“Knowledge is power” was first uttered by the philosopher Francis Bacon during the early 17th century. Bacon wrote about both science and politics and his words are timeless.
“Information is power” is another common saying that can be applied to many situations. It finds applications in many ways, including the knowledge needed to repair older equipment. That knowledge can be gleaned from forums or the insights of seasoned colleagues. The Internet and networking at biomed associations can also be sources.
Hospital budgeting is not new, but with recent healthcare reform. The C-suite is extra vigilant regarding cost management. As long as patient outcomes are not jeopardized, targeted savings is part of the new mantra. A focus on savings often means that older medical equipment has a longer life cycle than in previous years.
Clinical engineers are often charged with keeping older medical equipment running as long as possible. The task brings about challenges such as finding adequate replacement parts, professionals who know how to service dated technology, and creating a maintenance plan to help the device go the distance.
Resources include websites like MedWrench.com and networks of clinical engineers on sites like the TechNation Community. Independent service organizations can sometimes provide a wealth of knowledge and the ability to source service manuals and hard-to-find parts.
The experiences of a number of HTM professionals was sought to determine what resources are commonly used. Consistent themes, and a few unique suggestions, are what follow.
The ability to find parts and repair information has been aided by technology in recent years. As pointed out by Michael O’Brien, CBET, biomedical technician with Kaiser Permanente Westside Medical Center in Hillsboro, Ore., the methodology has improved thanks to resources available on the Internet.
“It’s changed a lot over the years with so much information available instantly online now. Many manufacturers have detailed information readily available,” O’Brien says. “There are still a lot who do not provide any information though. Not that long ago, I relied on forums such as Biomedtalk to pose questions and reply to people who were looking for assistance with something. Often, it was regarding equipment no longer supported, or not well supported.”
O’Brien doesn’t have occasion to work with much in the way of older equipment in his current position, but garnered some experience in a previous role.
“There are still a few sites like Biomedtalk, MedWrench, for example, but I don’t use them as much in my current role. I’m now working at a new hospital with all new equipment so this is not something I’ve had to do for the last few years,” he explains.
Partnering with service organizations that share your vision and zeal for customer satisfaction and equipment uptime is a suggestion from Walter Barrionuevo, MBA, CMLSO, CMRP, director of clinical engineering services for BayCare Health System.
“We receive parts consumption/usage reports, along with warranty/out of box failures,” he says.
“Being active in the local biomed society allows our technical staff to network with other HTM professionals, to not only obtain and share information regarding quality service/parts vendors, but to also share best practices,” Barrionuevo says.
Duane L. Hart, MA, BS, CBET, says that the most important resource is not necessarily technology, but human resources.
“Within my experience, the go to resources for mature equipment is a mature service professional. One challenge is the ‘graying’ of our service force and that knowledge base retiring,” Hart says. “There are few, if any, opportunities to capture and share experiences in a structured format — think the Wikipedia of service experience.”
“Our service professionals look ahead, with insight to the capital budget trends, and identify end-of-life devices which we will maintain in the fleet,” Hart says. “We work with our equipment broker to secure an inventory of donor devices for parts support.”
“Stock up” says Russ Magoon, CBET, MBA, an imaging service engineer at Legacy Health in Portland, Ore., and president of the Oregon Biomedical Association.
“I buy stock when a unit is not going to be supported any longer. I get all of the most commonly broken parts. Stock up before something is no longer supported. When I find a reliable supplier, I build a good relationship,” he says.
“First, utilize existing service manuals if you have them on hand. If not, reach out to your network and also check with the manufacturer to see if they have service manuals available,” says Jeff Ruiz, biomedical engineering manager at Holland Hospital in Holland, Mich. “If no service information is available, seek comparable test requirements for similar devices and get approval from your EOC or Safety Committee to approve.”
“An important note to keep in mind, verify if the device is needed for patient care. Part of our responsibility is to make sure to identify if there is any end-of-life or end-of-support letters issued,” he says. “If so, we should be communicating to our customers that they should be aware of the end of support and should have a capital replacement plan for the device.”
Ruiz says that listservs, search engines such as Google and other biomed departments are all potential resources. He also cites MedWrench as a valuable resource.
Andy Armenta, account coordinator in biomedical services at West Anaheim Medical Center, starts out with a status notification.
“First of all, I send a memo to the department manager indicating I may not be able to repair the equipment in a timely manner as a result of the equipment being obsolete. I also copy our Chief Nursing Operator so there will be no further emergency issues with this equipment. They will either purchase a new device, where parts are available, or they can take a chance on downtime issues. They usually request to purchase a new device,” he says.
When the older device is maintained, Armenta has had some luck with third-party suppliers.
“I sometimes go through vendor Tenacore Holdings when my equipment is obsolete and I can’t find parts,” he says. “Tenacore is able to get my obsolete equipment repaired.”
Armenta says RPI (Replacement Parts Industries) is also a good source for parts.
