Healthcare in the United States is changing, and bringing with it significant modifications to our current system that will continue, regardless of which way the political winds blow. What effect will these changes have on biomedical departments? To help us understand, we need to decipher the catch phrases that permeate the board rooms and hallways where we work, such as, “We have to do more with less,” and, “We are all going to have to wear different hats,” and, my favorite, “We all need to pick up the slack.”
What these statements boil down to is that fewer healthcare providers will be taking care of larger numbers of healthcare consumers. The recent changes in payments have only accelerated a trend that was already under way. In response, providers have already become more reliant on technology to perform tasks once done with manpower. Biomedical departments need to recognize this trend and stay ahead of the curve.
Be Part of the Discussion
This is a critical time for biomedical technicians to insert themselves into discussions about the future of healthcare. While other areas of healthcare will shrink, biomedical technicians need to leverage these uncertain times to make our case for the growth of biomedical departments. We need to be vocal about a few facts and make sure that people in leadership positions notice them.
First, fewer dollars in healthcare will certainly mean that medical equipment will stay in use longer. We will be the ones called upon to make sure those devices will last.
Second, fewer clinical staff will likely lead to more medical technology to fill the gap. This means an ever-growing inventory of active devices.
Third, after payroll, maintenance contracts constitute some of the largest expense categories for many facilities. We need to be prepared to suggest that some contracts are not cost-effective. This will mean making sure we can take care of the equipment less expensively than the OEM without sacrificing quality. Doing so will solidify our place in cash flow discussions with leadership.
Finally, we need to make every effort to be involved in budget decisions. We can provide insight into the failure rates, repair costs, and future repairability of equipment. We need to be the people who are called up to provide this data when budget time rolls around.
To take on this expanded role, we need to be more efficient. The following strategies for improving departmental efficiency are based on my experience in a 210-bed rural hospital, but they should work for almost any biomedical department. I will not begin to suggest that the implementation was smooth and painless. However, over time, we created a better and more efficient system.
Optimizing PM Procedures
Now that the Centers for Medicare and Medicaid Services will allow alternate PM procedures for most equipment, we should make good use of this flexibility. We have the right to make changes on the fly, but we don’t always use it. Biomedical departments should spend some time re-evaluating the risk and procedures of existing PM and safety tests. If we have used the same checklist for every vitals monitor over the past 20 years, we should see if there are things we can change to save time. Management should set up recurring meetings with the biomedical staff solely to discuss risk and procedure changes. This will give the technician with firsthand knowledge of a device a forum to weigh changes to PMs with other staff and management.
Designate Experts
Biomedical departments should find experts on complex devices within their staffs. These can be technicians who received factory training or have extensive experience with the devices. Often, the technician who receives a trouble call may feel obligated to deal with it, even though he or she is not the “expert.” To avoid the risk of wasted time and money, there should be a culture of teamwork and a list of the best teammates to contact for a particular device. It is vital that management make this part of the department culture, so that no egos are bruised.
Use Equipment Management Software Wisely
I would venture to say most hospitals use an electronic equipment management system. While it can be a real time-saver, you get out what you put in. Make sure you become familiar with your management software. It is a tool, but if you don’t learn to use it well, it can become an anchor.
One of the more difficult challenges we faced while trying to increase efficiency was a move to a paperless biomedical department. Our computerized management system was vital, allowing us to capture more data and increase our output. We issued everyone small handheld computers that were linked to the hospital network. This allowed us to spend more time in the field and to complete more work orders, since we didn’t need to return to our offices—any room or hallway would serve as a makeshift office.
Our mobile computers not only gave us quicker response times, but also allowed us to capture those “trivial” user-error or no-problem-found work orders that often get overlooked when you have to return to a set location to enter your work. By capturing more of the work that was actually being done, we gave our manager the ammunition to successfully request another technician, despite the fact that the funds were tight.
A Paradigm Shift
Moving forward into this new age of healthcare will be like any paradigm shift. There was fallout when society moved from agriculture to industry, and there will be fallout as we shift from industry to information management. As biomedical technicians, we should face these challenges with our eyes open and make every effort to stay ahead of the curve.
Tim Burwell is a BMET at Vidant Health in Greenville, NC.
Fellow Biomeds, Tim Burwell is right on target, our core value to our hospital is that we can maintain and fix it for less $$$. Biomed and CE is a support service that needs to provide value and service to patients, caregivers and the healthcare system. One of the key things we do is fix things for less money. If we can’t demonstrate to the C-suite this CORE function, what other cards do we have left in our hand? Every dollar we don’t send out the door for repair and maintenance is one more dollar we can use to serve our patient population. Every dollar we save in back-end costs results in ($3-4) less cost to payers and in turn, lower insurance costs for working families. IMHO, the parasitic costs of technology ownership are huge profit centers for OEMs that they have unilaterally declared “immune” from the belt tightening the rest of the healthcare industry has been subjected to. They do this by hijacking our “right to repair” our equipment and making hospitals pay for repairs and parts at whatever costs they want to charge. Healthcare providers are accountable for costs to CMMS, insurance payers, working families and patients who have to pay the bills. IMHO, Right to Repair is something every responsible hardworking Biomed should drive forward. Yes we can make a difference and that difference starts at your work bench.