From the August 2018 issue of HealthCare Business News magazine
Revisit department metrics, and aim higher
Traditional performance metrics like uptime and time-to-repair are fine and necessary, but demonstrating real value means going farther. One approach is to measure uptime in terms of impact on care. When a device went down, was a patient on the table? Did patients have to be rescheduled? Was care delayed? Was patient throughput affected? It’s conceivable at some point to tie such metrics into measures of patient satisfaction. Another approach is to align HTM operations around measurement of internal customer satisfaction, using a metric such as Net Promoter Score. This is squarely in keeping with value-based, consumer-centered care.
Approach technology with a life cycle mindset
The HTM role doesn’t begin and end with maintaining and fixing equipment. The department needs to take part in equipment-related decisions from start to finish – capital planning, pre-purchase evaluation, selection, deployment, ongoing management, and final disposition. In particular, HTM must have a place at the table for evaluating and selecting technology, giving insights to how well a given item meets clinicians’ needs, how it integrates with clinical systems, how it contributes to quality care and patient safety, and how to ensure cybersecurity and patient data confidentiality.
Don’t just react to problems, predict and prevent them
The best time to deal with equipment issues is before they happen. Examples of valuable predictive tools include manufacturers’ online monitoring of CT tubes and MR magnets to detect anomalies that signal potential failure. Repairs then can be scheduled and performed during off hours, such as overnight, avoiding downtime that disrupts care. Adverse events, especially those that occur frequently, should be followed by root-cause analysis. Sometimes equipment issues are staff education or process problems in disguise. For example, the Intermountain HTM team traced a persistent issue with occlusion errors in infusion pumps to cleaning procedures that were inconsistent with the manufacturer’s instructions for use. Once the cleaning method was corrected, a persistent equipment issue disappeared.
Raise your hand – take the tough assignments
Don’t wait for leadership to ask what you can do to solve a problem. Look at your capabilities and tell leadership what you can do and how it will help fulfill the organization’s mission and values. Take new assignments, no matter how challenging. If not convinced you’re prepared for the task, be willing to learn what’s required. At Banner Health, the HTM team stepped up to tackle implementation of a newly deployed radiation dose monitoring system, a hard job no one else seemed to want. The work included chairing groups developing systemwide standard CT exam protocols. While people generally don’t run toward jobs like this that are hard and sometimes messy, it’s in the DNA of the clinical engineering community to do so. It’s a powerful way to prove value.
