By K. Richard Douglas
Scenic drives and an old-west museum are just two attractions in Rock Springs, Wyoming. The western city was home to coal mining during the cowboy days and was known as the city of “56 nationalities” because the coal mines attracted workers from all over the world.
The local hospital has roots that go back more than 130 years.
On December 2, 1893, dedication ceremonies were held for the construction of the new Miner’s Hospital. Two years later, the hospital’s name was changed to Wyoming General Hospital. On the first day of 1948, ownership of the hospital was transferred to Sweetwater County and the hospital was renamed Memorial Hospital of Sweetwater County.
The original hospital eventually closed and a new, more modern facility opened its doors in 1978. Additional expansion projects in 1986 and 2010 further improved and added to the hospital. In 2014, a new building was added to house the many clinics that were affiliated with the hospital. Additional facilities were added in 2017 and 2020.
The HTM team that manages the hospital’s medical equipment consists of only two members: Jody Butler, biomedical equipment technician with four years of experience, and Mark St. Marie, biomedical engineering manager, with 26 years of experience.
“We’re a two-man shop that manages 1,600 assets,” Butler says.
With only two members, the Memorial Hospital of Sweetwater County Biomedical Engineering Department has to be efficient.
“Though Mark and I are first response, we have service contracts for equipment in our medical imaging department and our OR. Our service techs from those manufacturers can be hours away, most are based out of Salt Lake City, Denver or other parts of Wyoming. We work closely with techs from those manufacturers to see if there’s anything we can do to keep malfunctioning equipment up in the event of road closures, limited parts availability or long travel time,” Butler says.
With only two members, the team has to split up coverage while also needing a comprehensive knowledge of everything in the facility’s medical equipment inventory.
St. Marie handles the dialysis unit and Butler handles patient monitors.
“Mainly because each of us has attended manufacturer training for those. We do what we can to help each other out in all areas though. It’s hard to say ‘this is your area, this is mine’ when there’s only two of us for the whole facility,” Butler says.
The team uses its CMMS system to review asset histories through PMs and work orders to evaluate equipment and discover trends to determine if new equipment is needed.
“Whether that’s because a piece of equipment costs more to maintain than buying a new one, it’s going end of life or anything in between,” Butler says.
“We work closely with IT to make sure any devices the staff need can be supported by both departments. Whether that’s as simple as connecting devices to the network, security or working to make sure a device is talking to an IT-managed server. We help each other out wherever we can,” Butler adds.
Being the Float Sensor
Device integration was a recent project for the small team, but a necessary innovation.
“Having medical devices that send all their data to our electronic medical record (EMR) is new to our facility. In early 2022, we helped IT and nursing informatics in getting all our devices integrated into our new EMR. This included installing all new patient monitors that can interface with our EMR house-wide,” Butler says.
He says that they also connected the existing anesthesia machines.
“This was a big undertaking for Mark and me. While this was all happening, we were getting ready for a new CMMS system; where I had to manually import our years of existing assets/records using Excel sheets,” Butler says.
He says that before the project, their old monitors only communicated with a central station.
“Most departments were still manually charting all patient vitals. Getting new monitors was lumped into getting a whole new EMR, so our nurses could spend more time taking care of patients, rather than manually charting at a computer,” Butler explains.
He says that this turned out to be a yearlong process involving the nursing informatics, IT and biomed departments.
“We would work with IT to develop and test the patient monitoring network on a separate VLAN that would allow the monitors to communicate with the EMR. Nursing informatics had us simulating every parameter the monitors were capable of, to verify the data would flow into the EMR under the correct label. Then, to get ready for our EMR go-live, we had to check in all the new monitors (150-plus devices) and install them with some help from the manufacturer,” Butler adds.
He says that meanwhile, the biomed team had to keep up with its normal duties such as PMs and everyday work orders.
“It was a busy time. We had to come in on a few weekends to keep up. But I believe we handled it well,” Butler says.
In addition to the big projects, the two-man team has also addressed a real challenge using resourceful thinking.
“Our dialysis unit has an RO system that circulates water for all the machines. One day a float sensor in the RO tank went out. That float sensor was responsible for opening a valve that introduces new water into the recirculation loop. Without that float, the valve doesn’t open. Thus, not supplying water, and shutting down our dialysis unit,” Butler says.
He says that the new sensor could be overnighted, but they could not shut down the unit.
“Those patients would have to drive three hours to Salt Lake City, Utah, to receive treatment. So, Mark and I took shifts being the float sensor. We would stand in the RO room, watch the tank, and manually open the valve when the water level was low. We had to do this for two days. Day 1 we ordered the part; it arrived on Day 2. But we couldn’t shut down the system while patients were receiving treatment. So, we waited till after hours on Day 2 to shut the system down and replace the float,” Butler says.
In addition to their work duties, the team finds the time to broaden their knowledge and contacts.
St. Marie is an AAMI member and has been to a few conferences. Butler plans on taking the CBET test. Never underestimate a small biomed department because the team at Memorial Hospital of Sweetwater County is getting the job done and reflecting well on the profession.