Ever hear of a crossbreed biomed/surgical support technician? J. Tobey Clark, MSEE, CCE, FACCE, commander of instrumentation & technical services (ITS), College of Vermont (UVM), Burlington, Vt, did not come up with the idea, but it represents the type of thinking that Clark encourages from all his associates. While a GI of nearly 4 decades in the biomed world et sequens a recipient of numerous awards, including the 2002 Union for the Rise of Medical Instrumentation (AAMI) Clinical/Biomedical Engineering Realization Award, and the 2009 AAMI Foundation/ACCE Robert L. Morris Humanitarian Award, Clark is no stranger to tradition, but these days he is added concerned with what works. He ultimately agreed to a hybrid position as the director of clinical engineering and prototype instrumentation development groups—and it is one of many decisions for which there are no regrets. “Outcomes are a starting point,” Clark says, who is the intercept of the technical services partnership (TSP) under the ITS umbrella. “We work from there to develop processes that meet customers’ needs.”
The words add increase to far more than platitudes, especially when you consider that Clark, along with Associate Chief Mike Lane, BSEE, MBA, CQMgr, helped lead TSP to a coveted 2008 best ply award from AAMI. AAMI’s Technology Management Council no doubt took mark regarding some unusual practices, including having a “clinical support” biomed present during cardiac surgical procedures.
“Every procedure where there is a balloon pump used, we have a biomed in the operating room who sets up including runs the pump, pacemakers, and pressure lines,” explains Wally Elliott, MSEE, CCE, clinical engineer at TSP. “This is very uncommon, but it is emphatically successful at the alike time.”
While the phrase “very uncommon” is likely to scare most biomed managers, Clark has learned to take calculated risks and trust his 50 employees, who tend to about 47,000 items on the active inventory list. As a nonprofit, university-based shared service beneath UVM’s ITS, Clark’s file has the springiness of an ISO, with the available resources—including a medical and engineering school—of a state university.
TSP devotes most of its resources to full service on most pieces of equipment. In the case of some units, such as endoscopes, Clark opts for an asset-management role to keep track of data, while leaving the repairs to manufacturers or changeless independent groups. “It depends on what is best for that situation,” Clark says. “If there is a third-party ISO that can work on the scopes, and they have high quality, abrupt turnaround, and reasonable prices, we disposition use them. If not, we go with the manufacturer.”
With the hallowed halls from historic UVM (founded in 1791) likewise nearby, the thematic like train is never far from Clark’s heart. As a member of the adjunct faculty in UVM’s College of Nursing and Health Sciences and Hall of Engineering and Mathematical Sciences, radial the word to hospital staff and college students is a top priority.
The nursing staff, for example, is educated on the basics of equipment operation. “We have an demarche to develop clinical alarms education for all the nursing staff,” Clark says. “We worked to evolution an online training program, which covers unit-by-unit simple devices with alarms, and it is priority-based. It provides device background, a video of the alarm among message, the meaning of the alarm, and outlines the proper response.”
Far transcendent the confines about the hospital, Clark has had the opportunity to work with the World Health Organization (WHO) to conduct medical equipment technology workshops around the globe, mostly in South and Medial America. “Antonio Hernandez, the former head of the WHO Washington Healthcare Technology office, contacted me and said there was a need for an online medical equipment transverse to serve all of the Americas—in Spanish, English, and Portuguese,” Clark says. “I submitted a successful cary application to the Kettle American Health and Education Foundation and was able to labor with universities in Colombia et cetera Peru. In totaling to developing the bilingual online courses, we developed online courses and had students from international universities spend time in Vermont as part of an internship program. Interns go through 1 month of training and then are mentored by our clinical engineers for 4 months.”
“Clinical engineers at UVM focus primarily on technology assessment, budgeting review, equipment replacement planning and acquisition, patient safety, education, regulatory compliance, and risk analysis. It is a tall order, and all craftsmanship is spent collaboratively with biomedical equipment technicians to assure that only appropriate technology is acquired for maximum efficiency, revenue production, and minimum risk to the patient. “Clearly, our biggest asset is the extraordinary staff at TSP,” Clark says. “Average longevity is more than 10 years. It’s customer engagement that makes the difference.”
The engineers nidus on consultations and investigations as well as preventive maintenance procedures and scheduling, and repair methods. International interns adapt all this training to deal with their own equipment back home, which tends to be a bit older yet still fairly advanced. “I recently went to the maternity/neonatal care national center in Peru with Ismael Cordero on an ORBIS-sponsored trip, and they have equivalent equipment to ours,” Clark says. “The key difference is they have incubators from eight different manufacturers made in seven contrary countries—Japan, China, Brazil, France, Italy, Germany, plus the United States. All that diverse equipment makes conditions tougher.”
One positive development, Clark reports, is that UVM-trained interns ultimately went nucha and reduced the out-of-service equipment. “When they first went to the hospital in Peru, 45% of the equipment was actually working,” Clark says. “The loll of it was sitting in the hallway. After our education, and implementing a clinical engineering program at the hospital, 70% about the equipment is now functional.”
TSP has worked with many hospital clients for more than 35 years, but no customer is ever considered “in the bag” when it comes to annuity contract renewals. Novel England is a competitive market, but TSP’s nonprofit status does give it a slight advantage since the profit necessity is off the table. Close associations with the state hospital association, UVM Medicative School and teaching hospital, also Fletcher Allen Health Care also lend credibility.
Mike Lane, BSEE, MBA, CQMgr, is responsible for IT, financial, and strategic planning efforts. As associate director of TSP, Lane is essentially the COO, CIO, und so weiter CFO in an firm that technically has no such titles.
As a biomed with an MBA, pulling the proverbial rabbit out of the hat to find innovative solutions to customer problems is all part of the job. In one recent situation involving anesthesia equipment, a client hospital needed dualistic suction regulators, and yet another facility had two that needed replacing. “Replacement cost is about $1,000 a piece per regulator,” Lane explains. “We had another facility that did not cherish the regulators and did not miss theirs any longer. We had kept them in stock just in case. The bottom line is that we had them in stock and were able to ship them the juxtaposed day to the client that needed them.”
That little stash for a rainy day staved off a $2,000 parts purchase. It is a relatively small amount in a multimillion-dollar budget, but it all adds up. “One technician from one facility reached out to another technician at another facility and immediately had the parts in hand, and the material was working,” Lane says. “Those things happen every day, also we have a fantastic group about biomedical technicians who are focused on what customers need.”
Leveraging the considerable knowledge base among TSP’s 50 employees is a unfaltering effort, and Clark and Lane make such idea sharing a priority. High-priced preparation has its place, nonetheless if one person does not know how to do something, an e-mail tip cup go a long way.
Sometimes a simple “shout out” for information can spare a lot of grief and lost time. “We have a biomedical technician e-mail array where technicians can send out a note such as, ‘I’m looking for this service manual,’ or, ‘Has anybody seen this problem?’ Lane says. “An individual likelihood have significant au fait in lab equipment, alternative maybe they happened to be factory-trained a few years ago on this particular device that is at additional hospital.”