Multiple Anesthesia Machine Manufacturers in the same Facility

[OneTyme]

Need some help:

My department wants to transition from one manufacturer to another. The hospital is saying it’s “unsafe” to have two different manufacturers in the same facility… likely a guise to make use stay with the same company.

Are there any studies out there that say it’s safe to have two different manufacturers in the same facility? (IE Draeger and GE machines in the same hospital)

Thanks for the help, I’ve been looking for days and can’t find jack squat.

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[coffeebythelake]

Need some help:

My department wants to transition from one manufacturer to another. The hospital is saying it’s “unsafe” to have two different manufacturers in the same facility… likely a guise to make use stay with the same company.

Are there any studies out there that say it’s safe to have two different manufacturers in the same facility? (IE Draeger and GE machines in the same hospital)

Thanks for the help, I’ve been looking for days and can’t find jack squat.

That's a BS excuse from your hospital admin. Sorry. There are certain standards in engineerjng of these machines irregardless of the manufacturer. And yes we've had multiple different models and manufacturers at different anesthetizing locations in the same hospital.

 

[abolt18]

I can just say that we have numerous machines, mostly Draeger, but a few different generations and styles of Draeger (Perseus, Apollo, Fabius, Fabius MRI, and at least 1 more i can't think of). The occasional old Datex Ohmeda Aestiva 5 (i believe that's the model). We also have GEs in our attached outpatient surgery center that is staffed with the same anesthesia personnel. A separate outpatient surgery center that we rotate through has Mindrays, but that's what was already in place when our hospital bought the surgery center.

As a trainee i appreciate having different machines to learn on. Good experience for me without a doubt.

 

[woopedazz]

There's no study on it, because it's a dumb statement by them 😆. Only theatres 8-11 at my current place have the same identical machines, every other one is a random manufacturer/ model that is not repeated.

I've never worked at a hospital that only has one manufacturer, even if the main theatres are all on brand GE, the remote sites are always some random drager thing from eons past.

 

[Mman]

every hospital I have ever worked at (excluding tiny places with only maybe 1 or 2 ORs) has had multiple different types of anesthesia machines. Maybe some are relics from a previous round of buying that are still in rotation, maybe one is an MRI safe machine different from the regular ORs, etc.

 

[OneTyme]

Yeah… the ortho guys have like 7 different reps from 5 different companies constantly bringing things into operating room, but that’s like totes safe.

 

[GassYous]

Yeah… the ortho guys have like 7 different reps from 5 different companies constantly bringing things into operating room, but that’s like totes safe.

They are young and hot though so I don't mind

 

[Velefunt]

I'm a little surprised this is the hill you want to defend. As long as the new machines are a "better" or equivalent option, I'd be fine if all the machines are the same. There's no studies, but certainly having interchangeable parts and same serviceable components is more efficient and practical, much less having economy of scale in purchasing and awarding to a single preferred vendor.

If I have a component malfunction, ie: vaporizer, exhausted absorbent, module, cable, etc fail mid-case, and say we're operating on call and have limited staff, no techs available, it's easier to have the circulator scavenge me a part from another room vs trying to find what I need from the supply room or bringing me the wrong item.

The only time there's a different machine would be something like MRI-compliance or a traveling machine that's a little more stripped down. Most of the surgery centers we work at also have given us the benefit of assisting with their setup, so they all run the same anesthesia machines.

 

[GassYous]

I'm a little surprised this is the hill you want to defend. As long as the new machines are a "better" or equivalent option, I'd be fine if all the machines are the same. There's no studies, but certainly having interchangeable parts and same serviceable components is more efficient and practical, much less having economy of scale in purchasing and awarding to a single preferred vendor.

If I have a component malfunction, ie: vaporizer, exhausted absorbent, module, cable, etc fail mid-case, and say we're operating on call and have limited staff, no techs available, it's easier to have the circulator scavenge me a part from another room vs trying to find what I need from the supply room or bringing me the wrong item.

