Joseph Sheffer

Training Advances Biomeds IT Service Skills

The recent proliferation of networked medical devices, while offering great promise for more nimble care, also has brought a slew of drawbacks, exposing patients and healthcare organizations to safety and security risks. Also as a result of these enhanced technologies, the need for biomedical engineering staff to possess a hybrid skillset—with training in both healthcare technology management (HTM) and information technology (IT)—is becoming increasingly essential. “Across the healthcare industry, the convergence of IT systems and medical devices has become pervasive,” said Jennifer DeFrancesco, MS, CCE, CHTM, lead biomedical engineer for the Veterans Integrated Service Network (VISN) 11. “We’ve seen a jump in the past five years, probably from about 10% to 22–25% of our medical equipment portfolio being networked medical devices. These devices are in essence health information systems.” VISN 11 consists of seven healthcare facilities in Michigan, Indiana, and Illinois. The network employs a total of 67 biomedical engineering staff. Biomed staff for VISN 11 are responsible for supporting approximately

Group's Deep Data Dive Helps Optimize Medical Equipment Maintenance

300 million in medical devices and health information systems, which vary greatly in terms of complexity.

The Golden Year

To get the most out of its preventive maintenance (PM) activities, Technical Services Partnership (TSP) at the University of Vermont first needed to determine the failure rate for various types of healthcare technology. This massive undertaking, deemed the Comprehensive Preventive Maintenance Frequency Adjustment Project, would provide TSP with the data it needed to optimize equipment maintenance schedules based on overall risk. TSP operates as a not-for-profit department within the university, providing clinical engineering services to around 30 hospitals, clinics, and other healthcare delivery organizations in Vermont, New York, and New Hampshire. The majority of facilities in the TSP network are small community hospitals (100 beds or less), but it also includes larger regional institutions, such as the University of Vermont Medical Center. TSP helps its customers stay current on the latest advances in healthcare technology while ensuring patient safety, clinical efficacy, cost containment, and operational excellence. TSP has two primary staff positions: biomedical equipment technicians (BMETs) and clinical engineers. The BMETs are in residence at the various hospitals (community and teaching), performing frontline medical equipment safety and performance inspections, while the three full-time clinical engineers provide oversight for large geographic areas, including assessing the clinical efficacy of new equipment, conducting incident investigations, completing electronic medical record–equipment integration projects, and ensuring compliance with regulations and standards.

BMET Training: What Can the Military Teach Us?

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Group's Best Practices for PM Dovetail with Competency Checklists.

Biomedical Instrumentation & Technology January/February 2016 With more than 50 academic programs and 21,000 graduates per year, the Medical Education & Training Campus (METC) at Fort Sam Houston in San Antonio, TX, produces more trained biomedical equipment technicians (BMETs) than any other institution worldwide. Serving the Tri-Services (Army, Navy, and Air Force) and international students from various nations, this state-ofthe-art facility uses an exacting, rigorous training configuration to educate students on a range of essential skills for the repair, maintenance, calibration, and installation of medical and dental equipment.

Preventive Maintenance At VA Medical Center Gets a Boost

At a monthly managers meeting in summer 2015, the question was raised of how Baylor Scott & White Health (BSWH) was ensuring competency, as well as a high level of consistent performance, among its biomedical engineering technicians. From there, said Carol L. Wyatt, MPA, CHTM, CBET, manager of healthcare technology at BSWH, the idea began to take shape: “Within about 15 minutes, we had come up with a rough sketch of a plan to start using competency assessment checklists based on manufacturer-recommended preventive maintenance (PM).” The largest not-for-profit healthcare system in Texas and one of the biggest in the United States, BSWH’s network includes 48 hospitals and more than 900 patient care sites. Its biomedical equipment technicians (BMETs), imaging support technicians, and clinical engineers are responsible for the service of all medical equipment, nurse call systems, and monitoring systems. The healthcare technology management (HTM) department also manages medical equipment applications and medical equipment projects.

