EBME Forums Forums Management Equipment Libraries Next Blackpool Forum Discussion

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I wonder if President Sarkozy is available (just as long as he brings along Carla, that is)! Perhaps he could explain why Equipment Libraries are called libraries rather than "Le Shared Equipmente Pools" (or whatever they call them in France)!

Hi Jo,
As you know, I missed the last forum because of sickness, but I will be at the next. I'm not sure that it is a topic for a presentation, but I would be happy to give my views on how to track equipment successfully. I am new to this site, but there seems to me to be much on it about tracking equipment. I would be happy to explain why RFID tracking is completely unneccesary in a properly managed library, and how we do this at University Hospital of Wales, Cardiff. As I may have told you, we manage 2500 items of equipment across 2 sites ( 6 miles apart ), and some other ancilliary sites. Equipment is interchangeable across these sites to maintain stock levels. To date, we are unable to account for only one syringe pump after four and a half years of operating, and we know that this is still in our main building. RFID tracking would come under what I would call "boys toys". Probably OK in a hospital already equipped to read it ( and if the additional equipment cost was 10p ). Not the thing of the future - just another waste of NHS money!! Having read the site for many months, it would seem to me that we appear to have solved most of the questions that are frequently asked re libraries. If anyone wishes to call me, my direct line is 029-20743226. The other point that I think needs raising at the next forum is that "library" questions that appear on this forum are often "hijacked" by clinical engineers. Library issues are more often about the user, or customer. Clinical engineering questions more often relate to engineers, as you would expect. Often the two are different
Regards,
David Learthart
University Hospital of Wales,
Cardiff

An interesting post, David, so thanks for that and welcome to the forum. I would beg to differ on your final point, however, as I believe that most biomeds (as I like to call "clinical" engineers and technicians) are very "customer" (or user) oriented and driven. Providing technical services to the clinical user is the very essence of the job! I should imagine that most, if not all, biomeds (in the UK especially) see the Equipment Library as, if not actually part of their domain, certainly as peripheral to it. It's not a question of "hijacking" (?), but more of interest being shown in Equipment Libraries! By the way, some Libraries that I know of have a tech. on the staff, and resident in the store, carrying out equipment servicing right there. Personally, I reckon that's a good policy.

Your remarks about RFID are very enticing, I might say. I would also say that, on balance, opinion on this issue has not been overwhelmingly in favour (actually, quite the reverse). I for one (and I'm certainly not alone) am always moaning on about waste, idiotic procedures, "gee-whiz" technology just for the sake of it, and about the adoption of inappropriate technology in particular. I'm sure we would all be interested to learn about how you've been able to achieve what sounds like a remarkable level of efficiency! But let's not wait until "Blackpool" ... why not tell us right here?

Hi Geoff,
Thanks for the interest. The point I made about the difference between library issues and clinical engineering views is highlighted by the forum item on RFID tracking. It started with a question from Bob Perkins about the use of RFID tracking of library items. It appears now to be about types, quality, etc. of tracking systems. Hence my comment "boys toys". Also, in a working library, the main interest has to be about the "customer" who walks through the door with a request. As such, libraries should be "organic" in growth to reflect customer requests.
The growth of UHW library would be too long to tell here. However, there are two main points. Firstly. all infusion pump ownership was transferred to the library on day one. Secondly, the people who had to find pumps out of hours prior to the library, the SNPs, were recruited to run the out of hours service,
Regards,
David L.

Hiya,

The issues around equipment tracking and managements of assets are nothing new to clinical engineers but coordinated equipment libraries are a relatively new idea in the NHS. So are equipment library officer and library manager jobs.

The suggestion that ideas involving equipment tracking and equipment libraries should not involve clinical engineers is a bit odd (a bit cheeky as well) IMO because that sort of thing has always been an issue to people given the task of keeping asset inventories and servicing equipment.

For non-techs given libraries to run then its all relatively new to them and their still developing. That's why theirs the need to use existing forums for clinical engineering to promote equipment libraries maybe? Bit cheeky to say their colleagues on the same forum are hilacking it IMO......but Im new here myself (but I have lurked a bit) so I shouldnt say too much.

Some libraries I've been involved with and seen working myself actually have non skilled and non technical and non clinical trained people on the ground doing the work who carry out repairs do safety tests and give clinical advice and training to operators.

Most of this is done without the same level of understanding as clinical engineers. Not ideal. Many rely on technical input from others usually clinical engineers to keep things running.

Other libraries i know work very closely have clinical engineers who organise repairs and maintenance and give technical advice to operators and do safety testing of library equipment.

Id say that at the moment theirs no "right way" or best way of doing things because it all depends upon the individual trusts needs and resources their willing to put into it.