The only time there's a different machine would be something like MRI-compliance or a traveling machine that's a little more stripped down. Most of the surgery centers we work at also have given us the benefit of assisting with their setup, so they all run the same anesthesia machines.

I've never been in a position where I needed to have someone scavenge a part from another machine intraop though

 

[Velefunt]

I've never been in a position where I needed to have someone scavenge a part from another machine intraop though

Yeah, I don't know what to say about that; Maybe people are more rough with our gear or turnover cleaning wrecks stuff? It's not uncommon once in a while to have a temp probe cable fail, ECG cable fail, pulse oximeter fail, water trap exhausted and no replacement in the drawer, gas analyzer fail, discover the one absorbent canister in the drawer has already been used, the NIBP cuff inflating motor go out, so I've definitely had circulators go to an empty OR during the night and grab me the component from that room or drawer to keep the case going.

It's easier to point and ask them to bring back this particular part off the other machine, than go to the storeroom and find this.

 

[coffeebythelake]

I'm a little surprised this is the hill you want to defend. As long as the new machines are a "better" or equivalent option, I'd be fine if all the machines are the same. There's no studies, but certainly having interchangeable parts and same serviceable components is more efficient and practical, much less having economy of scale in purchasing and awarding to a single preferred vendor.

If I have a component malfunction, ie: vaporizer, exhausted absorbent, module, cable, etc fail mid-case, and say we're operating on call and have limited staff, no techs available, it's easier to have the circulator scavenge me a part from another room vs trying to find what I need from the supply room or bringing me the wrong item.

The only time there's a different machine would be something like MRI-compliance or a traveling machine that's a little more stripped down. Most of the surgery centers we work at also have given us the benefit of assisting with their setup, so they all run the same anesthesia machines.

Listen, I don't disagree with you. Having a single set of parts is great for cost and servicing. But the OP was told by hospital admin that it is because having different manufacturers make things *UNSAFE* and that is false. People in the healthcare field like to use terms like "patient safety" to justify their position and shut down the conversation no matter how ridiculous it is. The ulterior motive here has nothing to do with safety.

 

[kidthor]

Ask your hospital if the spine surgeons must all use the brand of (otherwise equivalent) pedicle screws? Because multiple manufacturers are unsafe per said hospital, of course.

 

[OneTyme]

I'm a little surprised this is the hill you want to defend. As long as the new machines are a "better" or equivalent option, I'd be fine if all the machines are the same. There's no studies, but certainly having interchangeable parts and same serviceable components is more efficient and practical, much less having economy of scale in purchasing and awarding to a single preferred vendor.

If I have a component malfunction, ie: vaporizer, exhausted absorbent, module, cable, etc fail mid-case, and say we're operating on call and have limited staff, no techs available, it's easier to have the circulator scavenge me a part from another room vs trying to find what I need from the supply room or bringing me the wrong item.

The only time there's a different machine would be something like MRI-compliance or a traveling machine that's a little more stripped down. Most of the surgery centers we work at also have given us the benefit of assisting with their setup, so they all run the same anesthesia machines.

The hospital NEEDS new vents for a couple of our ORs. Our department trialed Draeger, GE, and another brand.

We voted to go with a different manufacturer from our current one.

The hospital admin is upset and doesn’t want to change, you know, because SAFETY.

 

[IlDestriero]

We went through this process recently and liked a competitor of the brand we use exclusively in the ORs across the enterprise. We concluded that it would be easier and more efficient to continue with the existing brand and not change. It didn’t offer any significant advantages that would make the change worthwhile.
I don’t think it’s really a safety issue, but having 1/2 the stuff not work on 1/2 the machines is an issue for supply, storage, maintenance, etc. It’s worth considering if that hassle is worth whatever advantage you perceive to the other machine.

 

[deleted697535]

The hospital NEEDS new vents for a couple of our ORs. Our department trialed Draeger, GE, and another brand.

We voted to go with a different manufacturer from our current one.

The hospital admin is upset and doesn’t want to change, you know, because SAFETY.

