How a Systemwide Governance Council can Turn Clinical Assets into a Strategic Lever for Your Health System

Making the most of your medical device inventory can be challenging, especially if you are a large healthcare system with locations throughout your geographical area. Patient demand, organizational objectives, and budgets may vary greatly depending on a multitude of factors impacting each of your regions. So how can your organization implement best practices that allow your health system to work together to make the most of your collective medical device inventory while also meeting the unique needs of each region? 

A new best practice is emerging in the strategic management of medical devices—the establishment of a structured, collaborative and systemwide governance council. The need for clinician and administrative alignment through such a council is more important than ever and is being driven by the rapidly changing healthcare landscape that includes increased margin pressures, the transition of care outside the four walls of the hospital, as well as the recent surge in cyberattacks targeted at health systems. Each of these pressure points impacts how your medical device inventory is effectively managed and has health systems asking: 

1. How can I be more strategic in what medical devices I buy and when to make the most of my capital budget?  
2. Do I have the right medical devices in the right location to meet patient demand? How can I support the device needs of these locations in the absence of increased capital budgets? 
3. If our health system were to come under attack through a cybersecurity breach, am I prepared to quickly identify and remediate the damage to prevent substantial financial losses along with continuing to support the delivery of patient care? 

While the needs of each region in your health system may be unique, the above questions are those being asked in both small, regional hospitals as well as in the largest academic medical centers across the country. Through an effective governance council, health systems are supporting all areas of their organization in establishing an organizational structure that fosters systemwide adoption of available resources to maximize their program efficiency. Healthcare executives are tackling three key issues that are blocking them from more efficient management of their devices. 

1. Lack of collaborative approach to managing medical devices 

Given the competing priorities of regional providers who are part of a larger health system, it’s no wonder there is a lack of systemwide alignment on how services and medical devices are managed, along with no true understanding of the value of a systems’ clinical engineering programs. 

By establishing a systemwide governance structure, health systems can establish committees that are representative of the needs of each region, allowing them to collaboratively define the scope of what they hope to accomplish as a unified system, drive adoption of this structure across their regions, and effectively collaborate to impact change. 

2. Lack of systemwide standardization  

Often, health systems have multiple providers of CE services, from in-house solutions to OEM providers to third-party Independent Service Organizations (ISOs). These disparate, decentralized programs prevent a true understanding of the value of clinical engineering and leave a gap in accountability, with no single leader owning responsibility for delivering value. 

With the introduction of a governance council, healthcare executives are seeing success in identifying a system-level structure that includes: 

1. A system-level director of clinical engineering services, defining a central point person for accountability for the program.
2. A single inventory of all medical devices, documenting quantity and location of devices at all locations across the system.
3. A systemwide practice of reporting on the value associated with clinical engineering initiatives. 

3. Lack of clinical engineering program maturity 

With a lack of broader program accountability comes a lack of program maturity. Instead of medical devices being seen as strategic levers available across the system, hospitals often continue with the break/fix mentality of clinical engineering, being reactive to problems that arise without the ability to proactively identify strategic opportunities. This can lead to disaggregated and unnecessary capital purchases resulting in excess inventory. 

By maturing a clinical engineering program into a comprehensive clinical asset management program, along with the standardization that comes with the establishment of a structured governance council, health systems can leverage the data they’ve gathered on their medical device inventory to drive evidence-based, long-term capital planning decisions that improve the overall financial health of their health system. 

Practical application of governance councils 

As best practices continue to emerge, we have seen several health systems execute this concept with successful results. These governance councils have been established in the following way: 

1. One executive oversight committee: This committee provides strategic direction, coordination of major projects, and accountability for annual goals, initiatives, and performance improvement.
2. Systemwide steering committee: This committee holds accountability for the cross-system functional direction on all programs related to clinical engineering, including implementation of technology, management of mobile medical equipment, cybersecurity initiatives, etc.
3. Regional governance councils: These region-level councils hold accountability for operations and key performance metric tracking, providing root cause analysis along with countermeasures along with addressing local issues and planning. 

Delivering organizational value 

The outcome of this best practice can be seen in many key areas of the organization: 

1. Supporting quality and safety: Governance councils support consistent regulatory standards across the system, develop cybersecurity protocols for network-connected devices and establish lean processes for managing medical device inventories. 
2. Improved financial health: By more effectively managing inventory at a systemwide level, health systems can reduce or delay CapEx expenditures and reduce OpEx, simply by ensuring their medical devices are deployed across the system to meet the individual demands of each region. 
3. Enhancing the patient experience: Better management of medical devices means increased device availability for timely delivery of care. 
4. Team member experience: More effective management of medical devices means that clinical staff can worry less about the availability of medical devices and spend more time at the patient bedside. 

The benefits of a systemwide governance council are clearly evident. To meet the constantly changing demands of healthcare, they must be strategic, efficient, and prepared to respond to the unexpected. By establishing this collaborative approach to clinical asset management, health systems are becoming more focused, prepared, and aligned to meet the needs of their most important assets—their patients.