By Dave Harrington, PhD
With more than 50 years of healthcare technology under my belt, I wanted to delve into an important subject in the month’s Soapbox: Steps we can take to improve healthcare and keep it affordable. At first, not much came to mind, so I looked back at some of the advances and failures that have occurred to get a little direction for the future.
Case 1: the defibrillator. Although many of you reading this will not remember the early units and uses, back in the ’60s defibrillators automatically recharged after discharge. The rationale behind this? People thought that this would provide a quick turnaround if another shock was needed.
Well, the company I worked for at the time had a policy that engineers must present new products to the salesforce at their quarterly meetings. So, I was tasked with presenting a defibrillator. There were two problems with this, however. For one thing, I had never seen—let alone participated—in a Code Blue event. The second problem was that I had trouble speaking because of a throat injury. But what could go wrong?
So, I turned on the unit, selected the “joules,” (or what we currently call “watts” or simply “numbers”) and discharged the unit into the test load. While doing so, I attempted to point out that the joules delivered what was dialed into the unit—and I forgot that the unit had already recharged.
Making matters worse, I have a tendency to talk with my hands—and, not thinking about what was in them, both hands came to rest on my thigh when the buttons got pressed.
“Defibing” your bottom is not a pleasant experience and it took a few minutes for the sales team and others in the room to stop laughing. We took the automatic discharge out of the units that day—and, since we had not sold any of these devices, we did not have to notify the government about the error.
Some years later, the FDA started asking questions about the automatic recharge as several companies still had units in the field, and the FDA wanted to know if any injuries had occurred because of them.
As a result of my “injury,” when I took a position at a hospital, I helped institute a new policy: Whenever a salesperson brought in a device to sell the hospital, we asked the least experienced tech to set up and use it. What we found was that the final users of devices were often not included in the training and were new hires or technologically challenged. This method was a good way to test a new unit being considered for purchase.
Think about your trouble calls—how many of them are related to improperly trained users? The takeaway? Involve your trainers early in the purchase process and listen to their comments. After all, this could save you a lot of trouble calls in the future. Sometimes, this means talking with someone who has been with the hospital for many years and may not be comfortable with equipment—so be careful not to offend them.
Training Resources
Consider webinars, for instance. Webinars are a great training source and should be used as often as possible. [Editor’s note: 24×7 Magazine hosts and archives a series of webinars, which are available for viewing here.]
Be sure to get information on webinars that are offered for the clinical lab, operating room, imaging suite, and other areas where you have trouble calls or would like to ramp up activity. But do not stop participating in your regional and national biomed shows.
Yes, they’re expensive compared to webinars, but they offer you and your colleagues something a webinar cannot: The ability to see and talk to colleagues from other hospitals and learn about what problems they are having with certain devices and what they are doing to remedy them. Note: This discussion is often done with adult beverages in hand, so please be careful on the number you consume.
If you missed Y2K, talk with those who had the misfortunate of going through it. Ask them about the companies that would not help unless they had a service contract or would place a service call for them to check the device.
If the company was and is more interested in money than providing quality products at affordable costs and helping you, maybe these companies should be on your “do not buy” list.
Also, take any vendor that says their product can connect to any electronic record system with no problem with a grain of salt. In 1989, I made the huge mistake of publishing an article stating that everything would be interconnected within five years. I clearly missed the mark there.
Furthermore, take time to look back at the problems that have occurred in your hospital. Try to make any connections between these problems and attempt to eliminate future errors by planning and budgeting based on your conclusions. The past is a great teacher, and it reminds me of one of the great lines: “I am from the government and here to help.” Believe that, and I feel sorry for you.
Dave Harrington, PhD, is a healthcare consultant in Medway, Mass. For more information, contact chief editor Keri Forsythe-Stephens at [email protected].
Right on Dave !
Dave,
Thanks for the trip down memory lane. I remember those early defibrillators that automatically recharged. At that time, I was working for American Optical’s Medical Division. Back in the 1960s, American Optical was an early leader in defibrillator manufacture, sales, and design. Our defibrillators had automatic recharging because we thought it was a great feature that, as you state, “would provide quick turnaround if another shock was needed”.
If I recall correctly, it was Seymour Ben-Zvi, one of the great early leaders in our field, who pointed out that automatic recharging was dangerous feature. As a result of his efforts, we developed a program to rework all of our units that were already in the field. Ben-Zvi’s early work demonstrated the value of having hospital based clinical engineers who had practical knowledge and could provide an important link between medical device designers and the physicians and nurses who use them.