So theyre not refusing to buy new machines, just they want them all the same?
Thats not the worst point of view in the world is it?

Ive rarely worked in hospitals that have diff manufacturers with the vast majority being GE Aisys 99%, other 1% being drager apollo

Probably any 'new' machine is fine. at the end of the day these machines and volatiles are so safe right now compared to the stories of like 30 years ago does it really matter? Were not doing weaning trials on ARDS patients from ICU? Its just blasting out another lap chole etc... it doesnt matter

 

[Shimmy8]

This doesn’t seem like the spot or time to take a stand. Obviously they’re making **** up, but I can think of 100 more important battles to choose.

 

[OneTyme]

So theyre not refusing to buy new machines, just they want them all the same?
Thats not the worst point of view in the world is it?

Ive rarely worked in hospitals that have diff manufacturers with the vast majority being GE Aisys 99%, other 1% being drager apollo

Probably any 'new' machine is fine. at the end of the day these machines and volatiles are so safe right now compared to the stories of like 30 years ago does it really matter? Were not doing weaning trials on ARDS patients from ICU? Its just blasting out another lap chole etc... it doesnt matter

This doesn’t seem like the spot or time to take a stand. Obviously they’re making **** up, but I can think of 100 more important battles to choose.

I don’t disagree. They just won’t leave us alone about it…

Us, “We said our piece, just do what you want.”

Them, “We won’t do anything until you tell us we are right.”

I’ve asked to stop having the discussion in the last 4 meetings, yet here I am going to another meeting.

 

[IlDestriero]

Submit your written list of reasons you prefer A to B. Maybe have everyone in the group sign it.
Never say you want B, keep asking for A and saying that B would be an acceptable alternative if necessary.
Repeat prior to each meeting.
Try to find a new reason for A for each meeting to add to the list.
If they want to play dumb games, go all in!

 

[OneTyme]

Submit your written list of reasons you prefer A to B. Maybe have everyone in the group sign it.
Never say you want B, keep asking for A and saying that B would be an acceptable alternative if necessary.
Repeat prior to each meeting.
Try to find a new reason for A for each meeting to add to the list.
If they want to play dumb games, go all in!

UPDATE:

We had a meeting, included the CEO.

The CEO agreed with my reasoning.

We are getting our choice.

I’d like to dedicate this small victory to all my propofol homies out there that just bite their tongue and deal with what they are dealt.

 

[pjl]

We have all the same machines in our hospital. We told them which 2 we thought were fine, and they said ok. They then bought us all new ones.

By getting all the same brand the hospital saved about 40% per machine, so that’s the motivation. Savings with the other company would have been less.

 

[OneTyme]

We have all the same machines in our hospital. We told them which 2 we thought were fine, and they said ok. They then bought us all new ones.

By getting all the same brand the hospital saved about 40% per machine, so that’s the motivation. Savings with the other company would have been less.

I think that was the kicker.

I said, “Machine x is cheaper to use in the long run, we feel it’s safer, and we just plain like it. It isn’t going to hurt anything to put a few in the spots with no EMR integration. Then we can slow change vendors from there.”

Signed. Sealed. Delivered.

See you in two weeks Machine X! xoxoxoxoxoxoxo

 

[TheSandMan]

I think that was the kicker.

I said, “Machine x is cheaper to use in the long run, we feel it’s safer, and we just plain like it. It isn’t going to hurt anything to put a few in the spots with no EMR integration. Then we can slow change vendors from there.”

Signed. Sealed. Delivered.

See you in two weeks Machine X! xoxoxoxoxoxoxo

We're going to start switching out all our entire stock of anesthesia machines due to age (i.e. the manufacturer says they no longer support, though they work great). Hospital asked us to start trialing some potential replacements.
Curious what brand/model you went with and why?
Does anyone have any strong opinions on one brand over another?
The biggest factor for me is reliability, followed by cheap to run -don't want the hospital to be gouged on disposable parts like sensors and water traps.