Mel Roche

The integration of the clinical engineering and supply chain departments is not in the organizational chart of most health care facilities. Typically, clinical engineering will find itself aligned with plant operations or IT, or it will function as a stand-alone department. However, structuring such an integration can lead to major advantages and the avoidance of the usual complications that plague modern clinical engineering departments. The supply chain department of most organizations houses the functions and processes for capital equipment purchasing, support purchasing, and contracts administration, and has a process for the dissemination of excess or surplus medical equipment. Clinical engineering is a major stakeholder in each of those functions or processes, and being an integral part of supply chain can lead to participation in each of these functions from start to finish, streamline processes, and add value to the department’s service line. Let’s see how.

Capital Equipment Selection and Purchase: During each capital purchasing cycle, clinical engineering can and should be a participant in the selection and acquisition of clinical equipment. This can be accomplished through the use of an evaluation tool during demonstrations that rates not only ergonomics and clinical performance of equipment, but safety, reliability, and serviceability issues as well. This allows clinical engineering feedback on the front end of the potential purchase, and can prevent or eliminate problems with standardization, incompatibility, scalability, and support after the purchase is completed. Some supply chains utilize capital equipment purchasing software that contain invaluable tools for the clinical engineering department when preparing for the delivery of new equipment.

Contracts Administration: Contract purchase, coordination, and renewal are daunting tasks for clinical engineering. Centralizing this process within supply chain and employing a few simple tools can make this task much easier. Most facilities require administrative sign-off and legal review before implementing any service or support agreements. This can be accomplished most efficiently by utilizing an electronic copy of the contract and a standard form for signature that are circulated to the required individuals via e-mail. Once completed, returned to supply chain, and implemented, they can be scanned and entered into a process that utilizes a software application that will automate reminder notices to be sent out at preset intervals before renewal or expiration—a valid process for clinical engineering support agreements that can prevent equipment from lapsing into a nonsupport condition. Some vendors offer point-of-sale service agreements that are generously discounted if purchased near the time of sale.

Support Purchasing: This pertains to the process of ordering supplies or repair parts as a part of the routine, everyday function of the typical clinical engineering department. Through the integration with supply chain and by using the proper purchasing software and training, clinical engineering can fill purchase requests, generate purchase orders, receive orders, and validate invoices from within the department itself. This software is usually found shared between the supply chain and finance departments. What makes access to this system so beneficial for clinical engineering is that orders for repair parts can be completed practically in real time versus requesting purchase orders and having to wait hours, or sometimes days, before one can be issued. This equates to better access to overnight shipping for critical parts, shorter ship/wait times, less downtime for equipment, and reduced loss of revenue.

Surplus Equipment: Imagine a general store that one could browse through for needs that did not get approved on this year’s budget. This is exactly what can happen if fully functional and supported surplus equipment is stored in a centralized location and a list of the inventory is published on the hospital Intranet, Web site, or internal publication. Facilities or departments that need particular equipment, beds, or supplies can find what they want from the list and have it transported via supply chain to their respective facility or department.

Eric Smith, CBET, is the manager of clinical engineering, Bristol Regional Medical Center, Wellmont Health System, Bristol, Tenn. For more information, contact .

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“ThisisJohnSmithwithGenericBiocorpsixonesixfivefivefivesevenfivefournine.” It is even harder and sometimes impossible to understand that message when it is spoken with a thick accent or over a bad connection. By speaking clearly, support personnel can more easily contact you if they cannot immediately solve the issue.

The second item to have on hand is specific information about the device, software, or usage problem. Have the model numbers, serial numbers, and version numbers of the items in question ready. This will help you navigate voice mail systems and give support personnel information for tracking problems.

Finally, have all the information about the problem that prompted the contact in the first place. Support personnel will want to know what is working incorrectly, what is working correctly, and what is working differently than before. Dreaded voice mail mazes are annoying, but they are not as frustrating as bouncing among a group of incorrect people.

During a support session, the support giver may provide specific instructions and procedures to be followed step by step. Hopefully, you will not be run through procedures that you have already performed independently, but it may be necessary. The technician often needs to get your system into a condition or position that is known and understood. Do not “get ahead” of the technician as they may introduce a subtle change to the procedure. This stepwise operation helps the support technician visualize the problem.

Large companies will often have a tiered support network. The first level of a tiered support network triages the case. Personnel at this level usually uses a support script, a book or program that operates like a flowchart. Support scripts are good for resolving common and well-understood problems. In some cases, the people using a support script have never seen the product in operation. The second level of a tiered support network provides more specific help. Level-two personnel usually have had training on the specific products and can provide more specialized support. The top level is usually a product engineer, who has an equipment setup to try to replicate your problem.

Sadly, not every problem can be solved remotely. When it cannot, either a support representative will come on-site or you will send the equipment out for service. There are a few very important things to do when shipping items. First, confirm the shipping address and return address. Next, include a copy of the Return Material Authorization paperwork in the box, and display the number clearly on the box. Then, record the tracking numbers so you can confirm delivery and receipt of the unit. Remember to buy shipping insurance for your equipment. When shipping equipment back to the manufacturer or service center, always have at least 2 inches (5 cm) of proper filler between the edges of the box and the unit. Having less than this voids most shipping-damage warranties and risks aggravated damage to the unit.

In summary, remember to have pertinent information ready before you call. Also, record all names, numbers, and times of your communications. Speak at a normal pace, enunciate, and be polite. Remember, people who perform customer support rarely, if ever, get called when things are working right.

Jason Brookbank is the service and technical support manager for Metron US, Grand Rapids, Mich. For more information, contact .