Table 3 Examples of criteria for resource allocation decisions
WHETHER TO BUY | WHAT, WHERE AND HOW TO BUY | |||||
|---|---|---|---|---|---|---|
Organisation-wide Committee | Program Committee | Department | Individual decision-makers | Approved Purchasing Units | Organisation-wide Committee | Department |
Introduction of new health technologies and clinical practices | Purchase of capital equipment | Purchase of capital equipment | Determination of clinical practices and purchase of clinical equipment | General purchasing | Purchase of clinical consumables | Purchase of pharmaceuticals |
Explicit criteria required for decision-making | Criteria ‘usually’ considered A weighted ranking is used for prioritisation | Theoretical ‘ideal’ criteria developed in workshop (different to criteria used in current practice) | Criteria ‘usually’ considered | Criteria ‘usually’ considered | Criteria ‘usually’ considered | Criteria ‘usually’ considered |
▪ Conflict of interest (Applicant and Committee members) ▪ Evidence of safety, effectiveness and cost-effectiveness (quality of evidence, size of effect and applicability addressed) ▪ Cost ▪ Clinical feasibility (resource implications, training, credentialing and competency assurance addressed) ▪ Access and equity ▪ Legal and ethical implications ▪ Suitable patient information brochure | ▪ Equipment serviceability and impact ▪ Clinical risk ▪ Occupational Health and Safety risk ▪ Accreditation and regulatory requirements ▪ Strategic importance to Monash Health ▪ Savings in operational cost and/or ability to generate funds ▪ Improved access | ▪ Workload management ▪ Clinical evidence ▪ Patient benefit ▪ Need ▪ Prioritisation of patient groups ▪ Waiting list ▪ Benchmarking ▪ Replacement for obsolescence ▪ Staff capacity ▪ Allocated budget ▪ Ongoing costs ▪ Funding opportunities ▪ Financial benefit to health service ▪ Multi-use of expensive capital ▪ State-wide planning and coordination ▪ Impact on other areas | ▪ Quality and safety/clinical risk ▪ Reducing complications ▪ Ease of use ▪ Staff capacity ▪ Cost/cost effectiveness ▪ Consumer demand ▪ Delivery time of machines ▪ Brand changes (implications for spare parts, training, etc.) ▪ Training needs of staff and consumers ▪ Quality of care | All APU purchase decisions are made with commercial/financial consideration including ▪ Price ▪ Cost-effectiveness ▪ Improved supply chain efficiencies Other factors considered ▪ Clinical need ▪ Legal issues including Health Purchasing Victoria contract requirements | ▪ Price ▪ Australian standards and regulations for quality and safety ▪ Infection control/ Occupational Health and Safety standards ▪ Serviceability ▪ Business administration such as supply chain and logistics ▪ Meets organisation’s clinical emphasis and infrastructure requirements ▪ Clinical acceptability and effectiveness | ▪ Labelling ▪ Quality ▪ Price ▪Pharmaceutical Benefit Scheme status ▪ Acceptance |