Proposal project

Running head: PROPOSAL FOR TRANSEASOPHAGEAL

DISINFECTION 1

Proposal for Transesophageal Disinfection System

Student Name

Adventist University of Health Sciences

PROPOSAL FOR TRANSESOPHAGEAL

DISINFECTION

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Executive Summary

Non invasive cardiology is currently having issues with a transesophageal echocardiology

(TEE) disinfector. There is only one disinfector and it is currently out of order. This will have a

four week turnaround time. This poses a problem because there is only one machine.

The current solution requires sending the machine to the company for repair and using

the equipment that is the property of the operating suite. The operating suite has two machines,

but they are having mechanical issues with one of their machines.

PROPOSAL FOR TRANSESOPHAGEAL

DISINFECTION

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Problem Identification

In 2009, the Heart, Lung and Mechanical Cardiac Assist Program was established. By

2013, there were 70 ventricular assist devices (VADs) implanted and 33 heart transplants. To

date 216 VADs have been implanted, 42 lung transplants, one lung transplant and 59 heart

transplants.

The benefits of resolving this problem will be to increase productivity, and turnover time.

More procedures can be done in a shorter period of time.

A PEST was done to evaluate the forces that should be considered in the decision making

process. The chart (Fig. 1) illustrates the forces identified.

Political Forces

Economic Forces Social Forces Technological forces

National institutes

for health funding-

decline in

pharmaceutical sales

due to patent

expirations and

decline in new drug

therapies. This causes

reduction in public

funding worldwide.

Increase in revenue-

with an increase in

tests the machines

will pay for

themselves faster

Increased patient

satisfaction-

increased Press-

Gainey score- Patient

satisfaction.

Technologists will

be able to turn the

rooms over quicker-

providing reports

faster and availability

to do more tests.

Federal drug

administration-drug

lawsuits for drugs

that are used for some

of the disease

processes can slow

the approval of new

drugs.

Single device

inventions- pose a

single time fix

instead of years of

expensive drug

therapy

Same day procedure and reduction of

frequent blood test

visits to check of

therapeutic levels.

More machines will

make more tests

possible- less

equipment fatigue

and failure.

Affordable care act-

imposing new fees on

the pharmaceutical

manufacturing sector

Advantage of

technology-

Economies of scale

Reduction of cost-

drug therapy

important to patients.

Reduction in

nosocomial

infection- of patient

PROPOSAL FOR TRANSESOPHAGEAL

DISINFECTION

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of 2.8-4.1 billion each

year from 2012-2019.

causes per test cost to

decrease.

due to better

sanitation practice.

Affordable care act -

other hospitals in the

area are partnering

with larger facilities

to provide some of

these services that

have only been

offered here.

Competition will

increase for some of

these services.

Ability to increase

number of tests- the

ability of opening

another procedure

room.

Matching

performance with

patient

expectations-patient

expectations of

timely testing staying

on schedule.

Technologist’s

safety-technologists

are not exposed to

chemicals.

Figure1- PEST analysis

There has been a decline in the approval of the number of chemicals that become drugs

directed towards cardiovascular disease by the federal drug administration (FDA) since 1999.

Description of plan

The solution should be the purchase of three new TEE disinfectors.

Significance

This solution will resolve the problem of ever having to go without a unit to disinfect

probes for four weeks when there are at least 40-50 procedures scheduled for that time period

and the unknown number of unscheduled inpatients.

Methods

There is one vendor. Due to the exclusivity of the product, it is not recommended to have

one unit with the volume of studies done.

PROPOSAL FOR TRANSESOPHAGEAL

DISINFECTION

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Problems

There are potential problems in the current budget as money has been slated for some

construction that has gone over budget. The amount of $62,000 may have to come from a source

that will set back plans that are already earmarked and in the works. Current volumes can replace

the money in two-three months and can replace money for a project that is already on hold.

Budget

Proposed Budget 2016

Transesophageal

probe disinfector

$10,000 3 $30,000*

Transducer cabinet $0 $0

Plumbing $2,225 1 $2,225

Electrical $500 2 $1,000

Room outfit $0 $0

Discount for buying

multiples

$1,000 3 -$3,000

Components $30,225

Monthly supplies for

the year

Case of solution (32

bottles)

$250 24 $6,000

Case of cleaning

sponges(50 sponges)

$250 12 $3,000

Case of printer paper

(5 rolls)

$12 52 $624

Air Filter $395 1 $395

Neutralization kit $125 2 $250

Supplies $10,269

Maintenance

Repair $3,000-$4,000 2 $6,000-$8,000

PROPOSAL FOR TRANSESOPHAGEAL

DISINFECTION

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Shipping parts and

service

$5,000 2 $10,000

Preventative

maintenance

$300 (3 machines) 12 $3,600

Maintenance budget $21,600

Entire budget $62,094

*The disinfector company will offer a discount of $1,000 off for purchase of multiples.

The current charge per TEE is approximately $1,000-1,500 per study (the higher rate

includes an anesthesiologist). At $1,200 per study and 10 studies average per five day week, the

equipment will pay for itself in two-three months. This includes potential maintenance plan.

Timeline

The timeline, barring unforeseen problems should take four-eight weeks.

PROPOSAL FOR TRANSESOPHAGEAL

DISINFECTION

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References

Laslett, L. J., Alagona, J., Peter, Clark, 3., Bernard A, Drozda, J., Joseph P, Saldivar, F.,

Wilson, S. R.. . Hart, M. (2012). The worldwide environment of cardiovascular

disease: Prevalence, diagnosis, therapy, and policy issues: A report from the american

college of cardiology. Journal of the American College of Cardiology, 60(25 Suppl),

S1.

Rutala, W.A., Weber, D.J., (HIPAC) 3. (2008). Guidelines for disinfection and sterilization in

healthcare facilities 2008.Centers for Disease Control. Retrieved from

http://www.cdc.gov/hicpac/Disinfection_Sterilization/3_1deLaparoArthro.html