CE Team's Collaborative Efforts Help Streamline Temperature Control Monitoring

Opened in 1932, the William Jennings Bryan (WJB) Dorn VA Medical Center (VAMC) is a 216-bed facility providing acute medical, surgical, psychiatric, and long-term care. At the time of the initiative described here (2011–14), biomedical engineering was staffed by department chief Robert Hijazi, PhD, MS, MHA, CCE, CBET, and five biomedical equipment support specialists. (Hijazi has since moved to the John D. Dingell VAMC in Detroit, MI.) Each month, this five-man crew was responsible for performing preventive maintenance (PM) on about 220 pieces of healthcare technology. To maintain accreditation, hospitals must pass The Joint Commission (TJC) triennial survey, which includes meeting requirements for PM. Surveyors walk the floor, pulling numbers from several pieces of equipment, and request to see the equipment history on those items to make sure they’re up to date.

Hospital Takes Hard Look at Immediate-Use Steam Sterilization

In 2009, installation of a new wireless, automated temperature monitoring system was completed at the Women & Infants Hospital in Providence, RI. The state-of-theart system came with the promise of increased productivity; elimination of loss for vital supplies such as medications, blood products, and breast milk; and an overall improvement in patient care. In 2013, Jillyan Morano became director of clinical engineering at the hospital. She quickly noticed that a lack of strategic management was impeding the temperature monitoring system from reaching its full potential. Morano and her team provide clinical engineering (CE) support for the Care New England Healthcare System, including Women & Infants Hospital, through ABM Healthcare Support Services. ABM is one of the leading healthcare support service providers in the nation, specializing in clinical engineering and healthcare technologies. The CE team also includes four technicians and Samantha Herold, a clinical engineering intern—who took the lead on the project. Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation’s leading specialty hospitals for women and newborns. With approximately 8,400 deliveries per year, Women & Infants is the 11th largest stand-alone obstetrical service in the United States. It also serves as a major teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology, and newborn pediatrics, as well as a number of specialized programs in women’s medicine. The hospital, which was named a U.S. News & World Report 2014–15 Best Children’s Hospital in Neonatology and a 2014 Leapfrog Top Hospital, opened its neonatal intensive care unit (NICU) in 2009. At the time, it was the largest single-family-room neonatal ICU in the nation.

Two-Man Biomed Team Adds Bed/Stretcher Maintenance to Arsenal

By increasing the rigor of its policies surrounding immediate-use steam sterilization (IUSS), Aultman Hospital improved patient safety and lowered the risk of surgical site infection. Headed by Joanne Rhodes, a registered nurse and director of the Sterile Processing Department (SPD) at the hospital, the initiative by the SPD and operating room (OR) teams drastically reduced the rate of open IUSS and moved the sterilization process out of the OR and into the SPD, therefore strengthening the hospital’s efforts to prevent infections.

Courses help foster network-savvy HTM professionals.

As the Central Texas Medical Center, located in San Marcos, TX, is a small nonprofit hospital, cost is a constant consideration. Keeping work orders to a minimum while ensuring the safety of patients and hospital staff also are at the forefront of the collective mind of the hospital’s two-man Biomedical Engineering Department, which consists of Phil Alder, supervisor of biomedical engineering, and Richard Sanchez, biomedical engineering technician. As an in-house department working through the Adventist Health System, the hospital’s biomed team has no shortage of work, as the two-main crew is responsible for maintaining and repairing all general biomed equipment in the hospital. “We pretty much do it all,” said Alder. Alder has been at the Central Texas Medical Center for 15 years. The son of a nurse, he began his career working in consumer electronics, but eventually felt a calling to fix something more meaningful than camcorders. Alder found that his skills in electronics helped ease the transition into healthcare technology management (HTM), and after earning his BMET degree from St. Philip’s College in San Antonio, Alder landed at the Central Texas Medical Center in 2000. Challenge Prior to 2005, facilities staff at the hospital were responsible for maintaining beds and stretchers. But as they were taxed with other maintenance duties, the hospital facilities director decided to shift this responsibility to the Biomedical Engineering Department. At this point, said Alder, the system for repairs was informal; no asset numbers were assigned to the beds or stretchers, and therefore, no preventive maintenance was taking place. Initially, to help decrease the burden of this new responsibility, biomed sought repair assistance from manufacturers and third parties. “After about two weeks of that, we knew it wasn’t going to work just because it was too expensive,” said Alder. For similar cost-related reasons, bringing on another full-time employee was not an option. “So, it boiled down to, we just had to take them on and get them fixed. We had to take on a whole new process,” said Alder. Much of the repair-related expense, he said, stemmed from the increasingly complex nature of hospital bed technology. For this same reason, it was a natural evolution that biomed, rather than facilities staff, should take on bed/stretcher BrIGhT IdeAs