Place fewer devices into your maintenance program, lowering your manpower requirements, and you can achieve a higher compliance rating. That's risk assessment. And that's a whole other issue (see Risk and Balance, and Risk Criteria), with a whole set of variables and issues unique to a viewpoint. Place fewer devices in the denominator when you calculate compliance, and  you've instantly increased your compliance rating.

There are two ways to raise percent compliance--without increasing the number of inspections--adjust the risk assessment methodology, and adjust the denominator of the compliance calculation down (assuming we agree that percent compliance, at any given time, is the number of devices not due for a periodic inspection, divided by the total number of devices in the maintenance program).

What's the problem? JCAHO has set strict standards for compliance--95%, and according to JCAHO, surveyors are the ones who make a determination as to the efficacy of a particular program. The problem is, 95% in one facility can represent a different level of compliance than the 95% in another facility. The problem is, administrators and department heads can find a clear path in adjusting inventory levels on paper, compared with assessing a department's labor requirements. The problem is, the JCAHO "standard" only states that facilities must have a standard, not what that standard must be. In other words, a non-standard standard.

Smaller facilities with a smaller inventories may not feel the same pressure to adjust their denominators downward. But larger ones with big inventories, and that includes the larger service companies maintaining equipment at any sized facility, surly feel pressure to find any way possible to increase compliance without incurring cost.

Why pick compliance calculation instead of risk assessment to standardize?

Compliance calculation should be the starting point in setting meaningful standards for the business of clinical instrumentation maintenance because it is relatively easy to implement--there are few variables, and the standard can be applied to any institution regardless of size, quantity and sophistication of instrumentation, and services provided.