Creating a great place to work

Many companies say they want to be recognized and respected as a great place to work. Far fewer live up to that lofty standard, for many different reasons. It’s easy to say, but hard to do.
What do some of those great employers have in common? If you think, “A good pay and benefits package,” you’re only scratching the surface. Great employers also actively listen to their employees and ask for feedback, then respond appropriately. They invest in them. They leverage their workforce’s years of been-there-done-that experience into processes that best serve customers – and drive profits.

At J.M. Keckler, Inc., we seek to empower our 24 mostly sales-and service-based employees and make them proud of where they have chosen to work. Since 1973, we have created a culture and environment in which our employees can thrive through ongoing training, new opportunities and challenges, and fair compensation and benefits – all while working for the premier supplier of cutting-edge medical equipment sales, service and technology solutions in the acute care Industry in Northern California and Nevada.

We are proud that the average employee has been with Keckler for more than 10 years. We believe their experience and industry knowledge sets our company apart from the competition.
During the pandemic, our employees were considered “essential workers” and have logged thousands of hours repairing and maintaining the vital life-saving equipment found in nearly every hospital in Northern California. When the virus touched us, we covered for team members until they were better. Most importantly, while other businesses struggled to maintain staffing, not a single Keckler employee was laid off.
“The No. 1 strength of our JMK team is the way we respond to time-sensitive, complicated and adverse business situations,” said CEO Mike Keckler. “COVID -19 has presented our greatest challenge ever. The way our team has responded, to a person, is the greatest example we can cite of dedication and commitment in our half-century of business.”

Do you recognize yourself in us?

While recruiting, hiring, and retaining people who embrace and carry out our customer-centric philosophy is the foundation of Keckler’s success, we also aspire to do business with like-minded organizations who share our principals and devotion to sound, ethical business practices and treating employees right. We believe our support of such companies helps create a virtuous circle of honesty, integrity and respect. And this is our commitment to and foundation for wanting to create and maintain a great place to work.
Success is not guaranteed. Even a business with a nearly 50-year track record like Keckler must continually adapt and find the resolve to essentially embark on a renewal mission. That’s one reason that over the past few months, our management team and employees have begun a fresh dialog about what it means to be a great place to work given the company’s operating history and current reality.

This blog – and those that follow – is intended to share our narrative as we take a proactive and perhaps predictive approach to maintaining a positive, supportive work environment. Future blogs will touch on the impact that it’s having on our employees, customers, suppliers and even lenders.

Don’t miss this moment of change

It is our belief that we are at a unique time in history; perhaps, by many measures, an inflection point for transformative change not seen in decades. There are many important factors at play:
  • The impact of technology
  • The evolving concepts of work, compensation and education
  • The balance between careers and family or leisure time
  • The prevalence of legal drugs and alcohol use
  • Even the way society views serious mental and physical health issues
All these factors as they are today and as they will shift into the future will have a dramatic impact on every operating business. And the shifts explained by our human nature are likely to proceed at a pace never seen in our global sphere of business.
COVID is not the source of these changes; rather, the pandemic has undeniably cast a bright light on workplace shifts already unfolding and perhaps bursting at the seams. Though we are just one small company in Central California, we believe our experience and the examples we set in collaborating with our employees to create a great place to work can inform – and possibly even inspire — other businesses to make even better choices in their own workplace cultures.
Not convinced? Here’s one more tangible reason why any business owner should want to create a “great place to work” environment. According to multiple national surveys by human resource experts, the average open position takes about seven weeks to fill and has a financial impact of $5,000 to $25,000 because of recruiting and lost productivity. Higher-level positions costs soar even higher within an organization. Constant turnover at all levels of the company, exhaustive recruitment and continuous training is bad for the soul of any business.

Five solutions to help hospitals utilize the power of ‘Big Data’ analytics

The medical world is making a large shift toward “big data” to make faster, more informed and accurate decisions. Big Data is defined as chunks of information too large or complex for traditional databases to handle. Every day, doctors, nurses, technicians and hospital administrators are flooded with information. Data about patients, trends, outcomes, equipment, technology and more.
In such an information-saturated environment, it would be easy to become overwhelmed. A report on big data from Healthbox, a Healthcare Information and Management Systems Society (HIMSS) solution and advisory firm, acknowledges as much.
“The sheer volume, velocity and variety of data being collected poses challenges for harnessing and ensuring its validity to benefit both the macro, population-level health and the micro, evidence-based precision medicine,” says the report.
Translated: It’s hard for any one person in the health system to keep up with, much less analyze, the enormous volume of data being generated day in and day out from so many sources – medical devices, wearables, electronic health records, medical imaging, genomic sequencing and pharmaceutical research, just to name a few.
Fortunately, there are powerful tools available for hospitals that not only collect critical information, but also can cut through the mountains of data and make it usable for clinical and business decision making. Keckler Medical provides leading “big data” technology solutions to assist acute care hospitals overcome these challenges throughout Northern California and Nevada.

