By Dave Harrington, PhD
As we are nearing the second quarter of 2018, I want to reflect on two very important articles that have appeared in the last few months of 24×7 Magazine. In the December 2017 issue, Geoffrey Smith, CBET, wrote a Soapbox titled “Enough Is Enough,” which presented an extremely effective method of dealing with suppliers that will not provide us with service information or parts. (Read Smith’s article here.) The method was very basic: No service support, no purchase order. This may seem simplistic, but it works.
Dave Harrington
This brings me back to Ralph Nader’s rant in the Ladies Home Journal—an outstanding technical publication, by the way—where he stated that 40,000 people die in hospitals every year because of equipment failures. As a result of this statistic, some companies have pushed that they are the only ones that can be trusted to service their devices—something that many in the industry still believe.
Unfortunately, over the years, many “regulatory” bodies have established guidelines to support equipment that aren’t based on the realities we deal with every day. In my opinion, the panels that write the “rules” should be made up of people who actually work with the technologies—instead of just supervisors or department chairs. After all, I believe that we often know more about technology-related problems than the design engineers who push the new regulations and devices.
Re-examining Maintenance Requirements
Another noteworthy Soapbox, “Is It “Maintenance” If It Serves No Purpose?”, written by William Hyman, ScD, appeared in the February issue of 24×7 Magazine. (Read it here.) In the article, Hyman questioned how some of the equipment maintenance “requirements” came into existence.
He asked: “Do they presently serve any useful purposes and do they contribute to better patient care?” In almost all cases, the answer is “no,” but we are so brainwashed that we keep on doing these useless tasks. I believe it was Albert Einstein who said, “The definition of insanity is doing the same thing over and over again and expecting different results.”
Here we are in 2018 with a federal government that appears to not be able to get any legislation passed, unless passing such legislation helps someone make or save a lot of money. So we look to the various agencies that handle healthcare regulations, such as the U.S. FDA, the U.S. Department of Veterans Affairs, the National Institutes of Health, and the Centers for Medicare & Medicaid Services, to name a few.
Combine these with the Joint Commission, the National Fire Protection Association, and the College of American Pathologists, to name a few more. And we are understandably confused, as nobody seems to talk with one another, causing many of the so-called “regulations” to conflict. That’s why we, as a profession, have to step up and keep our patients safe in spite of what is going on.
Many years ago, at a monthly hospital-wide department meeting, the head of medicine got up and said “50% of the patients we have get better by themselves; 40% of the patients get better in spite of what we do to them; we help 8%; and we kill 2%.” With that, he sat down and let all the “leaders” spout off that he was wrong and should never say such things publically. But I am wondering if the percentages have changed over the years on how many patients we kill.
The one thing I want to add is that I have never seen a hospital death that was solely caused by a device. Even when an linear accelerator fell and crushed a patient, the user forgot to do the safety check before starting the treatment. Over the years, our profession has saved many lives and helped many people regain their health. And, for all of our hard work, nobody wants to see us unless they are having an equipment problem.
In fact, it’s more common that the equipment problems impacting patient care have nothing to do with the equipment itself—and more to do with the IT people we work with. (Personally, I believe they cause more problems than our equipment ever could!) So maybe we should put together a testing program for the IT personnel; if we did, we would probably find many more problems than either Geoffrey Smith or Bill Hyman mentioned in their Soapbox columns.
In closing, please keep up the great work that you are doing. As always, the patient comes first every day, and you are keeping the patient first in the service you provide.
Editor’s note: Have something you want to get off your chest? Submit your Soapbox submissions to [email protected].
Dave Harrington, PhD, is a healthcare consultant in Medway, Mass. For more information, contact 24×7 Magazine chief editor Keri Forsythe-Stephens at [email protected].
Hallelujah Brother! Those two articles are the embodiment of where the profession should be going. I have been saying for years that most, certainly not all, of the PM we do is pointless and at every inspection presents an opportunity to introduce a problem. Does it happen> I do have to say, it is mighty rare.
Who should service the equipment. Both the biomed staff AND the manufacturer. It is a two tiered system and yes, we pay them dearly for their service, so the only thing now driving their argument is greed for more of those outrageous dollars.
Somebody, Somebody tell me if I’m wrong! Please!
Thank you for the opportunity to comment. I usually leave a little ditty here each month.
Within my jursadiction we are seeing some seriously poor patient outcomes that stem from issues arising out of information systems that do not meet clinical expectations. It is true that the number of devices and systems under BME management do not generate anything like the issues that we see with IT systems.