According to the Peter Principle, every employee will rise to his or her level of incompetence—spoken metaphorically, “the cream rises until it sours,” (Laurence J. Peter, author of The Peter Principle, 1988). The trick is to keep one’s level of competence at least one step above what is required. To do this, people need to know their current level of competence and then seek the education and experience that will help them raise it. Metrics, matriculation, and mentality are, according to most managers, keys to biomeds doing a bang-up job.

Owning the Job

“People who want to be in the field really need to know what the field is about,” says Scott R. Sovocool, director of biomedical engineering at Methodist Health Systems, Dallas. He notes that some people enter the industry without understanding its demands. Biomeds, like all other health care professionals, are needed 24 hours a day, which can impact work schedules and lifestyles by way of night shifts and on-call time. But even more demanding is the fact that the work a biomed performs can also affect patients’ lives, often significantly.

Biomeds service equipment needed to support life, and if they make a mistake, it can threaten a patient’s life. “Sometimes, that scares people to death, and they should know that early, before they decide to enter the field,” Sovocool says.

The cool-headed biomed will fare well if he or she can deal with other people’s stress as well as his or her own. In fact, Sovocool suggests that much of a biomed’s on-the-job stress is more often due to other people rather than the actual work. For instance, a biomed servicing surgical equipment in the OR while the patient is on the table may also have to deal with irate physicians and stressed nurses. How each biomed handles this stress is up to the individual, but he or she will eventually have to employ methods to keep calm and level-headed.

“Not all biomed work will happen on the bench of the hospital that hired you,” says John Crissman, CBET, biomed manager for William Beaumont Hospital, Royal Oak, Beaumont Services Company, Royal Oak, Mich. “Biomeds must recognize that this business is as much a people business as it is a technology business. You have to like getting out and talking to people in addition to the self-satisfaction of fixing equipment.” Biomeds deal with everyone in the hospital, from housekeeping to top executives, all of whom speak slightly different languages. Biomeds need to learn to communicate with them all.

Crissman advises biomeds to be flexible, and even entrepreneurial. “We like to bring on biomeds who exhibit an owner mentality rather than a rental mentality,” Crissman says. Such an attitude better suits the business that biomedical engineering has become.

“Business is the other leg of the chair. Without a business or financial aptitude, you won’t be around long,” says Crissman colleague John Fragomeni, CBET, biomedical engineering manager, William Beaumont Hospital, Troy, Beaumont Services Company, Troy, Mich.

The Importance of Education

Though having the right personality can often open doors, competence in all areas should pave the path to success. A good way to prove competence, whether technical, business, or management, is through education. “To get into management, biomeds should go back to school and get a degree,” says Sovocool, who recommends a minimum of a bachelor’s degree, though a master’s, particularly in business, would be even better.

“Corporate management is looking for people who know how to run a business—how to save money and make the assets you have stretch to their limits—as well as how to manage people, both employees and clients,” Sovocool says.

Making technical training available to employees benefits the team and is also a way to retain personnel.

Of course, university matriculation is not always necessary; biomeds can also expand their skills through shorter classes, seminars, and conferences. Even though Crissman believes management is more art than science, he does think that classes can be helpful. “I have not taken any of the Carnegie managerial classes [Dale Carnegie Training, Hauppauge, NY], but I know people who have, and they have done well in management,” Crissman says.

Crissman and Fragomeni have benefited from in-house management training, such as seminars on hiring employees. “We have gotten some good training on conducting productive interviews and evaluating potential employees,” Crissman says.

Technical training also benefits the team. “We have pretty good training budgets, but our biomeds never think they have enough training, even the most experienced,” Crissman says. He adds that if he had an unlimited budget, he would expand the number of dollars devoted to training.

Making technical training available to employees is also a way to help retain personnel. At Methodist Health Systems, training directly contributes to biomed growth. Biomeds are promoted up levels one, two, and three as they acquire more advanced technical skills, and are assigned areas that include more complex equipment. “Along with responsibility for a service area comes repair training, which can be on the high-tech equipment that the biomeds did not receive in school. This knowledge makes them more valuable to the organization,” Sovocool says.

In addition, assigning equipment to specific biomeds can inspire a feeling of ownership. “Our biomeds actually become a bit possessive of their work areas and enjoy accomplishing what they need to accomplish through the program,” Sovocool says.

Show Your Worth

Although Sovocool, Crissman, and Fragomeni would not turn down additional staff, they feel that their departments run efficiently, and they have the metrics to prove it. “Like running any machine or operation, you need feedback, and the information we get through our work order system lets us know where we are,” Crissman says.

But it is not just about the numbers. In many cases, the tendency to simply look at completed work orders as a measure of productivity is wrong. Simpler instruments will require less time for maintenance and repair than more complex ones. For instance, a biomed could spend the day completing service on 35 to 40 infusion pumps or one complex lab analyzer. Therefore, managers use other metrics to accurately determine workload, productivity, and efficiency.

These can include customer satisfaction surveys, response and turnaround times, preventive maintenance (PM) and corrective maintenance (CM) completion ratios, work orders and complexity, equipment failure rates, user errors, and time logs. Biomeds who understand these metrics and how they are interpreted will view them as tools rather than as strict measures of performance.

Management often uses the data to establish workloads. At Beaumont, metrics are used to determine individual workloads and priorities. “We really look at a person’s time,” Fragomeni says, explaining that a full-time employee works about 2,080 hours a year, which actually equates to about 1,800 hours after vacation, sick days, and other time off. “We like to see 80% of this time devoted to actual tasks and 20% to responsibilities that maintain efficiency, such as prep time or housekeeping chores,” he says.