Like most industries, health care is moving toward big data solutions. These systems help clinical teams and administrators make more informed, more accurate and faster decisions to achieve safer patient outcomes while improving room utilization and workflow efficiencies to save the hospital money. And at the administrative level, it is a huge advantage to have this real-time data at their fingertips.

An article in the January 2018 journal of NEJM Catalyst suggests there are two trends at play pushing the healthcare industry to embrace big data.
“The first is the move from a pay-for-service model, which financially rewards caregivers for performing procedures, to a value-based care model, which rewards them based on the health of their patient populations,” the story says, adding that “healthcare data analytics will enable the measurement and tracking of population health, thereby enabling this switch.”
The second trend, according to the story, “involves using big data analysis to deliver information that is evidence-based and will, over time, increase efficiencies and help sharpen our understanding of the best practices associated with any disease, injury or illness.”
Keckler offers its customers multiple big data and video integration systems that allow hospitals and other healthcare facilities to more accurately manage and utilize their data and video records. Here are five examples:
  1. Skytron LENS (Location Enabled Notification System) Real-Time Location System (RTLS):  Manage assets with ease and track potential infections.  An asset-tracking system and a workflow enhancement system that many staff members within a hospital can utilize.  Infection control is vital in a facility.  This system allows you to access interaction history between patients, staff and equipment to contain infectious outbreaks.  You can pinpoint exactly where a piece of equipment is located in the facility as well as examine the workflow of staff and patients.  It can improve efficiencies by tracking a stretcher as soon as it enters the operating room. The surgeon would get a notification to be in the room in the next 10 minutes. It can also pinpoint the precise location of a piece of piece of equipment that is due for preventive maintenance to save the biomedical engineer perhaps an hour trying to track down the item in the hospital. Designed to boost productivity, improve workflow and lower equipment costs.  
  2. SkyVision SVIS-CAST Content Media Management System: This system can capture, archive and stream all video from operating rooms or other procedure environments. Doctors can record, store, share and collaborate with other physicians on videos and images with this innovative solution.  A doctor can be in the middle of a procedure and send a link via the Cloud to another physician 50 miles away and say, “Here’s what I’m looking at. What would you do?” Or a training hospital can have a room full of students watching the procedure, either live or later as part of their lessons. You can enhance surgical quality and patient outcomes through review and analysis.  
  3. SkyVision LINX 300 Video Integration System: This system manages and routes all the video sources in an operating room. This technology allows a surgical team to shift the images on the display screens on the fly throughout the procedure. It can also integrate data from the operating table as well as other sources. Two-touch Routing; Route Connected Sources to any Display; Stream Video Outside the OR to Multiple Locations Simultaneously; Easily Expandable for Future Needs; Configurable System Software
  4.  SkyVision Ascend Video Integration System:  This intuitive system allows staff to easily route images from any compatible device, allowing you to see what you want, where you want it.  Simple to Use; Access Stored Media from Anywhere; Communicate Audibly and Visually through SkyVision; Simple Installation; Reduced Footprint; Vendor Neutral
  5. Umano Medical Wi-Fi Bed Connectivity: Umano is a leading manufacturer of hospital beds. The newly added wi-fi connected technology allows multiple pieces of patient data to be collected from the bed itself to “talk” with computers and handheld devices, allowing for continuous and easier patient monitoring. It’s all about bed connectivity to enhance workflow and provide superior patient outcomes.

Wet Packs Prevention Protocol

Keckler Medical occasionally hears feedback from end users regarding condensate issues (wet packs) following sterilization. A wet load required that the sterilized materials be rejected and re-sterilized. This, in turn, can cause surgery delays and lost revenue in Healthcare settings.

Wet packs are the most difficult and complex technical issue to resolve in steam sterilization because of the numerous potential causes of excess condensation.

When working to identify the source of the problem, the following troubleshooting protocol is used by JMK based on over 40 years of experience.
Check the most common suspect first – steam quality.

JMK’s experience, along with that of numerous other sterilization experts, has shown that poor steam quality accounts for >95% of all wet packs issues!

