In 1938, the Sisters of Charity of Saint Augustine, founded Providence Hospital’s main campus in downtown Columbia, S.C. The hospital includes the Providence Heart and Vascular Institute and Providence Orthopedic in Columbia. Providence Hospital’s main campus is a 247-bed facility in downtown Columbia.
A six-person biomed department handles the duties of maintaining approximately 5,500 pieces of equipment for several locations. The department consists of Mary Coker, CCE, CBET, director of biomedical services, four biomedical technicians, including one BMET III, two BMET IIs, a BMET I and a radiology specialist.
The team’s techs specialize in radiology; general, C-arms, ultrasound, interventional and CT, as well as anesthesia/ventilators, perfusion and telemetry.
The department was not always an in-house entity.
“Historically, Biomedical Engineering was outsourced,” Coker says. “About five years ago, a commitment was made to build an in-house program. It meant rebuilding infrastructure — CMMS, tools, skill pool — as well as changing the user preconceptions.”
“Skill pool has been one of the more difficult challenges because of the size of the hospitals. Skill building is also dependent on local vendors that you can utilize to ‘fill in the gaps.’ Test equipment is another aspect that drives your ability to support, so it requires (the) balancing of volume, cost, and time,” Coker says.
“Since the two Providence hospitals are specialty hospitals, this also presents challenges — two completely separate surgical areas in the cardiac hospital with very unique equipment — but it also reduces the spectrum of needed support skills (no OB),” she says.
The department provides support to two hospitals; Providence Hospital and Providence Orthopedic Hospital. They also support Providence Physicians, South Carolina Heart and Vascular Center and Moore wvOrthopedic Center. Some of these facilities include multiple locations.
All the department’s members belong to the Healthcare Technology Management Association of South Carolina (HTMA-SC). Coker was recently elected treasurer of the organization.
In addition to the regular duties the team gets called to do, they have tackled some special projects recently. They were involved in the realignment of the clinical care unit to obtain greater care delivery efficiencies. This involved moving six care departments as well as the redesign and installation of patient monitoring systems.
“To gain clinical care efficiencies, six units moved their physical location, and scope of service was modified,” Coker says. “Monitoring and other equipment needs were assessed in collaboration with Biomedical Engineering. To keep costs down, Biomedical Engineering needed to plan and execute redeployment and modification of existing equipment.”
“Some new equipment was purchased. The biomedical engineering team had not tackled a monitoring network install before. David Hawks, BMET II and the team director, developed the project plan together to reconfigure 70 newly monitored beds,” she adds.
The department is also a team member of a capital asset process project. This involved the verification of the asset ledger, redesign of capital acquisition process and capital detail data integration into an existing financial database.
Coker says that her team also handled a project that came about because the nursing units had mobile manual vital signs stations that no one made anymore but the nurses/doctors wanted to continue to use. A department tech designed and fabricated new units.
“For him to build and weld a mount for it to work on something like an IV pole, it took a little experimentation,” she explains.
The department also utilized their knowledge to make the best use of available resources.
“Central monitoring space was inefficient, but there was not a space within the hospital to move the unit,” Coker says. “Our department reconfigured the monitors, computer, UPS, and printers to provide a better workspace.”
“Since this is a specialty hospital, the majority of people are monitored telemetrically,” Coker explains. “All that’s watched by a central monitoring room; and it’s grown. Unfortunately, there is no new space at this time that we can move them to, so we needed to rethink the existing space.”
“Originally, the computers for each monitoring system was at their feet, along with the UPSs. There were just so many wires. We’re talking about at least 17 monitoring systems in this room coming from different departments,” she says. “They also monitor the other hospital that we have which is 11 miles away; the orthopedic hospital. And, you can’t shut it down. The nursing staffing that would have been needed to make that project work would have been horrendous.”
“So, we had to do it while we were live with patients. The team had to mock up how much time the project would take and then stage one computer change at a time,” Coker adds. “We installed new racks away from the monitor technicians to house all of the printers and computers. The cords are managed in raceways and labeled. In addition the alarm speaker system had to be reworked. My staff can now easily get to the equipment for maintenance. Another part of the project included changing the existing carpet to carpet squares which will make any future facility repairs easier. The result is a much improved environment for the monitoring technicians and safer for the patients.”
Coker recalls another project that the team was able to accomplish.
“Telemetry processes for admissions, and the clinicians tracking of the transmitters, was not optimal. Biomedical Engineering worked with nursing directors and central monitoring to create a better workflow,” she says.
The hospital has many telemetry transmitters that are frequently idle since the transmitters are assigned to each bed. Biomed is working on having the transmitters distributed from central monitoring so they can be used more efficiently and equipment can be tracked more closely.
“The most difficult part of this workflow change is the logistics of physically getting the telemetry transmitter to the nursing unit. Admissions to units come from a multitude of avenues and if there is a heavy admission period it could slow workflow, which can’t happen,” Coker explains.
The department continues to brainstorm with the clinical teams to continue to make improvements. With the economic realities of running a hospital today, the team knows that efficiency is a necessity.
In the evolving world of networked devices, this HTM team works alongside their IT counterparts.
“We work with IT on projects, have few turf issues, and each team respects each other’s expertise,” Coker says.
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