“There are occasional semiconductors out there that are used in different OEM devices and these are mostly locatable on the Internet or at the local electronic parts store,” Armenta says. “For mechanical parts, most of the time, the OEM is listed on the mechanical parts and these are also locatable whether through the Internet or even the local Grainger dealer.”
“But, older boards are difficult to locate in some of these obsolete devices,” he says. “But being that I am a biomed instructor and the fact that I have put many biomeds into the local medical vendors, I can sometimes locate a used part from one of the local medical companies who deal with used medical equipment.”
“I also look onto the Dotmed, Medwrench, or eBay websites to locate the vendor who may want to part out the same equipment found on there,” Armenta continues. “I also have a couple of used equipment dealers I use from time to time. They buy up equipment from online auctions and also travel around the country to attend live auctions. They can also locate equipment and parts for me as well. They have business associates that help locate the parts and in turn sell them to me once located.”
“I would assume everyone is using sites such as MedWrench,” Ruiz says. “Also, if you are part of a multiple hospital or bigger organization, use your organization’s network for resources. If you come from a single hospital, utilize your local biomedical association for helpful resources. I would also check out Frank’s Hospital Workshop (http://www.frankshospitalworkshop.com). The site focuses on supporting older equipment both for the United States and with other countries.”
Carl Jones II, biomedical equipment technician, and Othaniel Williams, senior biomedical equipment technician, both with the Baylor Medical Center in Garland, Texas, agree with Ruiz.
“The MedWrench biomed forum has been a great resource for me, also FranksHospitalWorkshop.com has tons of old service and operator manuals,” Jones says.
Jones likes another source also.
“Mouser is a great source for electronics components very reasonably priced. Most biomeds tinker in some way and are probably already aware,” he says.
“Forums are a great resource. Really helped me with an Eagle sterilizer repair,” Williams says.
“Keep older units — at least one for parts [for] future repairs or when the unit is beyond repair, salvage whatever internal components you can and store them before disposing of the unit,” Jones adds.
“The best insurance is a contingent capital funding resource which can be utilized when it finally meets the end. Keeping it working is a balance between want, need and risk,” says Hart.
Several HTM professionals suggested MedWrench as a resource. The service offers a number of options including product information, forums and a bulletin board. It is a product-focused social networking site that also provides a shared network for users of medical equipment and instruments.
“MedWrench is a great source for FINDING SERVICE SOLUTIONS and/or manuals for older systems,” says MedWrench Media Manager Jonathan Payne.
“MedWrench is a product-focused support network geared towards HTM professionals. The purpose of our website is to provide a platform for medical equipment professionals to interact and help one another solve service-related issues,” Payne says. “This includes, but is not limited to, sharing of service manuals, specification documents [and] answering service related questions.”
The service also provides additional product information such as FDA alerts, PM tips, videos, archived discussions and more.
“There is even information on continuing education, when available,” Payne says. “If you can’t find what you are looking for, just post a question in our Q&A forums.”
“MedWrench covers all types of medical equipment, so chances are if you are experiencing an error with a system — even an obsolete model — we have it featured on our website,” he adds. “MedWrench houses a tremendous amount of specifications documents, brochures, as well as service manuals; however, we clearly do not have all manuals listed on our website.”
Payne points out that the networking aspect of MedWrench comes in handy when somebody needs to find a manual. With 22,000 registered users, there is a good chance that someone who uses our site has it, he says.
“If you use MedWrench properly, you will always be able to make connections with other HTM professionals who either have the manual or have experienced the same issue,” Payne says.
One benefit of Internet searches is being able to hone in on a specific topic or search-string. The ability to do a very specific search is another benefit of one of the MedWrench site’s features.
“One of our most valuable resources is the ‘My Bench’ feature,” Payne says. “As a member of the site, users can subscribe to communities — categories, products, and manufacturers — that they have an interest in. Using this feature allows HTM professionals to stay connected and receive instant access to anything related to what is benched on their profile.”
“Another aspect the average user may not be aware of is the ability to compare systems. If your healthcare facility is looking to purchase a newer/different system, you can compare models side by side to gauge the pros and cons of each,” Payne adds. “When making a purchasing decision, it is always imperative to educate yourself fully before making any permanent decisions. Comparing models allows you to really narrow down which system is the right fit for your facility.”
The Bulletin Board on MedWrench is one of the site’s newest resources. It can be found at: www.medwrench.com/?blogs.BulletinBoard.
“Visitors can find a weekly blog, expo/events, continuing education information and a career board,” Payne says.
“Having an accurate asset management program in place, which not only tracks the useful life, equipment failures, but also any end-of-support notices by the OEMs, prevents any mid-year equipment replacement surprises if no repair parts are available,” Barrionuevo says. “Being able to accurately forecast equipment replacement before repair parts are no longer available is the best strategy.”
Knowledge may not always be power. Sometimes it just makes life easier.
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