The HTM departments within the Veterans Affairs health system are made up of biomeds dedicated to the health of patients, specifically focused on those who have served their country in the U.S. Armed Forces. They often emphasize that taking care of veterans is important to them.
Serving veterans in Columbia, Anderson, Florence, Greenville, Rock Hill, Orangeburg, Spartanburg and Sumter, South Carolina is the William Jennings Bryan Dorn VA Medical Center (Dorn VAMC). The main hospital is a 206-bed facility located in Columbia and the other areas are served by community- based outpatient clinics. The Columbia location opened its doors in 1932.
Dorn VAMC is a level 1C teaching hospital, with the Veterans Benefits Administration and the University of South Carolina School of Medicine both located on the main campus. The 1C rating of the facility refers to the level of complexity of the patient population, clinical services offered and educational and research missions and administrative complexity with 1 being the highest complexity ranking and C referring to one of three subcategories.
The hospital provides training to approximately 730 trainees per year. All facilities offer acute medical, surgical, psychiatric and long-term care.
Handling the medical equipment repair and maintenance needs of the Dorn VAMC facilities is its biomedical engineering department. The department is made up of 11 members including Director of Biomedical Engineering Mahesh Shukla, eight biomedical equipment support specialists (BESS), a lead BESS and a biomedical engineer. Eight of the department’s members are veterans themselves and Shukla serves in the U.S. Army Reserve.
The specialty areas of the staff include general biomed tech, network, lab, radiology and image and an engineer for projects. The department operates out of the main facility with one biomed also stationed at the Anderson location.
“We provide customer facing services, which include corrective maintenance, preventive maintenance (PM) and professional services that cover technology assessment, technology implementation, technology sustainment and health care consulting,” Shukla says.
The department works closely with their IT counterparts to achieve networking goals along with meeting VA system metrics.
“We have a great relationship with OI&T,” Shukla says. “In this technology era, most of the medical technology is being utilized via [the] VA network, and to implement integration successfully, biomed and IT have to be a team in order to achieve the VA mission. We have various levels of involvement with IT such as network, ACL, MDIA rules, [and] 6550 VA directives.”
Before service contracts are utilized, the team takes the lead. “Most of the biomeds on the staff are COR (Contracting Officer Representatives). Currently, I and [the] Lead BESS, are managing the service contracts,” Shukla says.
He adds that the biomed department always acts as the primary source to diagnose the issue before calling the vendor.
The team of HTM professionals are also active away from work. They serve the HTM community in a variety of ways through their involvement with AAMI and national HTM groups, according to Shukla.
DEALING WITH THE UNEXPECTED
The department is constantly using data to measure its performance, employing tools that the VA has available.
“We have various tools to pull data, which is helping us to improve and set up a benchmark, as a part of quality improvements such as EBERS (Enhanced Biomedical Engineering Resource Survey). We are submitting quarterly reports to the HTM office [to] compare our facility’s key performance indicators with the VISN and nationally,” Shukla says.
“We have PM monitoring where we are submitting our report to the EOCC (Environment of Care Committee), so there are other reports we have from various resources,” Shukla adds.
The group has also addressed special projects that have gone beyond everyday tasks.
Some recent projects outside of the department’s routine work have included DECC migration, CBOC activation, VMDNS, Wi-Fi, Welch Allyn monitors, radiology X-ray room readiness, mammography room readiness, PACS and cardiology integration, Shukla explains.
On the problem-solving front, the talented staff has devoted long hours to ascertain that new equipment is installed and functioning correctly.
“We worked closely with the dialysis staff to ensure that dialysis equipment is working efficiently, especially [the] central RO (reverse osmosis) water system. Biomed staff, including myself, were coming [in on] off hours almost every day, in between January 2015 and March 2015, to resolve the issue as equipment was newly installed,” Shukla says
“Recently we have successfully accomplished auto disinfection of [the] equipment hoses and connectors of 16 dialysis machines. We want to make sure that biomed is involved [in] every aspect of medical equipment to reduce our turnaround time of repair, so equipment can be utilized to provide uninterrupted patient care to our veterans,” he says.
Occasionally, biomed departments are called upon to address emergency or critical situations that come about because of weather conditions. This was the case in October of 2015, when Hurricane Joaquin caused extreme rainfall, producing a disastrous and historic “thousand-year flood” that impacted the Columbia facility and presented the HTM team with a host of urgent challenges.
“During the flood, our facility was impacted in so many ways,” Shukla says.
“We worked as a member of Emergency and Disaster Management Team. We worked closely with the team to mitigate and complete the assigned tasks, such as replacing all the water filters in portable RO water systems, [the] central RO water system, DI (deionized water) tank in dental, lab and SPS,” he says.
Shukla says that the primary challenge was the loss of public water to the facility. It was necessary to get clean water for patient needs. They were also tasked with keeping heat and humidity under control.
The department also “worked with various vendors to make sure the complex medical equipment was operational per [the] manufacturers’ standards, especially the radiology department, where we have MRI, CT and gamma cameras,” he adds.
In South Carolina, veterans seeking health care are well served, even during emergency conditions, by the work of the dedicated WJB Dorn VA Medical Center.