Robert Child and his small El Paso, Texas-based company, Lyco, are addressing a problem many hospitals might not realize they have. In fact, any hospital that doesn't know if it has the problem probably has it, Child says.
Lyco holds the patent on a device called the Mediscan. Built like an open-ended barrel, it scans bags of trash and soiled laundry, sounding a high-pitched alarm when it detects surgical tools that inadvertently have been thrown away. Some hospitals literally are tossing as much as $100,000 per year or more into dirty linen and biohazard bags, Child says.
Precise figures are elusive. Obviously, if hospitals knew how much money in instruments they were losing, they would be making more of an effort to avoid throwing it away, Child says. So he typically asks administrators how much they budget for repair and replacement, because equipment lost in the trash could be a significant component of that figure. One hospital customer, he notes, told him it set aside $750,000 annually to cover those costs.
"I have found very, very few hospitals that can tell you how much they are losing," Child says.
A common problem
The Mediscan, which sells for $6,500, was developed about three years ago at the request of a Texas hospital that realized it was losing lots of money in the surgical trash. Child says he started checking around to see if other hospitals were experiencing the same problem. He found one in the El Paso area that chooses to remain nameless. It reported it was losing $9,000 monthly in reusable surgical instruments going out with the trash. That has been resolved since the hospital purchased the first Mediscan three years ago, Child says.
Since then, Lyco has sold "a few hundred" Mediscans to hospitals nationwide, Child says. On Feb. 1, it consummated a three-year contract with Novation, the joint supply company of VHA and University HealthSystem Consortium. He says it took a year of hard work to get his foot in the door of the group purchasing organization, but now that he has a contract "(Novation is) promoting the heck out of it."
Because surgical trash is chock-full of metal objects and aluminum packaging that should be thrown away, this baby-with-the-bath-water dilemma constitutes a problem that can't be solved with a garden-variety metal detector, Child explains.
So the Mediscan was designed with two settings. An all-metal setting ensures that both disposable and nondisposable sharp objects won't make their way into the laundry where they can tear up the expensive neoprene pads that squeeze the water out of washing machines. A second, so-called "discreet" setting is sensitized for stainless steel and can be calibrated by scanning a surgical instrument, such as a 1-inch-long clamp called a bulldog, a $400 item, Child says.
If anyone can appreciate the expense of small medical items (and the large margins that device vendors enjoy), it's Child. An electrical engineer, Child ventured into the medical device-manufacturing business in 1994 because, he says, "I couldn't believe the margins. It was unreal; (Isaw) triple the margins from what I was used to."
Child cautions that the Mediscan's effectiveness is only as good as the monitoring system in place at the hospital. "This product will not succeed unless you have someone in the hospital who is like a Marine drill sergeant, someone who will take charge of cost reduction," Child says.
The Mediscan comes with a built-in incentive: Anyone who, after the alarm sounds, has had the unenviable chore of sorting through trash filled with items such as wet gauze and perspiration-saturated wipes will not want to do it again, Child says. As a result, successful programs are only periodically scanning samples of their trash-just frequently enough to keep employees aware of the unpleasant task ahead if something valuable gets thrown away.
Results from using the Mediscan to avoid laundry mishaps are still inconclusive at 467-bed University of Wisconsin Hospital and Clinics in Madison, says Marlene Koch, business manager of the surgical services department. The hospital has been using the scanner since early last December. The hospital outsources its laundry with other hospitals in town. Surgical tools inadvertently were going out with the laundry but not always coming back, Koch says. The laundry now reports, however, that based on a preliminary review, the situation seems to be improved.
"It's a lot of work for the laundry people, but it keeps everybody on their toes," Koch says. She couldn't estimate the hospital's losses before it bought the Mediscan.
On the other hand, the Mediscan purchased more than a year ago by 379-bed Genesys Regional Medical Center in Grand Blanc, Mich., sits idle. No one is certain who ordered it in the first place or why, says Michael Herrington, the hospital's distribution manager. The detector was too sensitive, and since changing linen services and moving to disposable surgical packs, there's really no use for it now, Herrington adds.
"It's too labor-intensive because you have to handle every piece of trash or linen twice," Herrington says.