EBME Forums Forums Management Medical Equipment Management The Biggest Threat to Patient Safety

Yes, I agree with your leading assertion ... but let's start a new thread!

And let us be clear, George ... are these services (user manuals and so forth) being offered free of charge, or what?

Also, I am sure that many of us would like to learn more about the "Troubleshooting Guides" (and the "Quick Start Lists"). What are they like, I wonder? And who writes them?

In my opinion, the best biomeds are always (and always have been) assertive when need be. Especially those in leadership positions. If not, then they need to retire to the back of the workshop where they belong. Remember:- "Lead, Follow, or Get Out of the Way"?

Meanwhile, who are you proposing should do all that stuff you mention?

Now ... let's hear from others ...

It’s a professional service Geoff , so no its not for free , I don’t want to abuse my membership to the ebme site and so for the record I have not asked anyone or have any expectation that anyone should post a link to my site ( Just so others are clear on that Geoff )

I cannot say who writes the troubleshooting guides , there are 1000s of them but neither do most biomeds know who wrote the service manuals – but that’s what we have to work with – some are excellent , most are good / to ok , some are useless . They are getting better !

I am of the view that medical equipment is safe , in general manufacturing techniques and the current pm programs reduce most technical risk associated with them to single digit %’s – and so , if safe use / outcome associated with equipment is the objective ( fixing . pm’s , training ) then we need to look at the largest risk and deal with that first .

The current process is that equipment arrives in the workshop with a label “broken” and it reappears in the department with a note “fixed” or some or other version of that – what I propose is using the existing system, safety & quality , educators etc to get the best outcome . Reporting NPF is objective no matter what happens, either it works or it doesn’t. If over a 6 month period a device or department have a trend which is increasing – the system needs to intervene. Its reported as a metric , everbody gets to see that , educators do what they do , if it doesn’t work ( NPF is still going up ) , they change what they do , etc etc

As far as biomeds been assertive – I am not referring to individuals – I know quite a few hard nuts , including myself who don’t win popularity contests - “biomeds’ the profession !
See the following which was released by Engineers Australia in 2011 :

http://www.engineersaustralia.org.au/sit.../Crossroads.pdf

Look at page 17 , 1st paragraph – the organisation which accredits hospitals in Australia is deemed to be “ questionable “ in their ability to make a technical assessment of a biomed department according to this report ( something I agree with from personal experience and I posted that observation on their site ) - it’s our lack of involvement with the ACHS which is the problem , now there is some history here so I don’t want to say nothing has been done about it ( because I don’t know , yet ) but the end result is that , in my experience , unqualified assessors have ticked the box to say its all ok .

And let me not take credit for any of this Geoff – here is an extract straight out of the NIKI T34 Service Manual - Ref 100-091T , dated Jan 2011 , ( page 13)

Service Decision Route :-

Possible Issue - “ User Error”
Corrective Action –
“Refer issues back to department lead and suggest training/ alerting all users , to prevent the same error being repeated “

I included the link to your site for clarity of communication, George. It is already included at your Profile. And no doubt if Mr.Moderator has objections, he would have deleted it from my post.

As an aside about the quality of manuals. Some years ago (many, I suppose - the early 1980's) there was a good British Standard (BS-4884) which laid out sensible requirements (and a common format) for equipment manuals. Its basics were even adopted by the army, I seem to recall. But now that we are enmeshed with Europe - a place where things like "standards" generally sink to the lowest common denominator, as it were - I'm not sure where we stand with all that these days. In actual fact it hardly matters now, as next to nothing is produced in the UK anyway.

About the "assessors" ... what can I say, but repeat the well-known question:-

Quis custodiet ipsos custodes?

Assertive ... yes, I hear what you're saying. With all the "noise" (that is, unnecessary and puerile communication) that gets generated by life in general these days, sometimes you have to shout and yell just to be heard at all. But, on that point, how about this one:-

"The voice with most authority belongs to him who never has to raise it"!