Steam Quality

The first thing that end users must evaluate is the quality of the steam supplied to the sterilizer. Poor quality steam is defined as less than 97% (greater than 3% water content by weight) and can lead to excessive condensate formation within the sterilizer.
Things to check and evaluate:
  • Determine if excessive demand is being placed on the in-house boiler. Excess demand can cause carryover of water into the steam supply system
  • Examine the steam supply system for potential areas of condensate formation such as dead legs or improperly trapped or insulated piping
  • If the sterilizer is not physically close to the boiler, condensate will form and will need to be removed from the piping before the steam reaches the sterilizer. This is accomplished by properly located steam traps and filters along the route of the steam piping
  • Insulating the steam piping will help rescue heat losses and in turn reduce condensate formation.
  • Check the jacket steam trap and check valve at the drain port to ensure they are functioning properly.
If it is positively determined that the steam supply is not the source of excess condensate, the next step is to evaluate what is being loaded into the sterilizer.

Load and Load Configuration

Another potential cause of wet packs is the load itself. Overly dense packing is frequently a cause of excessive condensation which cannot then be completely “flashed off’ by subsequent steam injections. Large quantities of hard-goods or complex packaging can prevent proper steam circulation. Proper load packing procedures are thoroughly described by AAMI and should be followed.
When steam enters the chamber and contacts the product, the steam will condense on the product when a portion of its heat energy (latent heat of condensation) is transferred to the load being sterilized.
The resulting condensate will fall to the chamber floor and be discharged through the drain system. Proper removal of the excess water is crucial to prevent insulating the load from the steam.

Steam Quality

A wet pack in a clinical setting is a very serious issue. The wet load, by law, cannot be used and must be re-processed. This, in turn, causes the hospital or surgical center to fall behind in its daily routine. These inefficiencies are costly and often highly emotional.

In most cases the root cause of the wet loads is due to poor steam quality.

Often the end users believe their problems are due to a malfunction with the steam sterilizer itself!

Poor steam quality is usually caused by the inadequate design of the steam system, including the following factors:

  • Long piping runs from the in-house boiler to the sterilizer(s) with one or more “dead legs” (one temporary piping run was over 300 feet)
  • Lack of a bucket steam trap placed in the proper physical relationship to the sterilizer
  • Lack of a steam separator placed in the proper physical relationship to the sterilizer
  • Steam pressure not up to specification

This can be easily avoided if the proper attention to steam quality is provided early in the project (well before installation and start-up).

Again, discussions and agreements prior to installation will be the key to a well functioning sterilization process.

Other Technical Recommendations

Elevation wise, the separator should be mounted near but not above the sterilizer inlet with the trap line locating the bucket trap close to the floor. The bottom of the bucket trap should not be set below the drain line elevation.

Bowie Dick Testing – Part 2 of 2


The first step in troubleshooting is to verify that the vacuum system is performing properly.

  1. Have cycle parameters been changed to reduce the number of pre-vac or depth of prevacs?
  2. Vacuum pump seal water temperature must be below 70 degrees F.
  3. Water pressure to the ejector must be greater than 50 psig.
  4. Check for foreign material in the ejector.
There are two possible causes of a failed Bowie Dick test:
  1. Air not completely removed by pre-vac pulses
  2. Air leaking into chamber while under vacuum

The second step is a quick inspection of the most common causes of chamber leaks.

  1. Verify by independent test gauge that steam or air pressure to the seal gasket is set at 30-32 psig. Replace the gasket if worn or damaged. Use Dow Corning 111 silicone grease to lube the gasket.
  2. Inspect check valves common to the chamber for wear, damage, or foreign material that could be preventing a proper seal.
  3. Remove the air in filter and plug solenoid valve to verify that the valve is not leaking.
  4. Inspect for a loose pressure transducer.
  5. Remove and plug the chamber gauge and tubing.
  6. Verify that the RTD ferrule is not leaking.
  7. (While performing a vacuum test only!) Remove and plug the chamber safety valve to verify that the valve is not leaking. Replace the safety valve immediately and do not leave sterilizer unattended under any circumstances.
NOTE: Steam leaks to the chamber will not cause a Bowie Dick failure…only air leaks will!!!

The third step involves a chamber leak test.

Pipe fitting leaks (common during installation start-ups) often are due to the affects of transportation and handling. Vacuum leaks and pressure leaks are not the same! Looking for steam or condensate leaks while the chamber is pressurized is not a valid test for vacuum leaks.

If you need sterilizer service be sure to call Keckler Medical’s team of experts.

Bowie Dick Testing – Part 1 of 2

A Bowie Dick (BD) test is used to check for proper chamber air removal in vacuum steam sterilizers (commonly referred to as pre-vac or high-vac sterilizers). If the BD test passes, it tells the laboratory that there has been sufficient air removal to achieve required steam penetration into a standard load.

It is important to remember that Bowie Dick tests are not recommended for use in any other type of sterilizer!

The Bowie Dick test is designed to detect air pockets trapped within the sterilizer chamber. One and only one Bowie Dick test pack is to be run in an otherwise empty sterilizer.