Task time is then divided evenly between scheduled and nonscheduled work. This division, of course, is well supported with metrics that show biomeds do use this time accordingly.

“We try to balance the workload because there are constantly unscheduled tasks that come up, whether repairing equipment or helping to move it,” Fragomeni says. “We leave about 50% of the biomed’s task time for unpredicted events.” The other 50% of a biomed’s workday at Beaumont is devoted to scheduled work, such as PM, which is also ordered and tracked with metrics. Like many biomed shops, Beaumont and Methodist Health Systems prioritize equipment according to its importance in life support.

At Beaumont, all life-support devices should undergo their PM on time 100% of the time; nonlife-support equipment PM should be completed on time at least 95% of the time. At Methodist, the goal is to complete 95% of all PM on priority-one (or life-support) devices within 30 days, and repairs or CM within 24 hours of receipt. Reports can alert managers when these goals are not being met.

In both Beaumont and Methodist, biomeds are given their work orders monthly; exception reports and other alerts can identify where problems may be developing. Beaumont managers use biweekly work order reports to assess workflow status. “We find that most of our guys want to know where they are on their progress and how close they are to meeting their metrics,” Crissman says, adding that the team often meets its goals.

Biomeds who take an interest in the metrics are often seen as exhibiting ownership mentality. Those who meet their workload goals successfully will affect management’s perception of their competence and abilities positively. Benchmarks can help identify areas for improvement, both for individuals and the shop as a whole. Biomeds who view them with suspicion can miss out on opportunities to show initiative, team effort, and skill—all of which can exhibit a biomed’s potential and readiness for growth. Those who use these abilities to save the larger corporation money will draw positive attention from management.

Methodist Health Systems establishes new goals annually and uses the metrics to track progress. All employees are asked for suggestions, and all ideas are reviewed. Those selected as goals are then developed more fully.

“If we want to reduce the amount of user errors—specifically, the number of times a piece of equipment comes through the door and is not broken—from 10% to 2%, we determine how to do that, say, with user education and seminars, and then track our progress to see if we are meeting our goal,” Sovocool says.

Part of the Solution

Many equipment management systems provide these reports with ease, making data easier to collect and manipulate. The information is used to produce a more accurate and well-developed picture, which can help run the shop. However, to achieve this efficiently and accurately, biomeds have to complete their documentation. This, notes Sovocool, can be a challenge.

“Biomeds love to repair equipment and help people and do all of the fun parts, but they hate the paperwork,” Sovocool says. Biomeds can score points with management by completing their documentation without having to be reminded; reports will inform supervisors who is behind on their digital paperwork.

“I will speak with the team leaders and the individuals as we go along. There are no threats or punishments,” Sovocool says. Instead, he encourages biomeds to “own” their areas. “Without ownership of a given area and workload, you will not get good production,” he says.

The feedback process is often dynamic, with informal evaluations occurring throughout the year. Crissman and Fragomeni prefer to use metrics informally. “We don’t pull negative benchmarks out at evaluation, but rather use them throughout the year to analyze what went wrong and how to improve processes,” Fragomeni says. “The best-laid plans can go awry, and there could be a very good reason for not hitting a benchmark.”

However, more formal reviews can also occur, often annually. At Methodist, Sovocool uses metrics to help measure biomed performance. “We break the job description into categories, such as administrative work, repairs, and PM, and rate performance in each area on a scale of zero to four,” Sovocool says. The final score reflects an employee’s accomplishments and is tied to pay raises.

Whether or not the evaluation includes formal performance metrics and/or benchmarks, it should alert employees to areas where they exhibit competency and those where they can improve. The information will help them to do a bang-up job and rise to the top, before they sour on the job or it sours on them.

Renee DiIulio is a contributing writer for  24×7. For more information, contact [email protected].

Bio Bits

Just who is giving you career advice? Our sources for the story on biomed development speak from experience. All of them suggested that today’s biomeds should obtain degrees to help them move ahead, and all of them have, at some point, attended school while working.

Scott R. Sovocool, director, biomedical engineering at Methodist Health Systems, Dallas, suggests a minimum of a bachelor’s degree. “Although management does love a master’s,” he says.

Sovocool began his biomed career roughly 35 years ago in the military. He worked as a biomed while finishing a bachelor’s degree at night. After completing his military service, Sovocool took a position with an x-ray company where he learned the equipment and service side from the vendor’s perspective. He credits this experience with contributing to his understanding of the business side of the profession.

Sovocool moved up the ranks to achieve his current position and encourages others to do the same. “There is always a desire by young people to get to the top quickly—sometimes too quickly,” Sovocool says.

John Crissman, CBET, biomed manager with William Beaumont Hospital Royal Oak, Beaumont Services Company, Royal Oak, Mich, and John Fragomeni, CBET, biomedical engineering manager at William Beaumont Hospital, Troy, Beaumont Services Company, Troy, Mich, agree. They have held positions on every rung of the proverbial ladder and promote their biomeds accordingly.

Crissman entered the field in 1977 with a background in engineering electronics. As a young biomedical equipment technician with the hospital, he foresaw the growing importance of technology and continued to acquire the necessary skills and knowledge specific to the field. He started as a BMET I, completed a Bachelor of Science in engineering technology, became certified as a CBET, and progressed up the hierarchy, eventually becoming a manager.

Fragomeni followed a similar path, having been hired by Crissman in 1982 as a BMET trainee. Fragomeni completed a bachelor’s degree in electronics engineering, with a minor in business, while climbing the biomed hierarchy.