orm_mar_apr-2025 - 23

Finances
Regardless, Spring emphasizes that
renting and leasing are not the only options.
Others include:
* Rent to own. Like renting or leasing,
this funding scenario requires no
capital and no commitment, and it
includes a set term and price.
* Placed for product. The vendor
places the capital equipment in the
facility, and the organization commits
to purchasing consumables on
a monthly or annual multi-year commitment.
Failing to meet spending
commitments results in a penalty,
and the vendor retains ownership of
the device.
* Per-use agreement. The vendor
places the device in the institution,
and the organization commits to a
minimum number of procedures.
This pay-by-procedure for use of the
device also includes paying for the
use of consumables.
* Place for product and per-use
agreement. In this combination of
the previous two options, the hospital
or health system commits to
a minimum volume of procedures,
then pays by procedure for the use
of the device and any consumables.
This option presents no pathway to
ownership.
The direction hospitals go via spending
or
leasing depends on a given
healthcare facility's finances and the
philosophy of their institution. " Some
people want to own equipment, others
prefer to lease or rent it, and some
people do a mix because they can't afford
to buy it all, " Spring says.
At Mass General, Spring says he approaches
capital investments with a
mindset of " buy first, and lease second, "
with built-in upgrade options. If he
knows the technology for a given device
is moving quicker, then he builds an
upgrade opportunity into the lease. " So,
if in 2 years, something new comes out,
I give the equipment I'm leasing back
and start a new lease agreement, " he
explains.
www.ormanager.com
Staff shortages
Hospital staff shortages, especially in ORs,
are well documented:
➤ A new study by the Mercer consultancy
and its partner Lightcast projects
a shortage of about 100,000 critical
healthcare workers by 2028. The Health
Resources and Services Administration
(HRSA) forecasts a deficit of 78,610
full-time registered nurses (RNs) in
2025 alone.
➤ A 2024 integrative review of perioperative
nursing shortages cited annual
surveys from AORN, which found the
percentage of vacancies of full-time perioperative
nursing positions rose from
3.1% to 18% from 2013 to 2023.
➤ The annual OR Manager Salary/Career
Survey reveals consistent staffing
challenges from year to year. The
most recent edition, 2024, showed
slight improvements in some parameters,
but these gains were often offset
by other factors. For example, the
percentage of respondents reporting
an increase in open positions for STs
fell slightly, but more than a third of
Technological evolution
Technology advancements pose a significant
challenge for financial teams
who are constantly being asked by surgeons
and other influential stakeholders
to upgrade the equipment to ensure
their institution can provide the best,
most modern medical care. " Is the technology
changing every 2 years, every 4
years, or is it changing every couple of
months? It's really important to understand
the speed of advancement of a
particular technology, and whether you
want to upgrade it, " Spring says.
For example, OR tables are not being
reinvented every few years. However,
imaging equipment changes all the
time. " There's always new software,
and safer, lower-radiation image taking, "
Spring says. " You often want the
opportunity to upgrade without having
respondents still reported high vacancies.
Additionally, most respondents
reported increased surgical volume.
References
Future of the US Healthcare Industry:
Healthcare Labor Market Projections
by 2028. Mercer. 2025.
Nurse Workforce Projections, 20202035.
National Center for Health
Workforce Analysis. November 2022.
Saver C. Survey: Staffing woes ease
slightly, but challenges remain. OR
Manager. 2024;40(9):1,12-15.
U.S. Real Estate Market Outlook 2023,
Chapter 11: Construction Costs.
CBRE. December 13, 2022.
Xie A, Duff J, Munday J. Perioperative
Nursing Shortages: An Integrative Review
of Their Impact, Causal Factors,
and Mitigation Strategies. Journal
of Nursing Management. August 19,
2024.
to buy something every couple of years.
A lease allows you to swap out your
equipment. "
Surgical waste systems, such as
Stryker's Neptune system, also tend
to evolve quickly. " Three years ago,
there was Neptune Two, " Spring says.
" Now there's Neptune Three. Is it better?
There's this constant increase in
technology on the capital side and on
the product side in what we use on patients. "
Spring
suggests consulting with engineering
or technology teams who can
help finance managers understand what
the technology is and where it's going
from an engineering perspective. He
also advises talking to vendors, who
can point to where a particular technology
is headed in the near and long
terms.
OR Manager | Mar/Apr 2025 23

https://www.mercer.com/en-us/insights/talent-and-transformation/attracting-and-retaining-talent/future-of-the-us-healthcare-industry/ https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/Nursing-Workforce-Projections-Factsheet.pdf https://www.ormanager.com/survey-staffing-woes-ease-slightly-but-challenges-remain/ https://www.cbre.com/insights/books/us-real-estate-market-outlook-2023/construction-costs https://doi.org/10.1155/2024/2983251 http://www.ormanager.com

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