Capital Equipment Strategies
How best to maintain or purchase new
BY ROBERT KURTZ | FEBRUARY 2024
When you have three ASCs of different ages, capital equipment is almost always on your mind, says Erika Noll, chief operating officer of Peachtree Orthopedics. The organization operates a new ASC, a 10-year-old center and a 20-year-old center in the Greater Atlanta, Georgia, area. “The equipment is very expensive, so we want to always get the most out of our purchases,” Noll says. “While capital equipment is built to last, we also recognize that there will come a time when we need to replace our equipment, or we will want to change equipment because we can become more efficient and make better use of our space.” Considering the high cost of capital equipment and the integral role it plays in the operations and success of an ASC, surgery centers should make strategic decisions about their existing capital equipment, says Letitia Moore, director of supply chain and clinical innovation at Simply Supply in Minneapolis, Minnesota.
“A car can go for 200,000 miles, but you need to have it worked on regularly. The same is true for ASCs and their capital equipment.”
He advises setting up preventive maintenance contracts with external experts to evaluate and service your capital equipment regularly.
“This is not a place to try to save money. The people who do this work and do it well—who dig under the hood and check every little thing for you—are worth the investment and will end up saving you money in the long run.”
How often capital equipment should receive preventive maintenance will vary between types of equipment, Moore says. While your preventive maintenance provider should be able to advise you on the frequency, the original equipment manufacturer’s (OEM) instructions for use should include the recommended maintenance schedule.
Staff turnover has the potential to reduce the life of capital equipment, Blair says.
If the individual(s) tasked with performing ongoing upkeep, maintaining the calendar for preventive maintenance visits or communicating with service providers leaves the ASC, this introduces risk.
“You need to always have someone handling these responsibilities,” Blair says. “I have visited facilities that had some turnover and discovered they had paid for five years of preventive maintenance services which were never provided, so a piece of equipment needed a complete overhaul. Proper management helps you avoid getting behind the 8 ball.”
When you bring on staff who will use capital equipment, their onboarding should include training on appropriate use, Moore advises. “It is about pride of ownership. If you are careful and treat your equipment properly, you will have fewer problems.” Noll regularly communicates with her capital equipment vendors to stay current on upgrades.” Adding new software to imaging equipment may give us more time before we need to seriously consider a replacement.” If a piece of equipment is aging and showing declines in functionality but remains clinically appropriate and safe, having the OEM or a third party rebuild the machine and bring it back to its original OEM specifications might be an option, Moore says. “This can be an economical way to get a few more years out of your equipment.”
Making Strategic Replacements
“Determine what you are likely going to need to spend and start putting aside money on an ongoing basis, building up a slush fund. When the day comes that you need to make the purchase, you can do so then and there and not need to worry about where the money is going to come from.”
“There are some items I would highly advise against buying refurbished, including washers, sterilizers and ultrasonic cleaners. It is simply not worth the risk.”
“You are also likely to get a shorter warranty than if you purchased new and will likely begin to encounter problems sooner because of the equipment’s age,” he says. “Whatever you think you are saving now, you may end up spending it—and possibly even more—later.”
“$80,000 is a lot of money, but I tell them think about their equipment purchase like a car payment. It costs $100 to use the equipment, and you are getting all the benefits of something new versus used.”
“If the machines that are part of the engine for your ASC go down, you may not be able to do surgery and could lose control of the situation. Purchasing is like maintenance: It is always better to be preventive than reactive.”
Article Formatting edited. The original article was printed online by ASC Focus, The ASCA Journal. With an ASC Focus subscription, the article can be accessed at https://www.ascfocus.org/ascfocus/content/articles-content/articles/2024/february/capital-equipment-strategies