By K. Richard Douglas
Cook Children’s is a not-for-profit Health Care System based in Fort Worth, Texas. It is one of the largest freestanding pediatric health care systems in the country. In addition to a medical center, it includes pediatric offices, specialty clinics, urgent care clinics and surgery centers.
More than 100 years ago, Cook Children’s started as a 30-bed hospital in Fort Worth. Today, Cook Children’s has more than 1 million patient encounters each year.
The health care system offers locations across the state of Texas with primary service areas focused on Denton, Hood, Johnson, Parker, Tarrant and Wise counties.
The large health care provider requires a precision team to maintain and repair medical equipment and the clinical engineering department at Cook Children’s Health Care System answers the call.
The team is led by Director Salvador “Sal” Cruz, CBET. Leo Velasquez, CBET, is the team’s operations manager. Rebecca Vega serves as the asset manager/contract administrator. Catina Hendrix is the work control technician.
The department is divided into several teams; general biomed, radiology team, surgery team, electronics team and central equipment team. There are 26 biomeds and lead technicians among the five groups.
“We perform all of the standard CE/HTM medical equipment management jobs and duties. Our HTM teams are split into five different teams,” Cruz says.
He says that the seven-member general biomed team handles all the patient room and general biomed equipment areas including NICU, PICU, CVICU medical/surgery, hematology/oncology, psychiatry, physical therapy and emergency departments.
“Additionally, we service the medical equipment for our Teddy Bear Transport of ambulances, fixed wing jets and helicopters,” Cruz adds.
Cruz says that the surgery team is a dedicated three-man team covering all the surgical, peri and post-operative equipment for 25 surgical suites and two CVORs and four GI/special procedure suites.
“[The] radiology/imaging team is a three-member team managing the service for all the imaging equipment both onsite and off-campus. Modalities include MRI, CT, radiology, ultrasound, cath lab, interventional and echo/stress lab equipment,” Cruz says.
The electronics team is specialized to maintain specialty electronics systems such as nurse call, audio video systems, gaming systems and special effects systems in place around the hospital. This team also repairs beds, cribs and stretchers.
It takes this diverse team of HTM professionals to handle the vast amount of medical equipment in the health care system’s inventory.
“Cook Children’s Medical Center is one of the largest children’s hospitals in the nation, covering more than 530,000 square feet with 430 licensed beds. Our professional staff of nurses, technologists, therapists and other clinicians work alongside more than 500 physicians and dentists who provide primary, secondary, tertiary and quaternary levels of pediatric care,” Cruz says.
There are also specialty clinics, an ear, nose and throat center as well as five standalone urgent care centers in Fort Worth, Hurst, Alliance, Mansfield and Southlake.
What is the team’s integration with IT look like?
“We work with a special Epic integration team to migrate the physio data from selected medical devices into the patient EMR,” Cruz says.
“Our team is currently responsible for integrating our Philips physio monitoring, anesthesia, NIRS monitoring and ventilators into the patient electronic medical record,” he adds.
Solving Problems and Special Projects
The CE team recently took steps to be aware of the location of its inventory.
“Our department has taken the lead for implementing and administering an asset tracking system and is in the process of tagging medical equipment with Real Time Location System (RTLS) tags. We currently have all of our Alaris pump infusion fleet tracked on the RTLS tracking system. All of the central equipment devices used in our facility are tracked with RTLS as well,” Cruz says.
He says Philips MP30 monitors, specialty beds, shower chairs, bariatric chairs, Stryker Mistral air warmers, SCDs, T-Pumps and rental equipment are also tracked.
“The system allows our central equipment team to properly deliver medical equipment to the floors when needed. Recovering equipment for recalls, disinfecting, cleaning and reissue is the key for great patient outcomes. Since implementing the RTLS process, rental equipment is tracked and removed from service when no longer needed and returned to the vendor. The RTLS program is a valuable tool that makes the central equipment team highly effective and efficient with managing these assets,” Cruz adds.
In addition to special projects, the group has accommodated a growing workload and facility expansion.
“Over the last four years, the hospital has doubled in both physical size and bed count. Among the areas that were added are completely new surgery, CVOR, cath lab, cardiovascular ICU, cardiac stepdown unit, emergency department, laboratory and GI/special procedures area. Each unit posed their own set of special needs to be addressed at the last minute,” Cruz says.
He says that the CE department worked around the clock to complete installations, modify work areas, install equipment, run specialty cabling and power in order to make sure that all areas were opened on time and completely functional.
“This was an intense period of activity and the team was fully up to the task,” he says.
“The hospital is now expanding again to build another hospital over the next two years in adjoining communities and we are already gearing up to assist in these projects as well,” Cruz adds.
Cruz says another project the team undertook was helping the bone marrow transplant department and the hematology/oncology departments get in-room gaming with new Xbox 1 and PS4 units in each room.
“This project entailed set-up and wiring to make these games available in order to cheer up and help occupy those kids who will be hospital-bound for extended periods of time,” Cruz adds.
The pediatric patients in Fort Worth, Texas may be aware that there are clinicians trying to make them well again, but what is equally important, is that there is a team of biomeds who are focused on making those kids well too.
