title: Post-purchase reassessment and improvement of neuroendoscope holder: importance of physician-manufacturer communication.
abstract: BACKGROUND
  Modern medical management requires constant quality improvement of the various instruments used for surgical procedures. Higher quality, less complicated handling, and reduced maintenance are all desirable qualities. However, any improvements in instrumentation require that surgeons must clearly understand the application of the device by adherence to the manufacturer's instructions. The weakness of this one-way information flow depends on the low interest among medical personnel for post-purchase reassessment.
  
  
  OBJECTIVE
  Service industries have research departments to investigate the post-purchase behavior of customers, and service recovery is considered essential to retain customers after service failure. All service providers can suffer service failures, and even the best providers may make errors in delivering service. Such an approach has been increasingly adopted in the risk management at medical institutions.
  
  
  METHODS
  We report our clinical trials of the post-purchase reassessment and product improvement of surgical instrumentation. Medical personnel reassessed the use of a newly developed endoscope holder based on the manufacturer's manual and made recommendations for possible improvements, which were examined by the manufacturer.
  
  
  RESULTS
  Simple but important improvement was achieved for reducing the instability and uncertainty of instrument fixation.
  
  
  CONCLUSIONS
  This bi-directional post-purchase communication between medical personnel and manufacturers can improve risk management in medical institutions.
authors.affiliation: Department of Neurosurgery, Kohnan Hospital, Sendai, Miyagi, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: R&D Division, Mitaka Kohki, Co., Ltd., Mitaka, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nakata
authors.affiliation: Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
mesh_terms: D004867:Equipment Design; D004869:Equipment Safety; D006801:Humans; D007221:Industry; D033183:Interdisciplinary Communication; D007564:Japan; D044582:Neuroendoscopes / Q000592:standards* / Q000639:trends; D010820:Physicians; D011358:Product Surveillance, Postmarketing / Q000379:methods*; D058996:Quality Improvement; D013525:Surgical Instruments / Q000592:standards* / Q000639:trends
keywords: Improvement; medical device; physician-manufacturer communication; post-purchase; reassessment