title: Stakeholder challenges in purchasing medical devices for patient safety.
abstract: OBJECTIVE
  This study identifies the stakeholders who have a role in medical device purchasing within the wider system of health-care delivery and reports on their particular challenges to promote patient safety during purchasing decisions.
  
  
  METHODS
  Data was collected through observational work, participatory workshops, and semi-structured qualitative interviews, which were analyzed and coded. The study takes a systems-based and engineering design approach to the study. Five hospitals took part in this study, and the participants included maintenance, training, clinical end-users, finance, and risk departments.
  
  
  RESULTS
  The main stakeholders for purchasing were identified to be staff from clinical engineering (Maintenance), device users (Clinical), device trainers (Training), and clinical governance for analyzing incidents involving devices (Risk). These stakeholders display varied characteristics in terms of interpretation of their own roles, competencies for selecting devices, awareness and use of resources for purchasing devices, and attitudes toward the purchasing process. The role of "clinical engineering" is seen by these stakeholders to be critical in mediating between training, technical, and financial stakeholders but not always recognized in practice.
  
  
  CONCLUSIONS
  The findings show that many device purchasing decisions are tackled in isolation, which is not optimal for decisions requiring knowledge that is currently distributed among different people within different departments. The challenges expressed relate to the wider system of care and equipment management, calling for a more systemic view of purchasing for medical devices.
authors.affiliation: From the Engineering Design Centre, Department of Engineering, University of Cambridge, United Kingdom. s.hinrichs@cantab.net
authors.forename: Saba
authors.initials: S
authors.lastname: Hinrichs
authors.forename: Terry
authors.initials: T
authors.lastname: Dickerson
authors.forename: John
authors.initials: J
authors.lastname: Clarkson
mesh_terms: D001291:Attitude of Health Personnel; D003657:Decision Making; D006801:Humans; D010564:Personnel, Hospital; D011482:Protective Devices; D011682:Purchasing, Hospital / Q000379:methods* / Q000458:organization & administration; D013597:Systems Analysis; D013647:Task Performance and Analysis; D006113:United Kingdom