By K Richard Douglas
South of Los Angeles is the southern California coastal city of Newport Beach. The city is known for its beautiful harbor, which is made up of two bodies of water; upper and lower Newport Bay. The upper bay is known for its 10-mile loop trail and the four-mile-long lower Newport Bay is the setting for shops and restaurants.
A little further inland is the city of Irvine. It is located within Orange County, as is Newport Beach, and is home to many global corporations and manicured business parks.
Delivering medical care to the residents of Orange County is Hoag Memorial Hospital Presbyterian, a 499-bed hospital that is part of a nonprofit regional health care delivery network. The other Hoag facilities in Orange County include 120-bed Hoag Hospital Irvine and 72-bed Hoag Orthopedics.
Providing biomed services to these facilities is a Renovo Solutions team of biomeds headed by Director Bob Meninno. Other members of the administrative staff include Supervisor Theresa Heitchler, CBET; Asset Management Specialist Chris Sanchez and Administrative Assistant Elijah Sipin.
Other members include Clinical System Engineers Brandon White and Alexis Luna as well as Clinical Engineer KC Sanjong.
Biomedical engineers at the Newport Beach location include BMET IIIs Hai Tran, Lee Santos and Derrick Velarde. The BMET IIs on the team are Aaron Naraine, Christopher Pike and ultrasound technician Anthony Mekdara. The BMET Is are field service engineer Ryan Garrity, Michael Dempsey, Santiago Guevara and Rainier Solidum.
Biomedical engineers at the Irvine location include BMET II Chris Weiho Su and BMET Is Tannaz Hemati and Wayne Cormier.
“We also service and manage over 42 smaller offsite clinics, sports centers, women’s health, pediatrics and urgent care facilities,” Heitchler says.
“The biomedical engineering department at Hoag owns all medical device service agreements. We are vested with the responsibility for negotiating agreements to make certain they meet Hoag standards. We utilize both ServiceNow and our own CMMS,” Heitchler says.
She says that the team is notified 90 days before a contract is set to expire. During that 90-day window they audit the vendor’s previous adherence to the contract, request a new quote, review the terms and conditions and review pricing to see if they need to negotiate further.
The team’s data collection efforts are in the process of employing more synergy and automation. For now, information is carefully gathered and recorded.
“Data collection is primarily a manual effort, but we are working on an integration feature between the hospital’s purchasing system and our own CMMS that should help alleviate some of that. When equipment comes in, our biomedical asset specialist will capture the service contract information, warranty dates, etcetera and is retroactively adding it into the asset’s equipment page,” Heitchler says.
She says that when technicians are unboxing the equipment, the purchase order from the receiving documents capturing service/operator literature is forwarded to the QA team at the corporate office to be added to the CMMS. They are capturing manufacturer dates, assigning it a control number adding serial numbers, and adding equipment locations under the assigned cost centers.
“Like I said, highly manual now but we things are in the works to make this process much more effective and efficient,” she says.
Acquisitions, Alarm Management and other Projects
The biomedical engineering team has been involved in several projects lately in addition to its repair and maintenance duties. Among those projects is an aggregator effort.
“Biomedical engineering owns device integrations. We are the application owner of our Biomedical Device Integration (BMDI) solution. As the name suggests, it integrates medical devices such as cardiac monitoring, ventilators, pulse oximeter, etcetera and aggregates their data. This is also the pathway to send our secondary alarm notification for the integrated devices to nursing staff via a text/voice platform,” Heitchler says.
She says that the platform houses full life cycle of any given alarm event hence the data trends across multiple devices and can be used to create “smart alarms.”
The biomed team has also played an important role in clinical alarms management.
“Biomedical engineering is one of two business sponsors for the clinical communications and alarm management program. We act as a liaison between the BMDI vendor, medical device manufacturers and the clinical communications team,” Heitchler says.
“All supporting equipment acquisitions and integration are supported by our team. The goal of this team is to minimize alarm fatigue and provide actionable alarms utilizing the data trends from the source devices to the frontline staff,” she adds.
The biomed team also brings its skill set to the capital acquisition process.
“Biomedical engineering is actively involved in medical device replacement planning at Hoag and acts as a business sponsor to the biomedical asset management (BAM) program. The program required that workflows were developed/improved to streamline processes between multiple departments involved in sending out RFPs and purchasing the equipment, managing service delivery on the devices during its life cycle, to the decommissioning and disposal of the equipment,” Heitchler says.
Heitchler says that the BAM program utilizes various data on the equipment such as capital/non-capital, equipment age, AHA useful life, equipment supportability, mean time between failure and life expectancy to prioritize replacement across multiple years.
The biomed team has also solved problems regarding the development of innovative workflows and tweaks to current procedures.
“As an organization, we had observed that access to the most recent manufacturer IFUs was not available. We looked at the problem as a larger team including quality, risk, infection prevention, EVS, nursing and biomed. We also recognized that keeping hard copies of these documents or embedding them into policy had the potential for a regulatory ‘gotcha’ moment,” Heitchler says.
Heitchler says that to solve the problem, biomedical engineering created a dedicated group email so that members of the team can receive requests as documents that can be used to aid in the creation of policy and competencies.
“We request that departmental leaders request the most recent version from us when reviewing their policies so that we can be sure we are complying with the most recent instructions for use. This practice has been relatively simple to manage and is a much-appreciated service we can provide to our clinicians,” she says.
The Renovo Solutions biomedical engineering team at Hoag has added to the value of living in Orange County and providing patients with a high standard of care.