New Installations and Manpower

Cost-benefit considerations is necessary when we acquire or change hardware and manpower.  Hardware includes fixture, decoration, and equipment.   Consideration about institutional resources and considerations should go beyond justification.  An appropriate balance with cost-benefit analyses is necessary. On the other hand, when a need exists, especially in relation to patient safety, it is appropriate to spend resources instead of holding the wallet tight. It is an art to be APPROPRIATE.

For each decoration (change in premise), equipment purchase, headcount (staff), immediate and recurrent costs are necessary.

Some items for consideration in justification to installation/addition/replacement are listed below.

1. Data on service, present status, expected in near future with and without installation, new level of service reached with installation

2. Alternative handling without installation, flow expected with each alternative

3. Additional installation necessary with the change and (likely) expansion in service, on top to item in question, such as other hardware, space and manpower

4. Client/service net gain, in number of encounters and revenue in dollars

5. Expected duration with use-ability of new establishment

6. Recurrent costs: staffs, maintenance, consumables and utilities

7. Whether other arms may support the development, examples include availability of additional expertise, medical manpower

8. Other significant considerations related to the proposal

Choice of Supplier and Provider

There are likely to be multiple suppliers or vendors.  Reference is  made to the following considerations.  Principles parallel usual price comparisons for our own domestic purchases.

A. Obtain quotation for the product in plan, from more than 1 provider.  It is very reasonable to ask for the best local deal based on the amount of purchase, plus our reputation as a good customer and reference together.  It is inappropriate to ask for a deal predominantly to our own advantage, because it is not sustainable to the provider.  But it is equally inappropriate if our institute gets an unfair deal.  Counterproposals about bulk purchases are balanced between discounts and our ability to utilize the volume of goods ethically.

B. Ask the providers to give estimations on costs about products in the range, one price up and also one price down, together with features gained or lost with these alternatives.

C. Obtain preference and reference from end users and stakeholders.  Significant present and expected users must be consulted.  Sometimes the decision maker has to explain why not all users are consulted.  Again, active judgement on extent of consultation, and reasonable adoption of appropriate opinion is an art each manager has to develop.

D. If possible, obtain information about recent purchases of similar equipment, internally from the same institute (not necessarily same department), ally teams and unrelated organizations if possible.  This is very objective comparison about appropriateness with pricing.

E. Give an educated opinion as recommendation to institute.

Conflict of Interest

Being senior and respectable people, we declare any potential conflict of interest.