieved without using filters.

Another benefit of LED lights is their durability. LEDs are shock-resistant, unlike fragile incandescent and fluorescent bulbs. Fewer LED bulbs will be needed than other types of bulbs over the same period of time. Incandescent bulbs have an estimated life of 1,000 to 2,000 hours, and halogens have a lifespan of 2,000 to 3,500 hours. Fluorescent lights have much a longer expectancy of 10,000 to 15,000 hours, and LED lights more than double that range. Unlike these other types of bulbs which go out suddenly at the end of their use, LEDs gradually dim. An LED light can last up to 30,000 hours before significant dimming is observed, with an overall estimated useful life between 35,000 to 50,000 hours.

So how do you compare different models of LED lights to find the best value for your exam or operating room? There are few different measures of quality you’ll want to review.

First, there is light intensity, which is measured in lux. One lux is equal to one lumen over one square meter, or for reference, know that: a) direct overhead sunlight is approximately 130,000 lux, and b) the higher the lux number, the brighter the light. Intensity is determined by the strength and arrangement of bulbs, so even a product with fewer LEDs than its competitor could be brighter due to the strength and placement of its bulbs.

Next, Correlated Color Temperature (CCT) is measured in degrees Kelvin and indicates the color of light produced by the bulb. The higher the number, the whiter the light produced, and the more accurately the objects under the light will be perceived. Natural daylight is in the 4,000 to 6,000 range, which is also standard for most LEDs. Color temperatures above this range are cooler and slightly bluer, and those below it are warmer and a little more yellow or orange. Depending on what needs to be observed under the light, different temperatures may be ideal – or physicians may prefer different temperatures than each other for the same procedures. For this reason, you will find that most exam lights are standardized within the range of natural daylight, while many surgical lights have adjustable temperatures so that the best temperature can be selected for each procedure as needed.

Another measure of how closely a light reveals the color of an object as compared with how that object looks under natural light is the Color Rendering Index (CRI). The highest possible value is 100, identical to daylight; LEDs will have CRIs of 80 or more.

Other considerations when reviewing your LED light options are maneuverability of the light head, the size of the area of light produced, and shadow control. Shadow control is possible with LED lights because manufacturers are able to design the lights so that some of the tiny bulbs will shut off or dim in the presence of something obstructing the path of its light so that no shadows are produced and instead light is directed where it is needed for the procedure.

Before deciding, see the light in person. Ask vendors if they can bring in a light on rolling stand so that you can try it out inside your operating or exam room, or ask nearby facilities of similar size if you can observe their light in action. If you are able to discuss a particular LED light with a facility that has been using that model for a while, request their opinions on maneuverability, stability, focus, and shadow control based on their experience using the light for their procedures and exams. An important part of the planning process if you have an integrated OR and decide on an LED light from a different vendor is to confirm with each vendor that this will be compatible and to request room plans to avoid issues with lights or booms bumping into each other or your staff.

Many medical equipment manufacturers offer quality LED lights for the healthcare industry; here are examples of both exam and surgical LED lights available from just a few manufacturers, STERIS, Skytron, and Trumpf Medical:

EXAMPLES OF LED EXAM LIGHTS

Manufacturer

Model

Intensity

CCT

CRI

Average Life

STERIS

Harmony LED385

50,000 lux

5000 K

90

30,000 hours

Skytron

Triango

55,000 lux

4500 K

95

30,000 hours

Trumpf Medical

TruLight 1000

80,000 lux

4500 K

95

50,000 hours

 

EXAMPLES OF LED SURGICAL LIGHTS

Manufacturer

Model

Intensity

CCT

CRI

Average Life

STERIS

Harmony LED

160,000 lux

4400 K

97

30,000 hours

Skytron

Aurora Four AUA5

160,000 lux

Adjustable: 4100 K or 4500 K

96

40,0000 hours

Trumpf Medical

iLED 3

160,000 lux

Adjustable: 3500 K, 4000 K, 4500 K, or 5000 K

98

40,000 hours



 
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Posted on 02/08/2017 10:58 AM by Karen Dino
Wednesday, 04 January 2017
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When you're in need of a certified Fair Market Valuation, be sure to inquire about the contractor representative's qualifications. Several professional appraiser organizations provide designations to their accredited members. These designations represent an elite level of qualifications knowledge and experience that you will benefit from when engaging a certified professional to provide your valuations.

