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Methodology For Infusion Pump Audit - Scope and Purpose
Since 1980, Medical Products Marketing Services (MPMS), now a division of Market Dynamics, Inc. (a Wheeling, IL based medical market research firm), has maintained a private database of the inventory of a wide range of electronic infusion pumps in a sample of 7-800 US hospitals. Audit updates are conducted by means of telephone interviews with multiple hospital sources, primarily Biomedical Engineers, Central Supply and Purchasing personnel. When needed, departmental nurses are contacted to audit the availability of smaller or portable pumps, especially ambulatory pumps and syringes.
 
 
The contacts on the panels are long-time respondents, who update the database by checking their computer records and reporting over the phone or by mailing inventory updates. This phone-mail-phone approach has proven to be very reliable. Although there is a higher cost associated with this approach, registered nurses are used as phone interviewers because they have consistently demonstrated higher recruitment rates and greater accuracy in data collection.
The panel was originally recruited on the basis of a randomized selection process. Any replacements are chosen to keep the panel balanced along the original selection parameters: geography, hospital bed size and solution supplier.
A stratified sample of 700-800 hospitals is used to obtain updates at about 6-month intervals. The stratification is in 28 cells, including the 4 major geographical regions and 7 staffed bed size categories consistent with the SMG database. Additionally, hospitals are selected with the right proportion of the 3 IV suppliers: Hospira, Baxter and F.Braun. The data is then aggregated to 16 data cells (where 2 SMG bed size categories have been combined as shown in the report) and broken out by the 3 IV suppliers. While the SMG database universe is used as a basis for the stratification and targeting of contacts, only acute care-medical-surgical hospitals are used for sampling and projections. There are no long term facilities or long tem components in the mix, and only hospitals with a minimum of 25 staff beds (or greater than 15 census beds) are sampled. Furthermore, specialty hospitals, such as rehabilitation and mental institutions, are excluded from the survey. A universe of just over 5000 hospitals in the continental United States is used for the sample. Raw data is then projected to provide the installed base and placement of infusion pumps semi-annually.
Every item of equipment is maintained in the database. Each item has the following data elements:
1. Pump quantity
2. Month/year of installation
3. Installation type: New Placement, Replacement or Removal
4. One-to-one linkage of replacement information
5. Removal history, where applicable
6. Location/department and acquisition types are audited, but limited
Definitions
The definitions of count parameters and terms used in this report are:
Installed Base
Devices already installed and calibrated for use by the end of the period are counted as the installed base. (Comparisons to internal sales need to take into account that models “sold” in the most recent month prior to the close-off period will not impact the installed base of placements until the following period and the next report).
Placements
Increase in the installed pumps either from additions to inventory or from replacements.
Additions
New placement of pumps that increase the installed base. These are newly acquired equipment that do not replace existing units. Software changes to models (with the same manufacturer model code) are not reported separately as per the request of clients.
Replacements
Replacements are new devices that upgrade existing equipment, either replacing an item from the same manufacturer or switching-out to a competitor.
Removals
Devices removed from inventory and not replaced. A hospital’s inventory is directly
reduced by removal of these items.
Activity
The key to market analysis is to analyze the activity within a period, which is defined as the impact on the installed base of the components listed above and to analyze the market segments (bed size, region and IV solution accounts) in which this activity took place.
Installed Base Last Period
+ Additional this period
+ Net Self-Gains or - Net Self Losses
+ Net Competitive Gains or -Net Competitive Losses
–  Removels
= Installed Base For This Period
Validation and Verificiation
Several verification steps are routinely implemented. On a rotating basis, about 5% of hospitals are asked to send an inventory printout for a check against the database. If a hospital does not comply, that hospital is targeted for a multi-level (key departments) verification of hospital inventory. Hospitals that have been inactive over a 24-36 month period (old equipment) are also targeted for multi-level calling. Hospital staff (or census) device/bed ratios are compared to national averages to point out “suspicious” hospitals for special follow-up.
Aggregated number of both installed base and period placement are checked for reasonableness with internal numbers for each company.
 
 
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