Established in 1753, Salisbury, North Carolina is the county seat of Rowan County and located in the state’s piedmont. Two-hundred years later, the W.G. (Bill) Hefner VA Medical Center opened in Salisbury. The Center serves the health care needs of veterans living in a 24-county area.
It is one of the fastest growing VA health care systems and covers the middle strip of North Carolina from Charlotte to Greensboro. Two new health care center (HCC) facilities, in Charlotte and Kernersville, North Carolina opened recently.
The main hospital campus is in Salisbury and is a Complexity 1C facility with 259 operating beds including inpatient wards, long term care, hospice and mental health.
The centers in Charlotte and Kernersville offer most medical services but do not have inpatient beds. These facilities were built to expand services and offer them closer to veterans’ homes.
Additionally, there is a community-based outpatient clinic in Charlotte, which is smaller than the health care centers and offers primary care, mental health, lab and radiology services
Responsibility for maintaining the medical equipment for all four campuses falls on the 13-member biomedical engineering department.
“Our department’s growing rapidly alongside the growth of the system and is being driven by the goal of not just maximum uptime of equipment, but also maximum overall support to clinical staff, be it technical consulting and planning, process improvement or branching out into new areas (i.e. networking),” says David Sledge, chief biomedical engineer, who has oversight of all four sites.
Sledge and eight of the technicians work at the main facility in Salisbury. The facilities in Charlotte and Kernersville each have two in-house technicians.
“The department not only maintains the usual biomed modalities at each facility (operating rooms, imaging, exam room equipment), but are moving into the realm of information systems and server management,” Sledge says. “Most equipment has a NIC or wireless card, and many transmit and store data on a server. Networking and data management is becoming a crucial part of the profession.”
The team’s technicians are constantly looking for ways to bring services in-house, Sledge says. “For instance, staff recently began repairing dental hand pieces in-house with an expected cost savings of over $50,000 annually. This was a result of a technician identifying an unnecessary cost and proactively seeking a way to reduce it,” he says.
Sledge says that the department, working alongside IT, shares responsibility for server space and responsibility, which includes writing their own ACCESS Control lists and troubleshooting most of the medical device connectivity problems, including switch level issues.
“It has become apparent in the last couple of years that IT and Biomedical Engineering need to work together for the organization to be effective, and we are fortunate to have an IT department that is willing to collaborate and train in deficient areas,” Sledge says. “This is an ongoing effort, with the end goal having network expertise as a core competency for a number of technicians.”
The biomed team is made up of specialists who have unique responsibilities at the different facilities.
Besides Sledge, the team also includes Robert Monroe, the network biomedical equipment support specialist (BESS) for all three sites who is responsible for a number of regional medical information systems such as cardiac EKGs.
“Robert was selected as the National BESS of the Year within the VA for 2016, for his work supporting a revamped network security profile, while simultaneously supporting the opening of the two Health Care Centers,” Sledge says.
Mark Gridley, Lee Fisher, Frank Walton, Jeremy Brown, Danny Papageorgiou, Jim Cherry, CBET, and Lauren Wylie, CBET, are the department’s biomedical equipment support specialists (BESS). Gridley is responsible for the operating room. Fisher is focused on lab, sterile processing and endoscopes. Cherry specializes in cardiology, imaging and telemetry. Brown specializes in imaging, optometry and audiology.
Biomedical equipment support specialists Jeff Murphy and Lisa Morton serve the Kernersville HCC. Robert Naranjo and Carl Murray are the two biomedical equipment support specialists who serve the Charlotte HCC. They cover all areas of their respective facilities on an as-needed basis.
Networks and New Centers
The team participates on a national Networked Medical Device Database work group aimed at effectively tracking networked devices.
Sledge says that tracking is the first step toward making smart decisions, which in this case is related to network security and secure patient information.
“The group was critical to successfully activating two new Health Care Centers in 2016; one in Charlotte and one in Kernersville,” he says.
“The new Health Care Centers are amongst the largest to date in the VA, both accounting for approximately 400,000 square feet each, and gives the ability to offer more services to veterans closer to their homes. Biomedical Engineering was a major part of the planning for the new sites and implementation throughout the construction and installation processes,” Sledge adds.
Sledge says that the biomedical engineering department has been integral to steps to tighten up the security of the system’s networks.
“Hospital network security is a very hot issue as network cards are finding their way into many of our medical devices,” he says.
“Last year, new policies were put in place to greatly enhance security across the entire VA. Much of this work fell to Biomedical Engineering, as some of the most crucial databases, and systems storing patient health and identifying information, are managed by us,” Sledge says.
There was a tight deadline to ascertain that the system had security in place that met new enhanced policies as soon as possible. “In an effort to do things the right way, Biomedical Engineering reorganized itself to include a Network Specialist (who at the time had very little formal training),” Sledge says.
The new specialist was tasked with learning as much as possible while actively working with IT to implement the new security features.
“Our thought was that this was not a one-time thing, but would be an ongoing effort and that we really needed the capabilities to do the work ourselves. While the process started slow, as the specialist (Rob Monroe) began to learn the subject, he began to take on more and more of the responsibilities, up to the point of total ACL writing and some switch/router monitoring,” Sledge adds.
The new position has allowed the department to position itself, working with IT, to improve efficiencies and target higher quality solutions.
“The project was completed with no adverse patient care results (i.e. delays), but just as significant Biomedical Engineering was able to firmly take on a number of networking duties that have drastically improved response time to network issues on our equipment and servers,” Sledge says.
Veterans in Salisbury, and the other areas that this department covers, can feel confident that a team of biomeds and network specialists have their backs.
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