“He who fails to plan, plans to fail”

---

Last month, I wrote about the importance of replacing aged medical imaging equipment. But how is it best to go about convincing the leadership of a facility to invest in new equipment?

Radiology departments, imaging facilities, and private practices need to replace or add medical imaging equipment and technology continually. Often the reason for these new purchases is merely to replace old or broken equipment. Sometimes it is to acquire new technology, improve patient experience, or to achieve a higher throughput of patients. But no matter the reason, cost and revenue implications are the two usual speed-bumps in the road.

The cost to replace x-ray equipment is often the most significant part of a radiology department's budget. But the sometimes forgotten expenses associated with the purchase of new equipment will also include the cost to remove the old piece of equipment, the construction cost of the room to accommodate this new apparatus, the training fees necessary to train the staff, and the loss of revenue while all of these factors take place. Often because of these hurdles facilities cannot justify the expenditure and loss of revenue to purchase new equipment, so they continue to utilize their equipment past the typical "end of life" period.

One other factor for a facility to consider when receiving a request to replace old or broken equipment is the amount of reimbursement that insurance providers are paying for these services. Imaging providers are facing increased scrutiny as to if a procedure is necessary and then when it is approved, the amount of reimbursement declines every year.

The result is that imaging facilities are competing amongst other internal departments for budgetary dollars. The question then becomes, how to make your request for new equipment stand out amongst the other worthwhile projects from other departments?

One of the tools that can assist in organizing your request for new equipment is a Critical Event Timeline (CET). The CET is a tool used by many facilities to effectively plan and manage the purchase, installation, and training for a new piece of equipment. A good CET will provide all of the significant milestones as well as the party responsible, in the purchasing of new medical imaging equipment.

Included in the Critical Event Timeline should be the following milestones the creation of a business plan and defining the decision makers, team, department needs, equipment, and installation timeline. The development of bid specification and evaluation criteria are also imperative to a good CET. Arranging the vendor presentations and setting up a process to review and evaluate all of the quotes received against the evaluation criteria is also a part of the CET. Also, adding the vendor's installation timeline, the construction timeline, and training on the new equipment are essential parts of the CET. When creating a CET, it is best to start with the day that you want to see patients and work backward. Working backward will allow you to know when the planning should begin. If you find that your start date is before the current date, the Critical Event Timeline will allow you to adjust the timeline of some of the milestones or provide you with a more realistic day to see patients.

Lastly, and arguably one of the most critical components to the CET, is the Cost of Delay. The total days delayed multiplied by the revenue generated by that piece of equipment is the Cost of Delay. This dollar value will show the decision makers the cost of inaction and any delays.

The use of a Critical Event Timeline will ensure that your new equipment is ready to see patients on the day you want and allow your team to understand the monetary cost of delays in decisions. This tool will show your decision makers that you have invested the time to plan and research the future of your department.

Planning to succeed will definitely have a better impact on your department, than planning to fail.