By Kristi McDermott

Among the doctors, nurses, therapists, and other care providers so critical to patient well-being is a group of health professionals who play an integral, albeit often unheralded, role. After all, diagnostics hinge on their attention to detail. As does pain management. And as the COVID-19 pandemic showed, particularly during the initial wave, so too is the ability to give people critical care when they need it.

These healthcare professionals are largely unheralded because they are largely unseen. But this is not to say their efforts go unnoticed. Doctors, nurses, therapists, and others rely on clinical engineering teams to keep MRI machines, IV pumps, and other medical devices functioning and available when patients need them. Yet that only scratches the surface of the role they fulfill.

A well-functioning clinical engineering (CE) department should be viewed as a comprehensive medical equipment manager. The CE team has a direct influence on resource management, strategic planning, and patient well-being, but also—particularly in the years ahead—overall healthcare operations.

“Clinical engineers are recommended to play a growing role in future global disaster management and systems integration activities, owing in large part to their multifunctional expertise in technology assessment, hospital operations, and as stakeholders in healthcare innovation,” according to a 2020 report in the Global Clinical Engineering Journal.

It’s well known that medical devices are becoming more plentiful, more integrated, and more complex. A CE team driven by data, rather than presumption, keeps equipment running but also unlocks the kind of financial insights health systems not only depend on now but will rely on in the years ahead.

Clinical Engineering: Managing More Than Just Equipment

Yes, at their core CE teams manage equipment. They ensure equipment is serviced, maintained, and available. They address equipment recalls and software updates. Even something as straightforward as making sure the equipment is clean is not as simple as it looks. A typical hospital can have thousands of medical devices. But with the proper investment in technology, training, and teamwork, CE teams also can reduce the reliance on service contracts, improve operational efficiencies, and increase patient care.

Their data-driven insights provide health system administrators with a comprehensive view of where risk and opportunity lie. How much of a particular kind of medical equipment do you have? How much do you need? What devices need to be updated? What devices are nearing the end of their life? Which devices need to be maintained and by whom?

One of the first places hospitals start looking for ways to save money is in their clinical engineering department because of the expense of service contracts and new equipment purchases. But a well-functioning clinical engineering department can be a revenue source, providing the kind of information on inventory, downtime, productivity needs, and regulatory issues to help management make informed decisions.

Cost pressures in the short term will only accelerate. Kaufman Hall forecasts the lingering effects of the pandemic could drive hospital margins down 10% to 80% this year. One-third to one-half of U.S. hospitals may have negative operating margins by year’s end, the healthcare consultant predicts.

Wise expenditures of hospital revenue will be prudent. CE teams provide the kind of insight that directly benefits the bottom line.

Clinical Engineering Rising to the Challenge of COVID-19

The pandemic, as COVID-19 unfolded and as it lingers, crystallized just how important CE teams and their data-driven insights can be during a crisis.

CE teams nearly overnight set up nurse call systems, beds, patient monitoring systems, and other equipment as hospitals rapidly expanded patient units into new floors or buildings or even outside in tents, where “the gathering of supplies and equipment provided the most extensive logistical need for the setup,” according to a September 2020 article in Disaster Medicine and Public Health Preparedness.

They worked shoulder to shoulder with doctors, nurses, and other health professionals in the most difficult of circumstances to provide critical care.     

CE teams prioritized, through a computerized maintenance management system, the maintenance, updates and repairs, and allocation of devices shown to be most in need when treating COVID patients. They kept a close eye on critical items like ventilators and patient monitors. 

But they also paid close attention to the severity of COVID in their area, anticipating and preparing for specific equipment needs rather than just reacting to them. The CE team proved how it can be a valuable contributor toward decisions directly affecting patient care.

Promoting a Culture of Shared Knowledge and Responsibility

The pandemic has accelerated what technological innovation had begun for CE teams: securing a seat at the table of hospital decision-making.  

CE teams are crucial to capital equipment planning, purchasing, implementation, service and repair, and end-of-life management. They know which service contracts to keep, what to take in-house, what to fix, when to fix it, and when to replace it. They are the first line of defense in cost containment.

But their multifunctional approach and responsibilities are a template for hospital management. The teams reflect a culture of shared responsibility. The approach promotes knowledge sharing across departments, supports strategic planning, and encourages partnerships throughout the health system. 

Clinical engineers help health systems see the bigger picture of their organization’s current state and give a glimpse of what’s coming. 

Clinical engineers, according to the Global Clinical Engineering Journal, “share a common mission to optimize safety, efficiency, cost controls, and healthcare quality through the application of systems-oriented engineering expertise that encompasses not only devices, but processes, human resources, procurement, risk management, and strategic planning. 

“Compared to many other vertically specialized professions in healthcare, the multi-disciplinary, intersectoral span of professional relationships in CE provides a unique foundation to bring a more coherent, rapid-cycle integration of science, technology, standards, regulation, institutional strategy, planning, and execution.”

Put simply, clinical engineers are far more than the people who fix broken medical equipment.

Clinical engineering teams play a variety of integral functions in modern healthcare, yet you’re unlikely to see their role highlighted in the next hospital drama television show. Through keen inventory and maintenance management, they help control costs. When a crisis erupts, their skill and dedication help expedite the needs for patient care. Their multidisciplinary approach reflects a leading edge of healthcare management. The CE team in many ways is the MVP. 

Kristi McDermott, MBA, is president of clinical engineering for TRIMEDX, leading the growth in commercial operations as well as the service in clinical engineering field operations. Questions and comments can be directed to 24×7 Magazine chief editor Keri Forsythe-Stephens at [email protected].