By K. Richard Douglas
At the beginning of the Civil War, in Covington, Kentucky, Henrietta Cleveland and Sarah Peter, with the support of the Catholic church, turned a grocery store in the city into a hospital. It was the first St. Elizabeth Hospital. The new hospital was staffed by nuns and named after St. Elizabeth of Hungary.
A second location was established in Covington after the end of the war. Those two locations grew into a health care system that today serves Northern Kentucky and Southeastern Indiana.
The St. Elizabeth Healthcare Clinical Engineering Department manages the medical equipment inventory for the health system including more than 30,000 medical devices, including radiology, biomedical equipment, laboratory and CE/IT medical device integration.
The CE team includes Director D’Juan James, MBA; Imaging Specialist Aaron Fischer; CE Supervisor Penny Frederick, CBET, MBA; CE Supervisor Brad Swecker; CE/IT Specialist Nathan Fischer; Service Logistics Coordinator Gina Loudermilk and 20 technical professionals.
The department includes six imaging specialists and two OR equipment specialists.
“St. Elizabeth Healthcare operates five hospital facilities throughout Northern Kentucky and Southeast Indiana: St. Elizabeth Dearborn, St. Elizabeth Edgewood, St. Elizabeth Florence, St. Elizabeth Ft. Thomas, and St. Elizabeth Grant, for a combined total of 1,200 patient beds,” James says.
He says the system also operates an ambulatory care center, hospice center, three freestanding imaging centers and is in partnership with St. Elizabeth Physicians (SEP), which includes a network of over 185 physician offices located in Kentucky, Indiana and Ohio.
The CE team manages and negotiates service contracts to determine if a service agreement is necessary based on financial and service history data, proprietary equipment, department request, number of devices within the organization and equipment to technician sustainability ratio (ETSR), which is used to determine if the department has the full-time employee capacity to support the device in-house or outsource service contract.
James says that the vast majority of the department’s data collection is from its CMMS database (Medimizer).
He says that this includes financial and service history data, service contract management and preventative maintenance compliance.
“In addition, we are now using Internet of Things (IOT) among other resources to track IP addresses, MAC addresses, operating systems, medical device vulnerabilities, remediations, alerts and recalls, and equipment utilization management,” he says.
James adds that there is a high level of integration between CE and IT.
“All medical device integration projects typically go through a technical/security discovery meeting with either our ancillary care or acute care subgroups within IT depending on the device type, network configurations, infrastructure type (on premises or cloud based), licensing requirements and security parameters,” he says.
Coordinating with Vendors and Upgrades
As is the case with all biomed departments, there are projects and challenges that the St. Elizabeth’s team has tackled.
“St. Elizabeth outsources their telemetry monitoring and Tele-ICU services (virtual health). Technical challenges come along with that. The vendor uses their own computer hardware to integrate with our Philips patient monitoring system, gaining remote access to view/surveillance our patients,” James says.
He says that CE manages the installation, integration and troubleshooting of the remote hardware system.
“We experience intermittent or hard done network dropouts which causes the vendor to lose visibility to patient vitals momentarily. Our team works diligently troubleshooting by immediately enlisting the help of a nurse to assist us in gaining remote access to allow us to reboot the PC or reseating hardware connections, and sometimes, reconfiguring the display settings on the remote screen resolves the issue,” James says.
He says that the CE department is involved in many projects such as capital planning for a new cancer center, slated to open in late 2024, business plan proposals; providing ROI contributions and maintenance strategies, standardizing infusion pump management at the most recently acquired hospital, as well as upgrading the Philips patient monitoring system software to the latest software revision.
“Philips offers a software application called patient information center (PIC iX) that provides visibility into patient data and enhancing clinical workflow. Our central station monitoring across the system are on two different software revisions; Rev B and C. Revision B has been end of life for several years and C will soon follow. We are currently upgrading our monitoring system in stages to Philips newest 4.1 revision platform,” James says.
He says that the project required effective communication to nursing leaders without impacting patient care as it resulted in equipment downtime.
“CE assisted Philips with the deinstallation of the old MP series monitors (non-compatible) as part of the upgrade as well as staging, incoming inspection and inventory of the new MX series monitors into CMMS database,” James says.
The team also put its resources into a telemetry department remodel project that included a complete remodel of the telemetry unit and reduction from 32 to 26 beds.
“Our department worked with an outside vendor and IT department to run all new cabling and secure network drops. Installed and programmed the central monitoring PCs. Installed wireless access points and configuration of telemetry transmitters to communicate with the wireless network. In addition, installed patient overview hallway monitors for better visibility for the nursing staff to view patient vitals,” James says.
As a result of its efforts, the CE team carries on Henrietta Cleveland’s vision of helping ensure quality health care services to the residents of Covington and the Northern Kentucky/Southeastern Indiana region the health care system serves.
