Ask a respiratory therapy department how many ventilators it needs, and the answer is usually the number it needed on the worst day of the worst winter it remembers. That is a reasonable answer for patients and an expensive one for the hospital, because the equipment bought for that day sits in a storeroom for most of the year, ageing out of software support.
There are three alternatives, and most hospitals can use all of them:
- Flexible subscriptions that let a hospital add beds for the winter in blocks of two and return them in the spring.
- Loaner pools held regionally by the lender or the manufacturer, with a guaranteed delivery time.
- Utilization-based terms under which idle equipment costs very little.
None of these is a substitute for clinical judgment about what a unit needs on its worst day. They are ways of paying for that judgment that do not assume every day is the worst day.