By Michael Reed
In today’s constantly evolving environment of the health care industry, hospitals find themselves being forced to cut corners and make sacrifices. As budgets tighten, in-house biomedical engineers are challenged to take on more responsibilities and more types of equipment. At the advent of clinical engineering more than 30 years ago, the role was primarily thought of as a maintenance function, with the bulk of CE activities being allocated to inspection, preventative maintenance, and repairs. Today, the model has changed. CEs and biomeds are increasingly relied upon for “technology management,” which can include everything from strategic planning, to regulatory standards and compliance, to vendor management.
In addition, biomed departments are being called upon to manage more equipment and integrated systems with the number of clinical devices in hospitals on the rise. According to a GE Healthcare study, the number of clinical devices per patient bed in hospitals grew by 62% between 1995 and 2010.1
As a result, training has become increasingly important. However, rising economic pressures, time constraints, and constant turnover in the workforce leave many biomed departments strapped for time and resources. As a result, many hospitals are not able to fully give their employees the training that they deserve on every single piece of equipment and on every update and new piece of technology. Instead, the trend is for in-house biomeds to receive basic training on more devices, causing biomeds to feel increased pressure when a problem arises.
Below, find three tips that every biomed manager needs to know to help ensure that their biomeds are getting the training that they deserve to effectively address maintenance issues and keep up patient safety and quality of care.
1) Outline the training schedule, expenses, and travel in advance.
Training for in-house biomeds should be a top priority for every hospital. However, due to budget cutbacks, many department managers are forced to broach the subject of investing in training programs with accounting and management at the point of sale of a piece of equipment. It’s important that biomed managers seize on that opportunity and allocate a certain amount of the equipment budget on training, as well as travel and lodging associated with it, at the time of sale. Managers must invest in training programs early on to ensure that there will be resources available to them when the need arises. Proactively setting aside budget minimizes the possibility that changes in the economy or financial situation of the hospital will delay training. In addition, investing in training up front guarantees that engineers will be trained on each piece of equipment, rather than realizing a lack of training after a major equipment malfunction.
Foundational training on understanding classes of equipment and hospital IT networking can be accomplished effectively online. However, when it comes to operating particular pieces of equipment, it’s critical that each biomed have thorough, in-person training from a qualified instructor. Cost-cutting measures—such as sending one biomed to training, just to have them return and share that knowledge with a whole in-house team—can turn servicing equipment into a game of telephone, which could ultimately damage the equipment and cost even more money. When it comes to these life-saving devices, it isn’t worth risking the possibility that important information will get lost in translation or conveyed incorrectly.
2) Focus on understanding the connectivity of all devices and clinical uses for each modality.
In today’s hospital, most systems are interconnected and depend on the hospital’s IT network to share information. From a patient care standpoint, it is necessary for biomeds to have a foundational understanding of how their hospital’s IT network functions, as well as how specific systems interact with others.
For example, patient monitoring perfectly describes why baseline IT knowledge is important for biomeds. Due to the life-critical nature of the data involved, hospitals often have different networks devoted to patient monitoring. Take the ICU, for example. In each room, there is one device that is constantly monitoring the vital signs for each patient. That life-critical and time-sensitive information is then sent across a network to a central nurses’ station where the on-call nurse can view the vital signs of all the patients in the department, and respond immediately if any patient’s condition changes. With that, it is important for a biomed to understand how patient monitors feed data into that network, because if a nurse is unable to monitor patients remotely and be alerted to an issue—either as a result of the physical monitoring device or the network malfunctioning—the patient’s life is put at risk. Without knowledge of both the monitoring device itself and the broader network that it channels information through, a biomed’s ability to identify the root cause of the problem and respond in real-time is severely limited.
3) Ensure that the training program is robust, all-encompassing, and provides easy access to knowledge and skills building.
Above all else, it’s essential that biomed departments be trained as first responders in two key areas: commonly occurring and life-critical equipment failures. For instance, anesthesia equipment tends to be abundant in hospitals, and as such, it is often in need of servicing. Probe and transducer failure is common with ultrasound equipment, and sensor failures are common with monitors. It makes the most sense for all biomed engineers in a department to know how to service and resolve routine issues in order to return commonly used pieces of equipment back into patient care quickly. When life-critical equipment fails, such as critical care patient monitors and anesthesia products, it’s necessary for biomeds to be able to assess the problem and respond quickly. Otherwise, the hospital will need to dispatch the OEM to make the repair on-site, which requires more time and creates more risk in life-critical situations.
Perhaps one of the most important things a biomed manager can do is to provide employees with expertise and broad background on modalities as a whole. This includes training on the clinical use of a product and the language clinicians use when referring to that product. Having that foundational language knowledge is key as it enables biomeds to communicate with the nurse or technologist using the product and reporting the difficulty. So, for instance: a nurse reports that a patient monitor isn’t getting a correct SPO2 measurement. In this case, a biomed who knows that SPO2 monitors the oxygenation of a patient’s blood is better equipped to diagnose why the monitor is malfunctioning, to speak at the appropriate level with the nurse reporting the issue, and to solve it faster. Unlike a lot of the more specific, product-based training, this type of basic semantics training can often be conducted online in a relatively cost-efficient manner for the department.
Empowering biomeds with proper training is critical to the overall function of the hospital. Without all-encompassing training on all modalities and types of equipment, a patient’s life could be put at risk and quality of care compromised. Despite the tightening of budgets across the entire health care industry, hospitals must place training as a priority and set aside the appropriate funding. Making sure that equipment is properly maintained and serviced by top-of-the-line biomeds will help save lives and ensure that the hospital is doing everything possible to care for its patients. 24×7 Focus On July 2013
Reference
1. Horblyuk R, Kaneta K, McMillen GL, Mullins C, O’Brien TM, Roy A. Out of control: How clinical asset proliferation and low utilization are draining healthcare budgets. Waukesha, WI: General Electric Company; 2012. Available at http://nextlevel.gehealthcare.com/Out_Of_Control_Cost_Analysis-WP-01%2012_r2.pdf,
Michael Reed is the director of business operations for GE Healthcare. For more information, contact [email protected].