Most hospitals routinely run one Bowie Dick test in each vacuum sterilizer each day. While not absolutely required, it is a good idea that the test be run at the same time each day after the sterilizer is warm. It is important the the test not be run in a cold sterilizer. If a sterilizer has not been used within an hour prior to doing the Bowie Dick test, the chamber should be preheated to operating temperature by running at least one empty chamber cycle. A test run from a cold start may produce false failures. The warm-up cycle will also ensure that any air is cleared out of the lines.

If a Bowie Dick test should fail, another Bowie Dick test should be run as a verification step. If the second test also fails, the sterilizer should be put out of service until the problem is identified and corrected.

Numerous manufacturers throughout the world make and sell Bowie Dick tests directly to end users and through several distribution channels. Each manufacturer uses the same basic process of placing heat sensitive inks onto the commercial paper in various patterns.

A Bowie Dick test failure is noted by the lack of a total uniform change to the final color as specified by the Bowie Dick test manufacturer.

For more information on Bowie Dick Testing or service give us a call.

Door Gaskets – Maintenance and Service

The function of the door gasket is one of the most important features in any steam sterilizer. Its primary function is to serve as the primary seal to contain steam within the sterilizer chamber.

The Care, Feeding, and Evaluation door gaskets are:

  1. Visually inspect the door gasket frequently looking for signs of wear such as cracks or abrasion and replace when necessary.
  2. If outward steam is present around the chamber door, this is generally a visual indicator that the door gasket is failing and should be replaced immediately.
  3. Visually inspect the door gasket to make sure it is retracting completely into the gasket groove. If the door gasket is either partially or not retracting into the gasket groove, a problem with the vacuum system (either vacuum water ejector or electric pump) could be the cause.
  4. If a sterilizer will not pass a vacuum leak test, a bad door gasket may be the cause.
  5. If during the sterilizing cycle, the sterilizer gains temperature and the steam to chamber valve is closed, an internal leak in the door gasket may be allowing steam to fill the chamber and will eventually cause an “Over Temperature Alarm”, replace the door gasket immediately.
  6. Make certain that the steam pressure from the sterilizer steam pressure regulator is set properly and will not overpressure the sterilizer door gasket.

The door gasket is considered a wearable item on the sterilizer and normal life is 3 to 12 months depending on service. The extreme variability in normal life is affected by steam quality (assuming steam actuated), material which ends up in the door gasket groove from spillage, mechanical abrasion from a partially retracted door gasket, and the number of cycles run.

For more information on door gaskets or service give us a call.

Did You Know? Wet Pack Prevention – Part 3 of 3 – Sterilizer Operation and Maintenance

Wet packs caused by machine malfunction are generally the easiest to identify and correct.


  • Ensure that the correct cycle was selected
  • Verify that cycle parameters have not been changed
  • Verify correct load size and load configuration as outlined in “Did You Know”
  • Follow the ANSI/AAMI ST79 Standard


  • Verify that jacket temperature is controlling at the chamber set point
    • Is the floor of the chamber hot? If not, you could have a malfunctioning solenoid valve or jacket trap
  • Check the door gasket for wear. Replace if necessary.
  • Insure the steam to chamber valve is not leaking

During maintenance, verify that the vacuum system is operational at 25″ -28″ HG

If the Vacuum is not in this range, then check the following:

Ejector Vacuum System

  • Verify water pressure is 50 PSI or greater
  • Check for foreign material in the ejector
  • Inspect the chamber drain check valve
  • Inspect the chamber drain control valve

Vacuum Pump System

  • Verify proper flow of seal water
  • Verify correct rotation of pump
  • Inspect the chamber drain check valve
  • Inspect the chamber drain control valve
  • Verify the seal water temperature is less than 70°F
  • Verify proper water flow through the heat exchanger

Generally, these steps will reveal the source of the machine malfunction.

Having problems with wet packs? We are here to help.

Did You Know? Wet Pack Prevention – Part 2 of 3 – Pack Types and Pack Configurations

When discussing wet packs it is helpful to review the various pack configurations and their unique susceptibility to wetness. There are four primary pack types:

1. Paper/Poly or Steri-Peel

2. Paper/Poly or Steri-Peel

3. Disposable Wrap

4. Rigid Containers

Rule #1

All materials to be sterilized must be dry when loaded in to chamber for processing. Moisture loaded into the chamber will not be sufficiently removed during the cycle.

Rule #2

Containers, large instrument sets, and basin ware should be loaded on the lower shelf. Steri-Peel, towel packs, and light weight packs should be loaded on the upper shelf. Containers and instrument sets should never be stacked.

