Ladies and Gentlemen. What motivates us as clinical engineers? You've just had lunch, you're not going to be allowed to sleep, you've got to think! You've got to be there ready for the questions ready that I'm going to pose. That's my first one, but it's actually quite serious: what motivates us as clinical engineers?
A colleague that I worked with for many years was motivated by his mother dying, and experiencing his mother dying and promising on her deathbed that he would help to look after patients as best he could, although he was, as he put it, merely a technician. The dedication and motivation that he had, right up until his retirement, was wonderful to see.
I suspect among the answers to that question will be the desire to support healthcare, and now we don't talk just about healthcare but wellbeing, through the application of medical devices. In this 20 minutes I just want to look at some of the ways, some of the processes involved in supporting healthcare. We need to ask ourselves this as we go through them: how can we as clinical engineers support this? How can we add value? We heard the word 'value' used this morning. Our programme has a subtitle under it, or a title, 'innovations'. We need to think how we can innovate; how can we do things better? Because we all hear about this 'plan, do, check, act' cycle, which implies a regular review.
Working for the inventor of the world’s first blood glucose monitor was an interesting experience. I don’t think I’ve ever pricked my finger so many times in my three years that I worked for him. He was a guy who used to… He lived not far from Derby, in the Midlands, and worked out in Australia.
It was a great couple of years, working for an inventor. Everywhere you went, you would always see an opportunity to invent something and make some money out of it.
By now I’m told that, after 15 minutes, caffeine should be now seeping through your veins, reaching a maximum blood concentration of caffeine after about 45 minutes, so it should make a fun time of Dave Mulvey’s question-and-answer session in a little while (Laughs…)
Unfortunately, I’ve not got any slides to make you go, “Ah,” but I have got this one that makes you go, “Oh.” What I’m going to talk about this morning, the role of the clinical engineering department in the organisation, I’m not going to stand up here this morning and teach you to suck eggs. I’m sure you can all do that very well. There’s a lot of experience in this room, and you’ve probably been working in healthcare for many, many years.
What I'm going to talk to you today about is regulations, guidance, and standards.
What’s it all about?
What I want to try and do is bring some clarity to the difference between regulations, guidance, and standards.
Then I want to talk to you about an important issue for the future that’s coming through in the next couple of weeks.
Now, you may consider this the boring bit, but my colleagues will liven it up a bit later, but there’s an important message here, I hope.
Let’s look at regulations. Regulations are what the law is, but they're always written in very general terms, because most regulations are covering a very broad range of situations.
Usually regulations are followed up with guidance. It can be guidance that’s formal guidance from the organisation that’s been responsible for the regulations. There’s an awful lot of guidance documents from the Health and Safety Executive, for example.
What does that mean? I think if you look at other industries, for example the car industry. Over the last 80 years they've been improving their technology to the degree where it makes it cheaper and more efficient to run production lines. Healthcare isn't like a car factory. You often hear people coming in and talking about lean methodologies and how lean methodologies can work in hospitals.
I don't agree with that approach myself. I believe lean methodology will work in a factory. I think that the average NHS hospital is far more complex than a factory, especially on the emergency side, different processes. Technology does impact on the whole of the healthcare economy.
So, I’d just like to thank John for inviting me along to speak at the conference today, and when John asked me to come along, he asked me to present a challenging presentation on Risk and Reliability Centered Maintenance. I feel I’ve kind of dined out on this a couple of times now, so I thought, “What am I going to do to make this a little bit different?” So, as you’ll see on the slide there, I’ve called it ‘a cautionary tale’. Now this is not a cautionary tale about not using Risk and Reliability Centered Maintenance but perhaps more around why you should do it.
So, you need to bear with me here. Once upon a time we had these – now, the sharp-eyed amongst you will have noticed that’s a television set. Well, it was a television set back in the day. That’s probably from around about the late 60s or early 70s. The thing about television sets back in those days was that they were very expensive. They were cutting edge technology of their time. People couldn’t all afford them. And some of you won’t remember a time when everyone didn’t have a television, but there was a time when everyone didn’t have a television, and because they were so expensive, people rented them.
Dr. Douglas Clarkson.
Development & Quality Manager, University Hospitals Coventry & Warwickshire NHS Trusts
Currently I work in Coventry, within the bioengineering department there. Just over a year ago, I
became aware of the aspects of pulse oximetry accuracy through an NPAG meeting in London where Geoff Mathews from the Electrode Company gave a presentation on issues to do with the accuracy of the pulse oximeter probes.
This talk is based on a catch up with the issues that relate to the basics of the use of these devices and questions about the accuracy of the readings that they provide.