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In answer to your question


for several reasons all based on personnel experience.

The medics can not always be relied on to make the best decision; in particular there is often a marked reluctance to try/use alternate manufacturers regardless of quality, reliability, ease of use etc.

Unless the process is controlled the decision will often be taken by the senior clinician involved with little or no involvement of the rest of the clinical users.

Without the involvement of the engineering side clinicians will happily ignore the fact that previous items of equipment from the same suppliers are unreliable, expensive to repair or take excessive time to be repaired.

However it can be worse; if the clinicians don’t make the decision it could be made by the bean counters.

Lee

My own "recommendations" were based upon personal experience as well, Lee. Believe me.

By all means sit on the committee, and make sure your voice is heard regarding all the tech support points you mention (and more ... like service manuals, training, and the need to budget for parts etc.) ... but let it be chaired by the Head of this or that (Anaesthesia, Surgery ... whatever).

Those guys have resources that you can never hope to match ... even if it's just "clerical support" (to do the donkey work, as already mentioned).

And if the Bean Counters insist on muscling in:- let them. Why fight it? And then, when it all goes wrong later on, go to those same guys with your hand out for funds to put things right. That's assuming that they're still around, of course. But don't worry, fresh new Suits will have stepped in to take their place.

Unfortunately it doesn't matter who decides which equipment is bought it will still be the fault of the engineers that kit is unreliable and cannot be repaired instantly.(According to the users)

And as for going cap in hand for more funds, there’s no chance. As always any cost cutting in a Hospital/Trust relies disproportionately on the maintenance/hotel services side and when these have already been PFI and fixed there is even less wriggle room.

Lee

I hear you, Mate (and I'm not going to argue).

But I'm immediately reminded of that happy occasion during a meeting (yes, even me) many years ago when I blurted out (you know, the way you do):-

"I didn't design the [censored] kit! Neither did I make it. Nor, for that matter did I purchase the junk. But once this meeting finally draws to a close, there's a reasonable chance that I might be able to get on and fix the [censored] rubbish"!

I haven't said it but I've certainly thought it a few times.

Lee

My Ha'penny's worth.

If you're located in Maryland then you're just up the road from ECRI. They'll be more than happy to do a market evaluation for you based on the criteria you set & required & desirable attributes (but at a cost). When you got lots of users & decision makers it's wise to have a neutral party arbitrate. From experience I have seen an anaesthetist reject a model because the castors snagged her tights.

Apart from meeting the clinical need the model you choose also has to suit the health system you are part of & I would assume in the US that would include good (automatic) record keeping probably in conjunction with an integrated physiological monitoring system & as well as a cost capture system.

On the technical side a basic question would be whether nitrous oxide is required? It's not absolutely needed clinically especially if TIVA is popular & as it's considered a contributor to greenhouse gases there's a move to phase it out. But if there's a large number of users there will always be some that insist on having nitrous.

Another approach is to look at the common incidents associated with anaesthetic systems such as wrong connections or misconnections, misreadings/missetting of controls or just plain old bored anaesthetists emptying their coffee into them - see how your offerings address these.

Whatever you choose be sure a better system will be released shortly after.

That's a good comment Paul.

I've always been a fan of ECRI myself. As far back as the 1980's they published their excellent "Product Comparison System" (I can say that with some certainty as my own company at that time was a subscriber) and no doubt they have something similar available today*. But I digress ...

I note that the original poster (our friend in Maryland) seemingly works for a government agency. And I simply refuse to believe that the US Government doesn't have all this stuff "done and dusted". So perhaps Neil's earlier comment about "flying over" wasn't quite so trite after all.

For the penniless amongst us (ie, not the US Government) there are a few websites where interesting information may be gathered. For instance:-

1) Medcompare
2) IHE ... to name but two.

Meanwhile ... how many front line anaesthesia systems are currently available for purchase from new in the USA? Half a dozen? So ... why not just get them all in, and let the "tight snaggers" decide?

Failing that, simply collect up the brochures, collate relevant information in tabular form, distribute to whomever ... then stand back and wait? No. Give them ten days then set up the meeting to agree the way forward.

* ECRI .pdf

TIMSTA.
if you have a proper email i can send you the forms we use. my Trust email wont go to yahoo / hotmail type a/cs.

Hello KM,

You can contact me at rajahtm@mail.nih.gov.

Cheers
Tim