Condensate is formed as steam gives up its heat to the packs. The amount of condensate is proportional to the weight of the load. While the load heats up to the set point, temperature steam converts to water, rains to the chamber floor, and is mostly removed by the chamber steam trap. Residual water is flashed back to vapor by the heated jacket and removed by vacuum during the drying phase. If heavy instrument sets are placed on the top shelf, the lower shelf will experience a rain storm. 15 lb. instrument trays will condensate about a cup of water while heating from 70° F to 270° F.

Rule #3

 Water likes to pool. Pooled water is the enemy of drying. Evaporation only takes place on the surface. A pool takes longer to evaporate.

Pools Inside of Packs
Are formed in closed end vessels not positioned to drain.

  • Basins
  • Eye Cups
  • Tubing
  • Cup Shaped Instruments
  • Small Trays

Rigid containers should be prepared with a muslin wrap in the bottom to wick moisture over a large surface area to enhance drying.

Pools Outside of Packs
These pools are formed by poor loading technique. Folds and creases of disposable wrap will hold and pool water. Care should be given to positioning these packs to minimize pooling.

Steri-peel should always be positioned on edge and separated in a rack (similar to a letter rack) to allow condensation to drip off the bottom edge.

Water droplets on the outside of Steri-peel or disposable wrap is not desirable, but will not contaminate the pack. They should simply be blotted off with a cotton towel. Water repellency is the benefit of disposable wrap.

Muslin packs are typically easier to dry since muslin can absorb a lot of water and disperse it over a large surface. There can be a 20% moisture content in cotton before it feels wet.

If we could watch the sterilization process, we would see a dense fog caused by the continual phase change from liquid to vapor and vapor to liquid. Steam sterilization takes place in a saturated steam environment. Understanding pack construction and arrangement is the key to controlling wet packs.

Having problems with wet packs? We are here to help.

Did You Know? Wet Pack Prevention – Part 1 of 3

Wet packs are defined as moisture in or on a tray following an approved completed sterilization cycle. Wet packs must be avoided because moisture can serve as a growth media or provide a means for organisms to travel back into a sterile pack. If wet packs are discovered, the load must be reprocessed.

Wet packs are unfortunately a periodic, albeit highly emotional, frustrating, and costly issue for many users of steam sterilizers, regardless of brand.

When analyzing the root cause(s) of wet packs, it is best to remember that wet packs are not simply random events, but are often complex problems with several variables that have their origin in the laws of physics and thermodynamics.

Steam Quality

Some things that can cause poor steam quality include:

  • Malfunctioning steam traps
  • Poor steam pipe insulation
  • Time of the year
  • Time of the day
  • Additional loads
  • Steam supply lines
  • Boiler condition

Four Major Cause Areas

  1. Steam quality to the sterilizer
  2. Pack/Material preparation and loading density
  3. Operation and maintenance of the sterilizer
  4. Pack/Material handling after the sterilization process

Adding to this complexity is the fact that wet pack problems are often intermittent. Also, several different parties often play a role in discovering and solving the problem(s) – central sterilization technicians. Facility maintenance, ASAs, the sterilizer manufacturer, surgery, etc. As most of you have likely experienced with wet pack complaints, emotions can sometimes play a larger role than logic and must be considered when dealing with these issues.

Basic Initial Troubleshooting Questions and Data Collection

When first approached about a wet pack issue, you should observe directly or ask the following questions and record the data for further evaluation and troubleshooting:

  1. Date and time wet packs were first noted?
  2. Are the sterilizer cycle parameters set correctly?
  3. Who operated the equipment during the cycle where wet packs were found?
  4. Do one or more employees experience wet packs more than other employees?
  5. How long has the employee been operating the sterilizer? Is he/she inexperienced? New?
  6. Do wet packs generally occur at a certain time each day?
  7. Do they happen only on certain shifts?
  8. Do they occur more frequently in a particular season of the year?
  9. What is the humidity in the area where the packs were assembled and wrapped?
  10. What maintenance has recently been conducted on the sterilizer?
  11. What maintenance has been conducted recently on the boiler and associated systems?
  12. Do wet packs occur only with certain size/type of instrument trays or containers?
  13. How densely packed are the sterilizer loads? Is there adequate space for steam circulation or could dead zones form in chamber?
  14. Are only approved trays and loading carts (if applicable) being used?

Keckler expert offers tips to safely move surgical tables

Surgical tables are significant investments for hospitals and surgery centers, often running tens of thousands of dollars each. So it makes sense that medical staff who regularly have to move these expensive and complex pieces of equipment know how to do so safely and easily.
One of the most popular and respected brands of surgical tables is Skytron, which makes more than a dozen tables that serve a range of purposes and have many important features to ensure patient safety and assist operating room staff. The exclusive distributor of Skytron products in Central and Northern California and Northern Nevada is Keckler Medical.

