By Karen Waninger
A few weeks ago, the entire HTM team at one of our sites was displaced due to construction (destruction?) activities in preparation for a new hospital which will open on that site in 2018. My team was challenged to condense everyone and everything into an area less than half the size of our original space.
The team did a great job of separating the potentially useful items from the scrap in their efforts to consolidate and relocate within the required time frame. There were entire shelving racks filled with items that had been “saved” for decades, much of which had been salvaged originally by technicians who have been gone for years. That was somewhat understandable, I rationalized to myself, since the facility still has that old equipment stashed away in random locations throughout the hospital buildings. I was not as successful in my own efforts to manage the contents of my office.
I do remember a fleeting moment of dismay when I walked in and looked at the stacks of boxes that had been moved to the area I now affectionately call my “cage.” Actually, with block walls on three sides and the fourth side open, it is more representative of a jail cell minus the bars, but that’s all irrelevant. It was a typical crazy morning, so I found my essential piles and files for that day and headed out to my meetings, thinking I would start unpacking everything later that day — that was almost two months ago. As I was looking last week to make room for a new summer intern, I realized the boxes were still piled basically where the moving crew stacked them. The emotional needle moved from dismay to depression, which was quickly overshadowed by whatever the crisis of the day happened to be. The underlying issue, however, had triggered a deeper thought process: How often do we keep things that really will never be useful?
It seems to be a common characteristic among the people I know in this profession, to analyze and assign some real or perceived value to everything around us. Think about the way we hold on to our service delivery strategies, data collection processes, inventories of equipment and parts, and perhaps even personnel. Many of the things we do, and the way we do them, may really not be necessary in the current environment, but we keep doing them because it would require more effort to make changes than to just continue as is.
At the recent AAMI conference, there were some really good discussions around reliability centered maintenance and why it would be beneficial if there were standardized, defined sets of problem and corrective action descriptions. At the same time, there were hints that we may see new expectations regarding regulatory requirements. These related topics led to a discussion of developing some consistent methodology for demonstrating the safety and effectiveness of our medical equipment management strategies. Imagine the possibility of turning decades of collected data into meaningful information. With that thought, you can probably also envision the uproar that would result from any expectation of abandoning our numerous individual processes in favor of implementing some yet-to-be-defined, widely accepted, standard data collection methodology.
How much information have we gathered over our years of activities directed at making sure we were hitting those targets for completion of scheduled maintenance inspections? Or how about all those work orders that have been carefully coded with the different specific repair actions? Have you reviewed them and made changes to your program based on that information or have you diligently collected it and filed it away, never to be looked at again?
Coping with disruptions and interruptions has actually highlighted the key service delivery activities that have continued to be absolutely necessary because they are vital to our efforts to support the clinical care areas. As my team has come to realize, there are a few key resources we use on a regular basis. Once identified, significant efforts were made to assure those items were readily accessible and that everyone on the team was familiar with where to find them within our new space. Could the HTM profession decide to go through a similar type of disruption voluntarily, without it being mandated by any regulatory agency? What would happen if we simultaneously adopted a few new service codes and activity descriptions, and if the same ones just happened to be used by every HTM organization? Would we be willing to give up our known, comfortable processes for the long-term benefit of our profession overall?
As you ponder that, please also evaluate how many things you have collected, stored, set aside, filed, saved, or otherwise accumulated over the last several years. How many of those things are you really using? Those 12 boxes the movers stacked along the wall of my cage are still there, with the exception of two that I found time to empty. Almost everything from the first box went into the waste disposal or recycle bins. The contents of the other box were put back in or on my desk, and are used frequently. Regarding the other 10 boxes, maybe I will go through them eventually, or maybe I will decide after another two months that I am not going to do anything with whatever is inside them. It would certainly have been easier to go through the department move if someone had asked “What are you doing with that?” every time we put something on a shelf or in a drawer during the past decade or so. Perhaps we should start utilizing that same concept now with our data collection process. It would make sense to start looking for ways to store information that we really will want to use on a regular basis in the future, before some external decision maker sets a timeline that forces us to make changes before we are prepared to handle the disruption.