Dr. Dalia H. Elkamchouchi

CLINICAL ENGINEERING

part(4)

Sometimes, a Hospital will decide to start innovations in only one area, either clinical or hospital أبتكاراتengineering. In this case we say that it is implementing partial clinical engineering management.

The programs are the same as those for general management, but are applied to a specific area.

In the hospital engineering area, a hospital can chose to start on medical gases, electricity, water quality, steam generation, air conditioning applications, telecommunication, etc In the clinical engineering area, a hospital can chose issues such as diagnostics, therapeutics or healthcare equipment.

Partial Clinical Engineering Management

Partial Clinical Engineering Management

•Refers to the partial application of the 16 programs previously mentioned

–Medical Equipments–Hospital Installations - Facilities

•Using one program or a combination of specific programs to achieve an objective

–Inventory & Maintenance–Market Procurement–Patient Safety

•Accident & Incident Investigation

Back

Technology Advisory Counseling

•Administrators–Hospital that don’t have enough demand for an engineering

department but have important costs or needs to be supported•Legal standards and regulations, specific information on medical

equipment and installations•Engineers

–Lack of time–Lack of knowledge or information

•Other Professionals–Nurses, Infection control programs, occupational safety professionals

Back

Another possibility is for the Hospital to start getting control over its medical equipment and facilities, by applying clinical engineering programs led by a specialized professional or a company to give them technological support.

•The technology audit is a tool that allows us to evaluate how healthcare technology is being used.

•All hospital operations have to be analyzed, focusing on technology issues.

•At the end of the audit, it is possible to develop action plans to improve the use of technology in the

hospital.

•It is very common to find real opportunities to improve the Hospital’s situation and reduce economic losses

after the audit.

Technology Audit & Action Plans

Technology Inventory

•Quantify and qualify equipments and installations–Manufacturer–Regulatory aspects related

•Ionizing radiation•Quality of water

–Financial information•Price•Installation

–Conservation conditions–Reports

•Help hospitals to create performance indicators•Usually necessary to use accounting approach•Help hospitals to plan new investments

Back

•“ Economic Rescue Plans” are structured to analyze:

•The limitations and restraints of actual technology management that make

businesses vulnerable.

• The imbalances within the business that are created by poor technology

management.

Economic Rescue Plans

Economic Rescue Plans•Immediate actions that are possible because:

–Easy to do but nobody has done it yet–Have no additional costs to implement the

proposed solutions–Logic and reason are the only resources that

need to be applied–Simple knowledge is enough to resolve the

situation–Economic resources are always scarce and have

to be used correctly

Back

Technology Incorporation Planning

•As the quality of healthcare depends to some extent on the safety and effectiveness of medical devices, it is necessary to establish “Good Purchasing Practices”

that include the engineering point of view. This will allow Hospitals to:

*Prepare guidelines for preventive maintenance *Establish user training programs*Establish an information center on medical equipment

performance which will increase value for the Hospital, as a whole.

BackIncorporation ( اندماج )

Bibliography•Clinical Engineering Handbook – Dyro, J. F. – Elsevier – 2004•Principles of Applied Biomedical Instrumentation – Geddes, L. A.;Baker,

L.E. – Wiley Interscience - 1989•Seguranca no Ambiente Hospitalar - Brito, L. F. M. – Senac – 2003•Meditation on Ethics in Clinical Engineering Practice – Dyro, J. F., IEEE

Engineering in Medicine and Biology – 1988•Planning Hospital Medical Technology – David, Y.; Jahnke, E. G. – IEEE

Engineering in Medicine and Biology – 2004•Healthcare Technology Management – David, Y.; Judd, T. M. – Spacelabs

Medical – Medical Biophysical Measurement Book Series, 1993•S.Woolhandler and D.U. Himmelstein, “The deteriorating administrative

efficiency of the U.S. health care system,” New Eng. J. Med., vol. 324, pp. 1253-1258, 1991.

•J. Hay, S. Forrest, M. Goetghebeur, “Executive summary: Hospital costs in the US,” Blue Cross Blue Shield Association, October 15, 2001.

•Banta HD. Institute of Medicine, Assessing Medical Technology. Washington DC: National Academy Press; 1985.