Maintaining 75,000 assets isn’t easy; it takes a whole bunch of technicians, imaging engineers, administrative help and leadership. With facilities in four states and 7,000 medical staff, SSM Health is a big system for its Clinical Engineering Service (CES) department to get its figurative arms around. The department, staffed with a contingent of 113 members, does an admirable job of keeping up with the demands of such a large health care system.
Overall, SSM Health has 30,000 employees in 19 hospitals, nursing homes, hospice, physician offices, a pharmacy benefit company and even an insurance company.
Headed by Vice President Heidi Horn, the senior leadership team includes Regional Manager of Missouri and Illinois Bob Jakubczak, Director for Wisconsin Jim Anderson and Director for Oklahoma Bobby Thompson. The large staff includes professionals supporting medical equipment, imaging, procurement, maintenance software and data analysis.
The team includes three BMET Is, 39 BMET IIs, 10 BMET III specialists and 15 BMET III leads. Those equipment technicians are supplemented by 15 senior diagnostic imaging engineers for high-end imaging and nine diagnostic imaging engineers. The team is also supported by a director of clinical equipment planning and support, a CES analyst, 11 managers, a CMMS product specialist and three administrative assistants.
The department uses a system-wide team approach to accomplish large projects and to keep everyone on the same page.
The department spends several hundred thousand dollars annually on training. This reduces expenditures on service contracts. The team attempts to keep as much maintenance and repair work in-house.
“It is our practice to avoid service contracts as much as possible,” Horn says. “We budget $400,000-$600,000 annually for service training and have documented that by investing in our CES staff, we can save approximately 50 percent in annual clinical equipment maintenance expenses compared to a full service contract — inclusive of the training costs.”
Horn says her team has demonstrated they are just as skilled on most device types as the vendors, but because they’re already on site, can respond faster.
“And there is a sense of ownership that the CES team has regarding ‘their’ equipment, and they take care of it knowing that someday they or a family member or friend might be in need of it,” she says.
The department has a comprehensive laundry list of reports available to it, and to other stakeholders, that provide an assessment of everything the team touches.
Reports that show medical device inventory and purchase price, cost of maintenance by device/department/entity, service contract listing and expiration dates, information systems data on devices, clinical device replacement recommendations and cost, repair histories, alert work orders and a CES colleague satisfaction survey result report are among them.
Creative use of their databases offers the department the opportunity to help reduce capital costs and provide rock-solid replacement information.
“One problem that had a big impact on the system, as a whole, was the inability to prioritize clinical equipment replacement projects,” Horn relates. “In the past, capital was given to the clinical department that complained the loudest and not based on those with the biggest need. CES developed the Clinical Equipment Replacement Prioritization List, which is available upon request and sent out annually to all capital decision makers around budgeting time.”
Horn says that the department uses their CMMS to produce the list, using objective criteria such as age of device compared to AHA expected life guidelines; cost of maintenance; mean time between failure and cost to replace, along with subjective criteria based on CES’s and the clinical department’s feedback.
“The Clinical Equipment Replacement Prioritization List has now become one of the most used tools in the capital review process, and it’s not uncommon to hear executives ask someone requesting clinical device replacement capital if it’s ‘on the CES list.’ If it’s not, it most likely won’t be approved,” she says.
Projects and Decisions
Big departments are capable of taking on big projects and the team at SSM Health does not disappoint.
The department is “leading the system-wide implementation of approximately 8,000 CareFusion Alaris PCUs and large volume pumps system-wide,” Horn explains.
“This is a very rapid deployment, converting our entire existing large volume infusion pump inventory to Alaris in a two-month time frame. I am the executive champion overseeing the project, and am working closely with an IHT project manager and a CareFusion project manager to coordinate the implementation efforts of nursing, pharmacy, EMR team, IT, clinical engineering service and supply chain,” she says.
The department has also been active on the team that is selecting system-wide vendors for OR integration with the health care system’s EMR. Jim Anderson has taken the lead on this project. They have also been working with their IS department creating policies and practices for storing images and video taken in the OR during surgery and retrieving them for training, clinical review and other purposes. For training purposes, those images must be HIPPA compliant.
Along with a team made up of physicians and clinical leaders, patient safety and nursing, the clinical engineering team is also leading the SSM system-wide Alarm Management Team to ensure SSM Health is compliant with The Joint Commission’s National Patient Safety Goal on Alarm Safety, including identifying how best to decrease alarm fatigue and improve alarm response time, says Horn.
The corporate structure at SSM Health integrates the department with IT.
“CES is a department within SSM’s Integrated Health Technologies (IHT) division, which is led by the system CIO/senior vice president,” Horn says. “The CES VP — who reports to the CIO — sits on the IHT Administrative Council with the Regional CIOs and other IT VPs. In this respect, CES and IT are very integrated. There are many projects that CES and IT must work very closely together.”
The department has been under this reporting structure since 2007. This puts the department’s vice president only two steps away from the health system’s CEO.
Away from work, many of the department’s techs are involved in local biomed societies. Horn is active on the Executive Committee of AAMI’s Technology Management Council, on an AAMI task force and other AAMI committees.
Horn says that while some HTM departments may feel a lack of appreciation, that is not the case with their department.
“We know our SSM colleagues appreciate the multitude of problems we solve,” she says. “The SSM Clinical Engineering Service team takes great pride in our ability to help our SSM colleagues and provide them with the medical equipment technology expertise they need to provide exceptional patient care.”
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