Size-wise, Baltimore-based University of Maryland Medical Center (UMMC) is something to behold. The hospital, which encompasses six buildings and 966 licensed beds, is so big (and bustling) that its Shock Trauma Center is the subject of an eponymous Amazon Prime series. Supporting UMMC’s high patient volume—427,301 outpatient visits per year!—is the medical center’s biomedical engineering department.
Below, Patrick Lynch, CBET, CCE, CHTM, UMMC’s interim manager, biomed, shares what sets the department apart and how it uniquely navigates staffing challenges.
24×7 Magazine: What differentiates UMMC’s biomedical engineering department from other biomed teams?
Patrick Lynch: The department is unique in that we provide a comprehensive medical equipment service to the medical center and to our system. Below are 10 differentiators. (Many departments have some of these attributes, but I’ve never encountered any with all of them.)
- Our first-rate clinical engineering team: This group of three (soon to be four) highly trained and experienced individuals provide support to the clinical staff regarding replacement equipment acquisitions, recall management, capital equipment planning, new technology consultation and assessment, value analysis, and project support. At the same time, they provide valuable support to the BMET staff regarding higher-level issues, which BMETs who are bogged down by PMs and repairs every day may not have time to handle.
- We have a group of 18 BMETs, who support our fleet of more than 30,000 medical devices. They are divided by specialty, including the Pump Room (specializing in infusion and other pumps), laboratory (which includes monitoring of all medical refrigerators, as well as all laboratory instruments), imaging (to provide an onsite, fast response to imaging issues), respiratory, and, of course, the general biomedical shop. We perform more than 15,000 scheduled PMs per year, which occupies about one-third of our time.
- We have a group of 23 equipment distribution technicians, who are tasked with replenishing crash carts with essential supplies and delivering portable medical equipment to all six of the buildings that make up our medical center. We also employ several bed coordinators, who are responsible for responding to requests for low-rise or bariatric beds, as well as wheelchairs and stretchers. A large part of the bed coordinators’ job is performing nightly rounds and collecting vacant stretchers and beds during the third shift. The stretchers and beds are then pre-staged to our six operating suites in preparation for the next morning’s patients.
- We have a fully functional bed repair shop, staffed by four experienced mechanics. They maintain our 800-plus beds, along with our stretchers, wheelchairs, and other patient transport devices.
- Our hybrid clinical engineering/IT guru Sami Gurmu not only serves as a resource to the clinical engineering team, but also designs medical networks; assists in medical device integrations with EMRs and other IT systems; builds and maintains servers and dashboards; and consults clinical and support staff about new technologies.
- Our audiovisual team not only supports televisions in the hospital, but also manages all video in the operating rooms and conference areas.
- We have a very strong management team, including a director and several managers, who respect us and understand the entire clinical functions of the medical center.
- UMMC’s very experienced senior vice president understands and fully supports our benefit to the institution.
- Our corporate database team keeps our CMMS clean and provides us with the reports we need to manage ourselves, as well as our staff, our equipment, our service contracts, and our costs.
- We have a corporate imaging team, which provides high-end imaging service and management in concert with our own small team onsite.
24×7: It’s no surprise that the HTM field is dealing with staffing shortages, due to retiring professionals and biomed school closures. How does UMMC ensure a strong pipeline of talent in the biomed department? Lynch:
We take a multi-pronged approach to addressing staffing problems. First, we try to keep our existing staff by investing a lot of time and resources into training them. Second, partially due to our size, we provide career paths for our technicians in the Bed Shop and equipment distribution team.
With the proper amount of self-study, formal education, and on-the-job training, many of them progress to BMETs, albeit on a slower path than a formally trained BMET. We feel that this may be the best way to not only address staffing shortages, but also to provide career advancement for our more motivated and capable employees. Finally, we participate in career days at local high schools and maintain a close relationship with our local biomed school—Howard Community College in Columbia, Md.
24×7: Cybersecurity is a huge issue in HTM. What steps is UMMC’s biomed department taking to thwart cyberattacks?
Lynch: We take medical device cybersecurity very seriously—so much so that we have a CE/IT cybersecurity manager, who is responsible for keeping all medical devices safe from the outside world. In addition to attending a nationwide cybersecurity conference, we have strict cybersecurity/IT purchasing policies with detained risk assessments.
If we detect a vulnerability, we have several options:
- We can mandate manufacturer updates.
- We can prevent those from outside the hospital from accessing the equipment.
- We segment the medical device network from the rest of the hospital.
- We have rigidly enforced rules regarding electronic protected health information removal.
- We run “threat detection” software on all laptops and USB drives that vendors attempt to bring into our hospital.
24×7: Can you please discuss a time when UMMC’s biomed department directly impacted patient care?Lynch:
Recently, one of our pediatric units found that many of their bedside monitors had varying alarm configurations, resulting in life-threatening situations. It was suspected that the alarms were mysteriously changing from our desired settings. Thanks to the diligent efforts of the biomed staff, we rapidly set all alarms to their desired states, resolved the problems, and monitored the settings to assure that the problems were, indeed, resolved. Throughout the process, no patients were injured.
24×7: In your opinion, what are some of the biggest issues currently affecting HTM and why?
Lynch: We’ve already touched on the two largest issues: staffing and cybersecurity. But additional issues that continue to plague us are rising prices and being locked out of self-maintenance by manufacturers, who will not train in-house biomeds. The prices that hospitals can charge increase approximately by the rate of inflation each year. But when manufacturers and vendors choose to increase the cost of parts, labor, contracts, and consumables by several times the inflation rate, we have no choice but to cancel contracts, buy third-party parts, and hire local biomedical talent instead of manufacturers.
24×7: What else do you want 24×7 Magazine readers to know about UMMC’s biomedical engineering department?
Lynch: UMMC is one of the most innovative medical centers in the U.S. From our clinical areas to our clinical engineering department, we lead the way in many aspects. We also have automated dispatch systems for biomed and equipment distribution, using computers, pagers, phones and radios. And we are constantly revamping our biomedical job descriptions and responsibilities to meet the abilities of the recruits we hire. We flex with the market.
Finally, we have one of the most diverse clinical engineering operations in the nation. We do more different things, in more areas, than most hospitals do. There is not a single area of medical device support that we do not touch, control (to an extent), and add value to.