Ten tips for requesting capital equipment.Many R.C. Directors experience the frustration of having their capital equipment requests rejected, deferred, or even worse, not considered at all.
In the old days, directors would request "nice to have" items as well as necessary ones and enjoy an excellent chance of getting something major each year, often without any justifying documentation.
Today, however, there's so little money that most hospitals replace only essential equipment. These days, requests are subjected to intense scrutiny (and rightly so) -thus, it becomes of paramount importance to insure that the way you request capital items, doesn't itself, become the reason for denial.
To increase your chances of success, you should submit a request that is so well written, so well "armed", that it Is simply undeniable. You need to write up a request that so clearly documents the need and/or benefits that would come with its acquisition, that it would actually be bad management on the part of the capital equipment committee or the institution's administration not in approve it. Many would say in fact, that if you can't do this, you probably don't really need the equipment. (Needless to say, you can't expect blood from a stone either, so requesting something which is then approved but scheduled for a later purchase, is still a victory). Rejection or denial of your capital equipment request most often then, boils down to your writing ability and your ability to "make the case".
Making a case for a piece of capital equipment must be based on at least one of the following, but of course, the more points you can make, the better:
1. Saves money (anywhere in the hospital)
2. Reduces L.O.S. (especially in ICU's)
3. Reduces mortality
4. Required by regulating agencies (or JCAHO)
5. Needed for new service
Reason # 1 is a concrete reason that many a capital equipment committee can appreciate. Your vents, for instance, may now be a generation long past. They may still work for you, but they may also be costing you more per year to run and maintain than the cost of actually acquiring new units. Some research on your part, then, can get you some new vents while actually helping the hospital!
To get your slice of the pie, keep these tips in mind:
1. An analysis of the cost to benefits derived ratio should be performed on all potential purchases.
2. The above benefit-cost ratio should be 1 or higher.
3. Requests should be submitted with a narrative which addresses clinical or operational benefits that cannot be stated in monetary terms.
4. Narratives should be clear, concise, specific & devoid of simplistic phrases such as, "We really need this" or "This would be good to have".
5. Avoid very technical and/or clinical terms such as "This unit measures FRC and RV for us".
6. Schedule requests as a multi-year projection. What may be disapproved this year may not be disapproved next year, simply because it was previously rejected, (better late than never)
7. List alternate sources of funding your request--grants, donations, lease/purchase plans etc.
8. Perform a present value analysis of your current equipment.
9. Rally support. If your getting equipment helps another area of the hospital, show it. Get that area's manager to support you (very effective).
10. Make a professional, logical presentation with your administrator & Medical Director present. Your medical director can "dazzle" a capital equipment committee somewhat, but more imporantly your physicial medical director will be somewhat harder to turn down since he or she will be more likely to be seen as an independent reference rather than another hospital employee.
by Bob Miglino RRT, MPS