Most libraries and those working in them would probably agree that they get the best support by trying to work with clinical engineers rather than trying to alienate them....

Cheers!

Hi Rob,
I'm glad that I am not the only person who has lurked around the site. To clarify a point - I have worked for clinical engineering for many years,
Regards,
Dave L.

Hiya,

Without cooperation and discussion between clinical engineers and library officers concerning technology and best practices etc some libraries might not exist nevermind operate successfully IMO.

"Boys toys" is what makes medicine work these days. Personally Ive never had much time for administrtors or pen pushers but thats soemthing I'll have to live with.

Cheers!

Hi Rob,
The library here was set up by the Trust Board, so your first paragraph is irrelevant. Without the support of our main clinical engineering, Respiratory and Anaethetics Support Services , this library would not work. For example, we currently have 700 domiciliary nebuliser patients. Equipment regularly seriviced by us. However, "boys toys" seem to be a problem. What nurses need ( see my comments above about users ) is the ability to do their job properly on a day to day basis.
Not what clinical engineers feel are neccesary)

Dave L.

Guys, what we don't want is this (or any other) thread to degenerate into anything unproductive (what's the point?).

Here's the word from someone with long experience in varied situations (as usual I'll use BME or biomed as shorthand for "clinical" engineering, or whatever you want to call it):-


THE AIM OF BIOMEDICAL ENGINEERING

"To keep fit equipment in the hands of the clinical user"

("Fit Equipment" means equipment that is fully serviceable and fit for intended use)

How? by ....

1) Equipment management
2) Routine maintenance
3) Efficient repair service


PRIORITIES OF BIOMEDICAL ENGINEERING

1) Keeping the Hospital Running
- responding to urgent calls
- keeping wards and clinics operating
- carrying out quick and minor repairs
- dealing with outside repair agencies

2) Safety and Performance Monitoring
- equipment related safety issues
- quality assurance of critical equipment

3) Bench Repairs

4) Equipment Management and Routine Service Programmes
- advising users on equipment matters
- PM (Preventive Maintenance)
- technical services
- user training

5) Logistics
- maintaining spare parts stock
- maintaining technical library
- maintaining the workshop
- record keeping

... this is more or less what we have always done (or at least striven to achieve). Now we have "Equipment Libraries". Another misnomer, really, as they are really Shared Equipment Stores, but either way they are another tool in our armoury (as it were). The idea is to centralise commonly used "ward" equipment (infusion pumps being the prime example) into a central location, with controlled 24-hour access (eg, by nurses from the wards). Like a book library, staff come in and sign for the equipment, look after it whilst it's in their charge (?), and return it when they've finished with it. The Library has to be managed. Someone has to go around trying to locate and recover the equipment that was supposed to have been returned, but wasn't. Unlike a real library, there is (usually) no penalty applied for non-returned equipment. Why not (don't ask me)?

But all that equipment still has to be supported (serviced, repaired, maintained) just like all the rest. But we hope that having it under central control should help in that regard. The best libraries have a biomed as part of the library team for just this reason.

For more years than I care to remember, us biomeds have been the defacto custodians of the equipment inventory. I have worked in many places (overseas) where "Property Control" was a big deal, with a Manager and all the rest. But even in circumstances like that, in reality management used to rely heavily on my "list" (why? because it was the only accurate one around).

Frankly, all this talk of librarians versus clinical engineers is nonsense. We are both on the same side. And yes, both sharing the same aim of serving the clinical users. The bottom line is that the library function is part of biomed (as it is today), just as the equipment user training function is (or, at least, should be).

If equipment libraries are to become yet another exercise in empire building ... then to us biomeds, the library will become just another user!

I rest my case.

Hiya,

I'll go with that Geoff. Doubtful that clinical engineers have had no involvement in implementation or day to day running at Cardiff but Im not going to push that one just for the sake of arguing.

I get the impresion that David does not approve or recognise involvement of others in his own or others libraries which is a sheme. Im all for cooperation and credit were its due.

The way i look at it is that libraries make my life easier day to day because there is equipment available to exchange for stuff that requires service.

Somebody else cleans it and gives it routine inspections for damage and its delivered and they deal with the operators while i get on fixing the "boys toys".

Operators only get what they want if the library is setup correctly ie theres enough library equipment available to meet peaks in demand and servicing is well coordinated and theres people to run the library all hours.

24hrs support is a sticking point with many libraries in smaller hospitals because its expensive to provide. Normally left to hospital porters or operators themselves to run out of hours.

We should be clear on the fact that libraries are there to provide the right equipment when its needed and this can only be done properly as part of a bigger effort managing equipment.

Its true that some libraries do not have the luxury of being resourced fully from day one with people who know 100% what their doing. Maybe Cardiff werent typical in that respect.

Maybe clinical engineers are not involved in their library system.