Criteria for planning radiologic equipment replacement

The correct procedure for acquiring new radiologic equipment includes technology assessment, the analysis of needs, equipment purchasing/renting, room setting, equipment installation, management, and planned replacement. Therefore we need a simple, independent and objective procedure to analyze the technical and economic need of replacing a piece of radiologic equipment. We report on a simple evaluation method permitting to judge radiologic equipment acceptability, as stated by the relevant Italian laws.

Our system is adapted from similar business applications; it analyzes five main parameters, namely: support services (equipment age and working age, maintenance charges and the availability of spare parts), equipment function (life-supporting, diagnostic or treatment units; in an emergency department), the cost/benefit ratio, clinical efficacy and overall safety. If needed, another parameter can be added: accessibility by patients, involving such issues as time and ease of access to the examination/equipment and its location. The different criteria of radiologic equipment acceptability can be used to calculate the acceptability index (AI), as follows: AI = 0.4 (a + b + c + d) + 0.2 (e + f + g) + (h) where: (a) = unit's age, (b) = maintenance charges, (c) = non-use times, (d) = availability of spare parts, (e) = equipment function, (f) = operational analysis, (g) = diagnostic efficacy, (h) = safety. Each parameter is given a score according to the existing situation.

Four scenarios can result from the analysis: 1) the equipment needs not be replaced; 2) replacement is not urgent and another check is scheduled within 12 months; 3) replacement must be scheduled; 4) the equipment must be urgently replaced (within 12 months). In the latter case, the unit should be disconnected at once if safety measures are violated irremediable.

Our method is easy to use and a valid tool also for radioprotection purposes: the main difficulty is collaborating with the administrative offices in charge of equipment purchasing and maintenance. The facility's head radiologist can use the analysis to provide economic (and thus objective and indisputable) data about the need to replace, supplement, update, or repair pieces of diagnostic imaging equipment. Also, maintenance form and terms could be renegotiated and radioprotection improved. The Italian Society of Medical Radiology (SIRM) might suggest this method to the Italian Ministry of Health as the basis of the parliamentary bill on radiologic equipment replacement.