The American Society of Appraisers administers a thorough process of evaluation, ensuring only the most educated and experienced professionals are awarded its Accredited Senior Appraiser (ASA) designation. To receive the Certified Valuation Analyst (CVA) designation from the National Association of Certified Valuators and Analysts (NACVA), one must meet standards for ethics, objectivity, and professional competence. These certifications reflect a commitment to excellence.

Additionally, find out whether your appraisal will comply with Uniform Standards of Professional Appraisal Practice (USPAP), which ensures quality control. USPAP was established in the 1980s and is updated biyearly to ensure that current best practices are followed throughout the industry.

 

About Partners Healthcare Group

Partners is a women-owned business specializing exclusively in healthcare services involving medical equipment assets. Our 20+ years of experience includes performing dozens of valuations for medical centers, surgery and imaging centers, long term care facilities and physician clinics. Partners' Director of Financial Services, Amber O'Neal, is both ASA and CVA certified. O'Neal has years of experience providing clients with quality Fair Market Valuations and asset audits.

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Posted on 01/04/2017 2:32 PM by Karen Dino
Wednesday, 28 September 2016
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Ghost assets are assets accounted for on your fixed asset listing that do not actually exist at your facility. This can happen when an asset has been sold or traded-in for credit on another purchase, used by Biomed for parts to repair like items, or simply taken out of service (retired) but this activity was never recorded on the fixed asset listing.

In our experience, we have found that even facilities that are excellent at properly accounting for assets as they come into the facility will have at least some ghost assets lingering on their listing due to the sheer volume of capital assets in the healthcare setting. This is why we recommend our Asset Inventory and Reconciliation service once every 5 to 10 years so that such discrepancies can be identified and corrected.

Ghost assets are a real problem because: 

  • They can cause increased personal property taxes (i.e. for-profit organizations could be paying taxes on assets that don't exist!) 
  • Overvaluing due to ghost assets could result in overstated Fair Market Value
  • Ghost assets cause distorted financial reporting

An Asset Inventory and Reconciliation to remove ghost assets will provide:

  • Accurate accounting of assets for your financial reporting
  • Accurate Financial Analysis (ROI)
  • Personal property tax reduction
  • Improved capital budgeting

About Partners' Asset Inventory and Reconciliation Services

Partners' Inventory Services are patient-staff oriented. Partners Inventory Specialists make every effort to avoid any inconvenience to patients and hospital staff as they move through the facility to record and tag equipment. Assigning barcode tags capitalizes on time spent inventorying; it turns the point-in-time view of existing equipment captured through the inventory into a working tool that can be utilized well beyond the project's closeout. Tags will be useful for logistical planning for any construction project and for financial accounting for the life of the equipment. Contact Partners today at 800-270-7582 for a proposal tailored to your specific needs.

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Posted on 09/28/2016 2:20 PM by Karen Dino
Monday, 19 September 2016
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Equipment procurement for healthcare projects can involve a variety of types of medical equipment from a number of different vendors. Before you buy medical equipment, consider the advantages of purchasing from medical equipment distributors. 

First, there's the time saved on a multitude of quote requests. If you've ever been responsible for requesting quotes for a healthcare equipment project, you know that this process can be quite a hassle. By going through a distributor, you're able to request a single quote on most or all of the items you need at once. Medical equipment distributors offer thousands of different products from hundreds of manufacturers, ranging from basic to brand name items. 

Next, you'll notice that most distributors take pride in providing only the very best customer service. Establishing a relationship with a dependable distributor can extend the convenience of a one-stop-shop on to routine, operational purchases as well. You'll find that medical equipment distributors offer competitive pricing, too. 

Lastly, logistics services from a distributor can be the solution you never knew you needed, especially if your facility lacks storage space. Some medical equipment distributors will offer such services to store, assemble, stage, and then help to install the items you've ordered into the appropriate rooms as soon as your project is ready for them. The next time you buy medical equipment, contact a distributor first to see what a difference it makes for your project.

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Posted on 09/19/2016 4:10 PM by Karen Dino
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