The Keckler team not only proudly sells Skytron surgical tables, it is also the factory authorized service center for them, providing expert advice about their care and maintenance.

A question that often comes up regarding surgical tables is how to safely move them out of an operating room – whether for maintenance or because a different table is needed for a specific procedure. 

A senior technician at Keckler, offered these tips:

    • It is recommended that two people work together to move tables.
    • Unplug the power cord before moving a table. Running over the cord can damage it and risk safety problems.
    • Always make sure the brakes are unlocked before trying to move a table.
    • Never use the emergency brake release to move a table unless there is an actual emergency. If the emergency brake is used, it must be reset before it is operational again.
    • Always push a table; don’t pull.
    • Push tables so that the casters are in the front. Pushing in the wrong direction can damage the brake pads.
    • Never pull a table by its power cord. Doing so can damage the cord, cause sparks or possibly an electrical shock.
    • Never pull on the head section or the leg section of a table. They can come off and operators can lose control of the table.
    • If a table starts to roll away out of control, let it go. Tables weigh between 600 and 700 pounds, depending on the model. They can injure operators who try to stop them.
    • Once the table is properly positioned, lock the brakes.
The Keckler team has certified technicians who have passed Skytron’s rigorous, weeklong training course at its Grand Rapids, Mich., plant. Skytron recommends that each surgical table is serviced every six months. The Keckler technicians travel to hospitals and surgical centers to perform routine parts and maintenance work — a process than typically takes about two hours per table — as well as to make emergency repairs.

Modern hospital beds address risk of falls, pressure ulcers

Each year, between 700,000 and 1 million patients fall in a hospital in the United States, according to the Agency for Healthcare Research.

About a third of those falls result in an injury to the patient. Sadly, about 11,000 of those falls lead to deaths. The agency estimates that non-fatal falls in adults 65 years and older cost about $50 billion each year, while fatal falls average a cost of $754 million each year.

Pressure ulcers are another all-too-frequent occurrence in hospitals. In some U.S. facilities, as many as a third of patients develop some degree of pressure ulcer while being treated or while recuperating from a surgical procedure.
To avoid becoming part of these statistics, hospitals have developed extensive protocols to reduce the risk of falls as well as patients developing pressure ulcers. One of the most effective methods of minimizing risk is to provide patients with beds and mattresses that incorporate the most current technology that can warn health care workers of potential issues.

Companies making high-quality hospital beds are Umano, Span-America and Oxy-Mat. All are leaders in the industry, well respected and available through Keckler Medical.

Umano’s beds are used in many health care settings — from high-acuity critical care through long-term care and even inpatient psychiatric or correctional health. They are designed to maximize fall prevention and infection control, while being easy to use for caregivers and the lowest total cost of ownership for the hospital’s budget.

One of their most important features is the low height of 10 inches off the floor, reducing the risk of a fall while the patient is in the bed as well as making it easier for patients to get in and out of bed. Ingress and egress are two of the riskiest times for falls.
Sensors alert nurses to when a patient gets out of bed, rolls near the edge or moves the upper torso (level of sensitivity controlled by caregiver). Lightweight construction and dual casters make the beds easy to move, but they also are sturdy – they can handle maximum patient weights up to 1,060 pounds, and have length and width adjustments for bariatric or taller patient needs.
The beds also include an integrated computer system, which incorporates the latest technology such as full-color smart screens, turn reminders, unique safety warnings and a system that logs patient weights and exit alarms. There are USB ports and auxiliary outlets to provide ease of use (for the caregiver and patient), reduce fall risk, remove trip hazards and allow for software upgrades over time.

Span-America and Oxy-Mat both offer mattresses that reduce the risk of pressure ulcers and skin shearing.

Span-America’s mattresses incorporate low air loss and pressure redistribution technology where body length air chambers slowly inflate and deflate to reduce pressure points and turn the patient every 12 to 15 minutes. Its Geo-Mattress® UltraMax™ reactive surface with 3-Dimensional Zoning™ offers protection to the seat section against “bottoming out” even during repeated head and foot of bed elevating. The UltraMax™ bi-directional stretch cover prevents heels, hips and shoulder blades from “digging into” the surface. Instead, patients are gently guided back to the original position following head of bed elevation.

The Oxy-Mat mattress has air pockets in foam that disperse pressure points “on the bony prominences” of the body. The unique design reduces the vertical and horizontal shear forces that lead to pressure ulcers in the sacrum, scapula, trochanter, ischium, head and heels. The mattress helps the patient’s own body to naturally optimize deep-tissue blood oxygen values in anatomical areas at the greatest risk of pressure injury development.

