CLINICAL ENGINEERING

part(3)Dr. Dalia H. Elkamchouchi

Inventory•Applied to medical equipment and facilities and accessories•State of Conservation•Age of Technological•Registers in organizations as FDA•Recall Evaluations•Value – US$

–New–Substitution

•Energy consumption•Technical & Administrative Data

–Serial number–Model–Manufacturers–Owner–Contracts–Warranty–Technical Responsible

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Market Procurement•Improve the knowledge of medical equipment

market•Improve the knowledge about the market of

healthcare facilities–Medical Equipment Fairs–Mechanical Fairs–Electrical & Electronic Fairs–Specialized Magazines–Technical Papers and Newspaper–Internet groups–Engineering and Maintenance Associations–Benchmarking أرشاد عالمات

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السوق أقتناء

Law, Standards and Regulations

•State and Federal Laws–Water Quality–Electricity Supply–HVAC–Sterilization

•Standards–NFPA, ANSI, ASHRAE, ISO, AAMI, JCAHO

•FDA–Registers, Recalls

•ECRI – 1991–13,000 standards and guidelines

•800 organizations and agencies (North America) Back

These regulations can help Hospitals to become active participants in healthcare technology improvements by correctly applying legal and technical standards and, in addition, make more money.

Equipment Control

•Equipment history•Maintenance procedures•What are the expenses and costs related to maintenance ?

Are they high?•How many hours of work?•Who is the Responsible for the equipment?•What are the maintenance indicators?

–MTBF–MTTR–Availability

•Up Time•Down Time Back

Costs & Expenses Control•Actions may be applied to the two principal types of

costs and expenses, i.e:.–Medical equipments–Facilities

•In addition, actions may also be taken to recuperate money as related to:

–Review contracts•How to obtain more from the same contracts?

–Contractual compliance–New contracts–New technologies

•What kind of knowledge can be used to change the operational costs?

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Process Management•How to manage a clinical engineering department using

processes?

–Define how workers and patient can have benefits from processes

–Create internal administrative procedures•To open work orders•To prepare requisition of spare parts and consumables•Register engineering activities to monitor performance to

achieve defined goals•Issue management reports•Evaluate medical equipment•Register activities of maintenance

–Corrective & Preventive and others

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Risk Management

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• Helps hospital by to: Avoiding exposure risks Minimizing liability exposure Staying compliant with regulatory reporting requirements

• JCAHO – PSTM Require minimum technology-based risks management activities

Recognition, evaluation and risks control– Determination of technology-related incidents with followed-up steps to

prevent recurrences– Evaluation and documentation of the effectiveness of these steps

Contract Management

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•Helps hospital fully explore its contracts on:–Service and Maintenance–Electricity–Medical gases–Combustibles–Warranties–Acceptance tests–Price of spare parts–Timeframes–Performance indicators evaluations

Personal Management

•Helps the hospital’s maintenance and engineering staff be:

–Involved–Prepared to execute its functions–Properly assigned to specific technical tasks–Creative and solution-oriented–Focused on objectives and goals

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Technology Incorporation*

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• Helps hospitals organize and take full advantage of technologies by: Analyzing needs and developing specifications Developing a vendor list Analyzing proposals and site planning Evaluating samples Choosing the best proposal Controlling deliveries and installations Performing acceptance testing Final acceptance

Technology Incorporation

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• Clinical Team Requirements Ability of staff to assimilate the technology Medical staff satisfaction (short and long term) Impact on staffing (numbers, functions) Projected utilization On-going related supplies required Effect on healthcare delivery and results (convenience,

safety, or standard of care) Written, clinical practice guidelines Credentialed staff Clinical staff initial and ongoing training Effect on existing technology in the department or

other services/departments

Maintenance•Preventive

–Documentation•Operational manual•Operational maintenance•Registers

–Tools•Adequate tools required•Simulators and performance equipment tests•Calibration certification of these equipments

•Corrective–Service manual–Training–Functional principles

•Management of these processes

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Patient Safety

•Safety is a condition of being safe from:–Danger–Injury–Damage

•Regulations and Standards–Air conditioning (tuberculosis)–X-Ray dose–Medical air quality–Electrical current leakage–Burns associated to electrosurgical units–Alarms management

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Strategic Technology Planning

•Is an accountable, systematic approach to ensuring that cost-effective, efficacious, appropriate, مالئم و and safe فعال

equipment is available to meet the demands of quality patient care, and allows an institution to remain competitive.

•Ex:–In house service management–Management and analysis of external service providers–Involvement in the equipment acquisition process–Involvement in facility planning and design–Reducing technology related incidents–Training equipment users–Reviewing equipment replacement needs–On-going assessment of emerging technologies

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Training

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•Training is one more management tool to be used in preparing people to meet the new

challenges brought on by new technologies.

•Therefore, training must enable the Hospital and each of its staff members to grow and to develop, as needs and opportunities change.

Quality•Quality of Care

–It means providing healthcare with the most efficient use of resources

•Measuring quality of care–Quality Assurance (QA) & Quality Improvement

(QI) are formal sets of activities to measure the quality of care

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Quality of Medical Technology

•Inventory–Institution’s experience with that and similar

devices–Equipment functions–Industry standards (state of art)–Age–Current device condition

•Select a valid indicator to measure equipment’s clinical performance

–Availability–Functionality–Financial performance–Safety

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Quality of Medical Technology •Types of indicators

–Type and # of devices scheduled for service–Total # and type of devices inspected–Type and # of devices that failed an inspection–Type and # of devices for which on-demand service was requested–Type and # of devices found with physical damage–Type and # of devices for which user’s complaint was registered, but

no problem found–Type and # of devices involved in accidents or incident–Type and # of devices that were serviced more than one time in any

7-day period–Type and # of devices for which abnormal labor or replacement parts

were required

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