Good luck with your Crusade, George. The cause is certainly noble enough. But apart from "spreading the word" (and perhaps, offering a bit of moral support) on here, there's next to nowt that I can do about it all myself. So I shall leave that now to others (also known, apparently, as "the fresh audience").

With regards to your second post, George ... in well-organised establishments, the requirement for user staff to report faults has been normal practice (and, in some cases these days, a legal requirement) for as long as I can remember!

So, for what it's worth, here is my own contribution (advice to users):-

1) Make friends with the biomeds
2) Read the manual
3) Understand what you're doing
4) Report faults

OK ... let's get some *posters made!

And in similar vein, and with regards to "NPF" situations, here is a thought for the biomeds:-

Listen carefully to users complaints regarding failures. Separate, but don't discount their idea of cause and effect. Have them explain the symptom (by gentle coaxing, if need be).

* I almost added:- "Keep Calm and Carry On"! That 1939 poster seems to be cropping up all over the place these days. A sad indication of our present predicament, perhaps.

Having just downloaded the .pdf that you linked to, George ... let me say straight away how heartened (?) I am to note so many of the "usual suspects" cited at the References.

It looks like an interesting document - with many familiar headings spotted as I glanced through it - and I plan to read through it later over a cup of tea (or two). I find that the quiet of the night is generally the best time for that sort of thing.

Meanwhile, I urge others to take a look at it, in the hope that it can be a basis for discussion here on the forum!

Yes. We've been hearing this stuff for at least the last 25 years! You know, the usual moan:- "we don't get any respect"*. Blah, blah (boo, hoo).

Notice that "they" want to change the name again. I wonder why they can't just leave stuff alone? It seems to me that (for these biomeds who really want to be CEO's, HR managers - "celebrities", whatever - or just suits in general) it's a question of:- "anything but just getting on with the work"!

OK ... back to the topic - how about this as a threat to patient safety:- so-called "biomeds" who take their eye off the ball!

Lastly, one question (to All and Sundry) ... no doubt we can guess ... but what does "C-Suite" stand for?

* Yet, as we all know:- respect has to be earned.

Arent C suiters the organisations top tier bods. Being Chief Exec, Chief Finance Officer, Chief operating officer etc etc . So the "C" must stand for Chief I guess?

Chief Biomed Tech? Sounds good to me.

It's funny (?) how things change. Many years ago we had the "A-listers" ... in the Admin Corridor!

C-suiters sound a bit, well - "C-list" to me.

Best to be in the B-team, I reckon (that's B for Biomed, of course, rather than Basement)! LOL

Meanwhile, the biomed shall continue to be the true custodian of patient safety in the hospital, regardless of all these Grand Schemes (which, at best, simply come and go).

Geoff you quite right , in the Grand Scheme of Things, many things come , and most go - however its been quite a while since we used carrier pigeons . Is it not the nature of the free market for ideas to be cultivated , put forward and tested ie Evidence Based PM’s ( EM PMs) – from the link below :

http://thetracejournal.com/u/Philips/bYXiyHsN1sROBJNLkLf/660185/Feature-Story.htm

“CMS has had a regulation for many years that basically says that if you receive funds for Medicare or Medicaid patients, you must maintain equipment according to the manufacturers' recommendations.”
If we all accepted that things are the way they are , then EB PM’s would never have been considered – there is nothing wrong with a healthily disregard for the rules , regulations and standards and in an open forum like this hopefully “we can all move forward “ [ my kids love the Ratatouille movie – I must have watched it a 1000 times by now ]
Hospital based biomeds are ideally situated to make big contributions to moving forward in patient safety , cost of ownership etc etc but unless more people stand up the basement workshop will become a permanent fixture for biomed departments – remember the typists from days gone by , they never saw what hit them and don’t think it can’t happen to us , in general we a disorganised bunch ( ie the Engineers Australia link ) who don’t support one another .