Whether the hospital’s initiatives are to reduce the risk of patient falls, reduce the risk of pressure ulcers, reduce the risk of hospital acquired infections or maximize (recently) reduced capital budgets, Keckler Medical can assist with products from Umano Medical, Span-America and Oxy-Mat.

System helps hospitals rebuild operating room revenue

In mid-March 2020, most hospitals in the United States began to cancel elective surgeries in response to the COVID-19 pandemic to reduce the risk of the infection spreading.

This decision had a significant impact on hospitals’ bottom lines. According to the April 16 issue of Becker’s Hospital Review, the typical hospital – with 11 operating rooms (the U.S. median) and a surgical average of 58 cases per month (the U.S. average) – likely cancelled in the neighborhood of 60% of those elective surgeries. In that average hospital, that equates to 375 surgeries that didn’t happen. Some hospitals have expressed losing multiple millions of “typical” revenue per month to the cutback in cases.
Since COVID-based restrictions began lifting in May, hospitals have found themselves in a very difficult situation playing catch-up on these elective procedures. Many outpatient surgery centers were not hit as hard by COVID-19 restrictions and have been able to continue operations somewhat near normal case volume.
As hospitals strategize ways to quickly rebuild surgical revenue, Keckler Medical offers two proven systems that increase efficiency, improve patient safety, save time and reduce costs.

SteriCUBE saves time, money

The first is the SteriCUBE system, which offers a measureable improvement in the processing of instrument trays. SteriCUBE’s advantages include:
  • Improved Patient Safety. It removes the risk of having holes in the blue wrap, wet packs or contaminated trays that need to be re-sterilized.
  • Increased Productivity. It eliminates prep time devoted to wrapping instrument trays in blue wrap as well as the time needed to check each wrap in the OR for holes. It also allows hospitals to keep 12 “surgery-ready” instrument trays that can be grouped together and stored for up to 30 days locked in the cube. Faster start times can lead to improved morale of surgeons and the surgical staff.
  • Dramatically Reduced Costs. It lowers costs associated with materials and labor including wraps, corner protection, linen, individual rigid containers, technician overtime expense, bio-hazardous waste and workers comp injuries.

“We have been able to reduce set up time in the OR down to 2 minutes and 18 seconds from our average of 30 minutes,”

When questions arise, Keckler Medical team has the answers

Keckler Medical is known for the quality of the medical equipment and supplies it has sold to hospitals, surgery centers and doctor’s offices for nearly five decades. The company also has earned a sterling reputation for customer service.

Keckler Medical’s motto is “it’s all about what happens after the sale.” Those words are borne out each time a customer reaches out to ask for help with a piece of equipment or product that has been purchased.

It is also why we formed J.M. Keckler Bio Medical Service, Inc., which is committed to provide high-quality, high-functioning services through long-term maintenance contracts or one-time responses.

When customers call, here are the top five troubleshooting questions we ask:


Is the equipment plugged in and does it have power?

It sounds simple, but you’d been surprised how often this comes up, almost always in relation to operating rooms. ORs typically have many cords and cables running across the floors that can make it difficult to see if all the machines are plugged in. That’s why one of the first questions we ask is, “Is the equipment plugged in at both ends?” Good cable management can help reduce the stress on your cables. It also is an important part of creating an effective and efficient operating room for physicians and hospital staff. Avoid contouring cables in a way that may create undue stress at the connection point to the equipment or power outlet.


How long have the issues been happening or how long has the equipment been down or acting up?

It is important to know when the equipment first started having issues.  As we review the timeline of issues, we can troubleshoot the equipment more effectively and possibly come up with the solution more quickly. We encourage all customers to reach out to us by phone or email at the first sign of any problem.


Have you changed how you are using your equipment?

Changing how you use a piece of equipment may result in functions that you have not previously experienced. If that’s the case, we recommend that you consult the owner’s manual, a certified technician or the manufacturer for specific operating directions.
Changes in protocols, team members or auxiliary equipment also can affect the proper function of your equipment. It’s possible that all that is needed is additional training for those new to the process.
In the case of sterilizers, sometimes the water or steam the sterilizer needs to be tested to ensure proper water quality. Cart washers also are sensitive pieces of equipment. Issues sometimes pop up because of changes to the boilers or heat exchangers that heat the water, or the water treatment systems.


Have you recently replaced any parts or made any mechanical changes to your equipment?

When changing parts on equipment, there sometimes are unforeseen issues that cause other parts on the equipment to fail. That could indicate compatibility issues between new and old parts, or the new part could cause stress on an older part.
Our JMK Bio Medical Service technicians welcome an opportunity to help customers in these situations. If equipment is still under warranty, customers also can call the manufacturer for assistance.


