Instead of blindly following manufacturers’ maintenance recommendations, Clinical Engineering (CE), also known as Health Technology Management (HTM), professionals can use a method similar to Evidence-Based Medicine to keep medical equipment safe and reliable while using judiciously their limited resources. Evidence-Based Maintenance (EBM) analyzes the causes of equipment failures and uses these results to continually improve maintenance. EBM is particularly suited for those who want to take advantage of the Alternate Equipment Management (AEM) program allowed by the Centers for Medicare & Medicaid Services (CMS) because it allows comparison of different maintenance strategies and provides concrete evidence to prove the safety and effectiveness of the AEM program adopted.
Numerous misconceptions and myths have accumulated in the last 3-4 decades in clinical engineering (CE), also known as health technology management (HTM), in the inevitable process of becoming a mature profession. While some of them are not serious, others may cause harm to patients or, at least, waste precious limited resources, which is ill affordable by the healthcare industry due to the ever-rising costs. This book is the compilation of over a decade of presentations made by the author to challenge the conventional wisdom and uncover the truth. To make the more interesting to read, a series of tests—in the form of statements—is presented for the reader to decide whether they are false (fake news), true (true facts), or myths (legends). Each statement is then examined in detail (fact checked) to determine which is the right choice.
This book provides the fundamental concepts and tools needed by Clinical Engineering (CE), also known as Health Technology Management (HTM), managers to properly manage their financial resources, as well as to prove to their senior leaders that they are comparing (benchmarking) well against their peers. After introducing basic accounting concepts and tools using a case study based on real data, different methods for financing the CE/HTM department are explored. Next, opportunities for improving financial performance are explained through analyses of budget, costs and productivity. After a critical review of various benchmarks available, proper ways to use them to evaluate performance and seek improvements opportunities are demonstrated, enabling CE/HTM managers to secure recognition and support from their senior leaders, as well as defend their departments against consultants and outsourcing companies.
In addition to being essential for safe and effective patient care, medical equipment also has significant impact on the income and, thus, vitality of healthcare organizations. For this reason, its maintenance and management requires careful supervision by healthcare administrators, many of whom may not have the technical background to understand all of the relevant factors. This book presents the basic elements of medical equipment maintenance and management required of healthcare leaders responsible for managing or overseeing this function. It will enable these individuals to understand their professional responsibilities, as well as what they should expect from their supervised staff and how to measure and benchmark staff performance against equivalent performance levels at similar organizations. The book opens with a foundational summary of the laws, regulations, codes, and standards that are applicable to the maintenance and management of medical equipment in healthcare organizations. Next, the core functions of the team responsible for maintenance and management are described in sufficient detail for managers and overseers. Then the methods and measures for determining the effectiveness and efficiency of equipment maintenance and management are presented to allow performance management and benchmarking comparisons. The challenges and opportunities of managing healthcare organizations of different sizes, acuity levels, and geographical locations are discussed. Extensive bibliographic sources and material for further study are provided to assist students and healthcare leaders interested in acquiring more detailed knowledge.
Technology is essential to the delivery of health care but it is still only a tool that needs to be deployed wisely to ensure beneficial outcomes at reasonable costs. Among various categories of health technology, medical equipment has the unique distinction of requiring both high initial investments and costly maintenance during its entire useful life. This characteristic does not, however, imply that medical equipment is more costly than other categories, provided that it is managed properly. The foundation of a sound technology management process is the planning and acquisition of equipment, collectively called technology incorporation. This lecture presents a rational, strategic process for technology incorporation based on experience, some successful and many unsuccessful, accumulated in industrialized and developing countries over the last three decades. The planning step is focused on establishing a Technology Incorporation Plan (TIP) using data collected from an audit of existing technology, evaluating needs, impacts, costs, and benefits, and consolidating the information collected for decision making. The acquisition step implements TIP by selecting equipment based on technical, regulatory, financial, and supplier considerations, and procuring it using one of the multiple forms of purchasing or agreements with suppliers. This incorporation process is generic enough to be used, with suitable adaptations, for a wide variety of health organizations with different sizes and acuity levels, ranging from health clinics to community hospitals to major teaching hospitals and even to entire health systems. Such a broadly applicable process is possible because it is based on a conceptual framework composed of in-depth analysis of the basic principles that govern each stage of technology lifecycle. Using this incorporation process, successful TIPs have been created and implemented, thereby contributing to the improvement of healthcare services and limiting the associated expenses.
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