By K. Richard Douglas
Hospitals who serve the health needs of children are a special breed. In Texas, the seeds were planted back in the 1940s for one of these valuable institutions. With the charter of the Texas Medical Center in Houston, along with the establishment of the Texas Children’s Foundation and the securing of six acres of property, the plans were laid for the new Texas Children’s Hospital.
Ground was broken in the spring of 1951 and two years later a 106-bed pediatric hospital was dedicated. The first patient was admitted early the following year. In the decades to come, the hospital would expand and gain a lot of positive publicity.
Today, Texas Children’s Hospital is a large not-for-profit 650-bed tertiary care hospital with its main campus located within the Texas Medical Center.
“The main campus is comprised of seven buildings designed for providing patient care, clinics, and research. Outside of the medical center, Texas Children’s locations include two community hospitals, two centers for women and children, six health centers, four maternal fetal medicine clinics, a radiology center and 52 pediatric practices around the Houston area,” says John Weimert, director of biomedical engineering for the large institution.
Weimert’s department is up to the task of handling the facilities approximately 36,000 devices. The department includes 73 staff members presently, with plans to add two leaders later this year, and next year, to add five new technical positions; bringing the total to 80 by the end of 2017.
In addition to Weimert, the department includes Assistant Director Ron Robb, Managers Randy Taylor, Roy Stuedemann, Ralph McCall and Jeffrey Wessels. There is currently one vacant manager position.
There are six equipment planners, one computer programmer, one contracts coordinator, three secretary/call center dispatchers and several employees serving in technical positions. There are three levels within the technician category: BMET, Senior BMET and Specialist, according to Weimert.
The department’s equipment planners plan medical equipment for all projects. This work includes collaboration with contractors, architects and clinical end users to plan equipment and infrastructure as care areas are re-modeled, or as new spaces and buildings are constructed, Weimert says.
The group’s contract coordinator handles service contracts.
“We currently manage about 220 contracts (about $7M in annual contract cost). The contract coordinator meets regularly with department managers to review contract status, renewal dates and to assist with negotiating contract revisions, including conversion to in-house service and contract cancelation,” Weimert explains.
“Contracts are then forwarded to Supply Chain for final processing. Department managers coordinate with clinical end users when making significant decisions regarding service contracts,” he says.
While not a part of IS, the team has a number of areas where cooperation exists.
“Biomed operates separately from the IS department, but coordinates closely with EPIC integration, physiologic monitoring networks, nurse call systems, infusion pump networks, neurophysiologic monitoring networks and regarding other issues where networks are involved. Biomed coordinates with IS on all projects as well,” Weimert says.
Biomed provides the hospital with the full gamut of services, from pre-purchase evaluations, planning and installation, to clinician training and rapid response.
“This large and diverse in-house servicing group provides coverage from 6 a.m. to 11 p.m. weekdays. The off peak hours are covered using technicians on call,” Weimert adds.
The department employs the Infor EAMS database for data collection.
“Each piece of durable medical equipment is assigned a unique asset tag number as the equipment is received,” Weimert says. “The equipment history reflecting every service intervention is documented against that unique asset tag. The Infor database runs specific reports on a weekly and on a monthly basis. Report analysis is performed weekly by department leadership and reporting out to committees is done on a monthly basis.”
Recognition for Innovation
Special projects come with expansion and the department has been fully involved.
“Projects include building renovations, new construction and growth into the community. During these projects, Biomed is involved in the RFP process, equipment evaluation and selection, and performs equipment planning, equipment initial inspection, equipment acceptance testing and installation,” Weimert says.
Some of the current projects the department is involved in include the CareFirst Tower, a new 21-floor expansion to the existing women’s pavilion building. This is a pediatric tower that will house a heart center, CVOR, cath labs, PICU, additional operating room space and expansion space for other care areas.
There is also the Woodlands Hospital, a new 100-bed community hospital with operating rooms, ER, PICU and an adjacent medical office building.
“Many other projects are in play, such as new care areas, remodeling of clinics and physician practices, growth and expansion of other care areas,” Weimert adds.
“Biomed receives new equipment, unpacks, inspects and prepares for first patient use. Project go-live activities include carefully coordinated communication for equipment rollouts such as preparing 1,700 new syringe pumps, or new ultrasound machines to be set up on a network, or new anesthesia machines requiring connectivity to the EMR,” he says.
The department received some well-deserved attention recently when it was awarded for its pioneering work in the often troublesome area of clinical alarms.
“To address the problem of improving the management of clinical alarms, Biomed partnered with clinicians to dig deep and discover a better way to manage alarms at the bedside,” Weimert says.
“Multidisciplinary Teams were formed to study alarm settings, environmental factors, work flows and we also partnered with a third-party vendor to develop a dashboard for bringing alarm management into bedside care. This project was submitted to the ECRI Institute as a best practice for clinical alarm management and bedside care. The ECRI awarded Texas Children’s with the Devices Achievement Award in March 2016,” Weimert adds.
In addition to the work that gained ECRI recognition, the department is involved with AAMI, IEEE, ACCE, NFPA, ASHE, RSNA and others.
While Texas Children’s Hospital is one of a special breed, its biomedical engineering department deserves that classification as well.