Are you and your team members trained on the proper use of the equipment?

Medical equipment is a complex piece of machinery. Reading and reviewing the owner’s manual and implementing proper training for all who use the equipment will help everyone understand its full ability. If you don’t have a clear understanding of how the equipment works and how it can be used most efficiently, reach out to a certified technician.
Again, our team at JMK Bio Medical Service is ready to help. We recognize the vital nature of the medical industry and its impact on the communities it serves. Our purpose is to position each of our customers so they can provide the best medical care they can in every single case.

Do you have a question for JMK Bio Medical Service team? If so, please call (800) 523-1010.

Germ-killing robots help Keckler Medical meet COVID-19 demand

When hundreds of hospitals in California and northern Nevada had to swiftly improve their ability to disinfect rooms, surfaces and other items because of the COVID-19 pandemic, they knew exactly where to turn for critical equipment and supplies: Keckler Medical.

Keckler Medical has been a trusted supplier of high-quality medical equipment for nearly 50 years, so it was no surprise when its customers – operating facilities on the front lines of a global health crisis — began clamoring for items from their longtime partner.
“We work with every single hospital north of Bakersfield and Santa Barbara; maybe 250 acute care hospitals. We’ve heard from most of them,” said Brett Manning, Keckler’s sales development manager. “In the beginning, it was all hospitals. Now, it also includes dentists, doctors’ offices and surgery centers that are preparing to re-open.”
Among the most asked about items are germ-killing robots that use ultraviolet light to infuse and disinfect rooms and ElectroClave UV light disinfection boxes, used for smaller, high-touch items. Keckler also offers many other equipment items to meet the needs of customers suddenly faced with COVID safety challenges:
  • Swab and transport mediums, rapid IgG/IgM antibody tests and protective testing exam screens
  • Disposable/recyclable curtains treated with antimicrobial elements
  • Hospital beds (emergency, ICU, telemetry)
  • Hospital-grade disinfecting wipes and spray
  • UV-C ceiling air purification system
  • Washable, antimicrobial keyboards/mice/screen protect
  • Stretchers, exam tables, wheelchairs, recliners, overbed tables, transfer boards and patient positioners

Robots disinfect surfaces

The robots made by Skytron and Surfacide are used to disinfect operating rooms, patient rooms or any other high-traffic setting with many hard surfaces. The tall robotic cylinders emit UV-C wavelength light rays that alter the DNA of the micro-organisms so they are unable to reproduce, thus becoming harmless to humans, Manning explained. The systems typically are sold in sets of two or three robots, and are strategically placed in a room to provide as much UV-C disinfecting light as possible to the various surfaces of the room.

The UV-C rays are so powerful that no one can be in the room during treatment, which takes 15 to 45 minutes depending on the size of the room. The robots augment – but do not replace – the deep manual cleaning provided by hospital housecleaning crews. The ElectroClave serves a similar function. About the size of a microwave oven, it also uses UV light to quickly disinfect small high-touch items like cellphones, pens, keys, telemetry boxes and staff ID badges.
It’s not only hospitals that are concerned about preventing the spread of the coronavirus. Law enforcement agencies in the Bay Area and Central Valley also have ordered the robots and ElectroClaves from Keckler Medical to enhance the safety of the environment in their facilities, especially jails.

Hospital, facilities looking ahead

Manning said medical centers that are preparing for a potential surge in COVID patients have ordered or rented extra beds, stretchers, patient monitors and other equipment to furnish emergency spaces they hope they never have to use. “A lot of hospitals needed additional beds and built supplementary areas of care outside of the hospital,” he said.
Keckler’s warehouse houses some of the supplies, but many items have to be ordered directly from the manufacturers. Delivery times range from a week or two to a month, depending upon the item and the demand from the market. With many hospitals and medical facilities all wanting the same things, planning ahead is critical, Manning said.
And when equipment is delivered, Keckler Medical’s experienced staff stands ready to help with any training that is necessary. Keckler’s motto is “it’s all about what happens after the sale.” “We’re there for our customers,” Manning said. “We want to assist them in any way that we can to ensure whatever they’ve ordered fulfills their needs. We stand behind our products and we want them to know that they can call us with anything they need.”

About Keckler Medical: J.M. Keckler Medical Co., Inc. is a premier supplier of medical and surgical equipment and technologies specializing in hospitals, surgery centers, clinics and physicians’ offices in Northern California and Nevada. Its vision is to help its customers achieve operational excellence through superior service. Since 1973, it has earned national recognition because of its dedication to sales expertise, reliable technical support and knowledgeable customer service. For more, visit its website at or call (209) 847-4100.