British Columbia Ventilator Selection Survey

Background: Purchasing capital equipment such as ventilators is an important decision for providing critical care, as ventilators come with not only significant initial costs, but continuing costs as well. As a result, we sought out more information about what factors are considered when purchasing a ventilator beyond the newest high-tech mode or feature. Methods: A 29-question survey was distributed amongst RT department leaders in British Columbia, Canada, 21 leaders responded. Hospitals ranged in bed size: 14% ≤ 55, 19% 56-200, 48% 201-400, and 19% ≥ 400 funded beds. The ages of patients ventilated on a daily basis were: 14% birth-18 years, 38% birth-30 days AND ≥ 18 years old, and 48% ≥ 18 years old. Results: Feedback on ventilators from different professions was assessed with ‘very important’ being selected 91% of the time for the site’s own RTs, other hospital RTs 48%, biomed 19%, nursing 5%, medical directors 0%; feedback was considered ‘not important at all’ or ‘slightly important’ 0% of the time for the site’s own RTs, other hospital RTs 0%, biomed 14%, nursing 76%, and medical directors 62%. When assessing ventilator modes, 86% felt high quality noninvasive ventilation (NIV) was ‘fairly important’ or ‘very important’ and 81% felt neonatal invasive and NIV was ‘important or very important’. 62% felt high quality HFNC was ‘fairly important’ or ‘very important’. Capital funds are becoming tighter although 33% felt the purchase price was ‘not important at all’ or ‘slightly important’; while purchase price was ‘fairly important’ or ‘very important’ 29% of time. Ongoing costs were ‘fairly important’ or ‘very important’ for preventative maintenance 19%, proprietary supplies 29%, and warranty 14%. In regard to vendors, 67% of leaders reported both trust with the sales representative and the vendor’s ability to provide quality, in person, hands-on education as ‘very important’ to them. 48% said vendor technical knowledge is ‘very important’, and 52% reported history of support and response time as ‘very important’. Conclusions: This study examined interdisciplinary feedback, ventilator capabilities, price and quality, plus relationships with vendors and how each plays a role in the decision-making process. Although financial pressures continue to increase, this study revealed that quality care is still the most important goal highlighted by the importance of frontline RT feedback and the ventilator's ability to provide high quality neonatal modes, NIV, and HFNC.Importance of various modes/adjuncts once the decision is made to purchase a ventilator(s)Mode/AdjunctVery ImportantFairly ImportantImportantSlightly ImporantNot Important at AllAutomatically Wean "Simple to Wean" patients9%0%14%48%29%Automatically Wean "Difficult to Wean" patients0%0%38%24%38%High Quality Heated Humidified High Flow Oxygen19%43%19%9%10%High Quality Non-Invasive Ventilation57%29%14%0%0%Quality Invasive & Non-Invasive Ventilation for Neonates/Pediatrics43%38%10%0%9%Importance of costs associated with purchasing a new ventilator(s)CostsVery ImportantFairly ImportantImportantSlightly ImportantNot Important at AllPurchase Price of Ventilator5%24%38%28%5%Warranty5%9%48%24%14%Preventative Maintenance (Biomed Time/Supplies)14%5%38%29%14%Proprietary Ventilator Supplies10%19%52%19%0%Training Staff14%10%14%43%19%

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