Sizeable Care for the Smallest Population
Size-wise, Cincinnati Children’s Hospital Medical Center is something to behold. A 629-bed pediatric hospital, Cincinnati Children’s Hospital Medical Center boasts the nation’s busiest pediatric emergency department and ranks No.2 among all children’s hospitals in terms of the number of surgical procedures performed. Supporting this patient volume—and the equipment used to keep patients safe and healthy—is the hospital’s clinical engineering team. Below, Glenn Schneider, CRES, MHSA, Cincinnati Children’s Hospital Medical Center’s director of clinical engineering, discusses the challenges of working in a large teaching hospital and reveals how his team is handling succession planning.
24×7 Magazine: Can you please tell us a little bit about your department and the equipment you maintain?
Glenn Schneider: Cincinnati Children’s Hospital Medical Center’s clinical engineering department operates 24/7 and is made up of 37 staff members, including 17 certified technicians, a director, a coordinator, and a data analyst. Our team covers more than 8.2 million square feet of space—including 66 buildings—and Cincinnati Children’s is opening a 600,000-plus-square-foot critical care building in the fall of 2021.
The CE department is responsible for a wide variety of equipment, ranging from general biomedical devices, to anesthesia machines, to perfusion and ECMO equipment, to interventional radiology labs—in total, over 63,000 devices. The equipment inventory falls into two categories: clinical equipment and lab/research equipment.
Cincinnati Children’s also has one of the largest pediatric research facilities in the world, and our department is dedicated to supporting their needs from an equipment maintenance/repair perspective, as well as via electromechanical and circuit design and development. We also have several 3D printers to help prototype those designs.
24×7: What would you say are the biggest challenges your team faces on a daily basis?
Schneider: Teaching hospitals tend to be fast-paced, non-standard, and utilize cutting-edge equipment and procedures—especially in pediatrics. While there is never a shortage of challenges [in clinical engineering, the teaching hospital] setting presents several. For one thing, the education and training required to keep up with the pace of the rapidly advancing technology we use is extremely demanding.
Our CE team actively participates in a network of committees/value analysis teams that collaborate in an effort to mitigate non-standard equipment and supplies from entering the organization without proper vetting. [The committees also provide] education for new items and monitor outcomes after deployment. We feel that maintaining minimum variation in the equipment is a necessity for patient safety; however, we also feel strongly about making the most innovative equipment available to our physicians and patients.
24×7: Maintaining a strong pipeline of talent is a challenge for any biomed department—especially given the widespread greying of the field. So how does your team attract and retain department members?
Schneider: Our personnel tend to be long-term employees. The average age of our technicians is 42 and their tenure is 12 years, even with the influx of young talent. However, we are in the same situation as most departments across the country, having several very experienced and highly trained employees approaching retirement.
So CE leadership has established an internal mentoring program, allowing the younger technicians to directly work with our more veteran employees. This provides opportunities for new technicians to design career paths specifically for them, in addition to providing them with feedback about what skills they need to be successful.
We are lucky to have a BMET AS-degreed program at Cincinnati State Community College, located right down the street. We carry up to eight co-op students per semester, and our CE leadership is on the program’s advisory committee. This program has fed technicians to our organization for many years. In fact, only a few of our technicians received their training from the military or other sources. The majority graduated from that program, with some continuing on to the University of Cincinnati to earn a BS.
Having a co-op program gives us a unique opportunity to “interview” students over several semesters. We also have as many as two bioengineering students from the University of Louisville JB Speed School of Engineering each semester, who work with our clinical engineers.
24×7: Can you please discuss a time when your team directly impacted patient care?
Schneider: One morning while we were transitioning to internal support of our interventional labs, the cardiac cath lab would not operate during daily start-up. [However,] the system was still on a full-service contract. So the director reported the problem to our imaging team and began mapping out a plan to shuffle patients between labs in order to keep the schedule.
Our technician immediately contacted the OEM and took action. He quickly troubleshot the problem to a failed power supply and was able to repair it and restart the system. The whole process took approximately 45 minutes, which meant no patients had to be rescheduled. We later discovered that the quickest an OEM technician could respond was three to four hours.
24×7: Great! How is your department working with IT to keep devices secure and thwart cyberattacks?
Schneider: The CE director reports directly to the chief technology officer. Since we are a part of the overall information systems (IS) department, we work closely with the IS security team and have biweekly meetings to discuss current and developing medical device risks. Currently, we’re evaluating applications that will be useful in monitoring medical devices on the hospital network to help identify—and address—unknown risks. These meetings are also used to discuss trends in the medical equipment cybersecurity field, which may guide us in our journey. It is a perpetual job to monitor the health of the network as it relates to medical equipment.
24×7: What else should 24×7 Magazine readers know about your department?
Schneider: Having a 24×7 team speaks to the organization’s desire to provide the highest availability of support for our clinical staff and the best possible outcomes for our patients. And as we’ve developed relationships with outreach [facilities] and hospitals in secondary service areas—some of which are more than 100 miles from our main campus—Cincinnati Children’s footprint is becoming larger. This dictates autonomy in that we must rely on technicians to manage their assignments and shared responsibilities with minimal supervision.
[Finally,] over the last several years, we have worked hard to develop processes, procedures, and digital tools to help guide younger technicians and manage both scheduled and emergent maintenance.