By K. Richard Douglas
Much has been written about team collaboration. After all, the team is one of the molecules that holds an organization together. Just above the individual employee is the team. This team can be an autonomous unit or an actual department.
There is often a common vernacular and esoteric language that is used among team members and it is not uncommon for those on a team in the workplace to know some away-from-work information about each other.
This synergy or gelling of team members helps keep the team in synch, focused on common goals and objectives and more productive.
With all of this collaboration within teams, there often remains challenges for the team unit to find ways to collaborate with other teams or departments. Managers frequently serve this function, but there are many interactions that don’t involve a manager that have to be facilitated.
Those interdepartmental interactions will determine the reputation of a team by their colleagues in other units, and that reputation can be won or lost on the image of just one team member. For that reason, a concerted effort by every individual in one department is necessary to maintain a reputation of cooperation and support throughout the organization.
As mentioned already, much has been written about teamwork, but not as much about interdepartmental or inter-team collaboration, cooperation and interaction. Within the hospital environment, that cooperation is ultimately beneficial to the patient. It also helps when various departments are not butting heads but instead finding ways to assist each other.
“Building and maintaining relationships is critical to our role in clinical engineering (CE) and is one of the differentiators between departments well regarded within their organization and those not so,” says Samantha Jacques, Ph.D., FACHE, AAMIF, vice president of McLaren Clinical Engineering Services (MCES) at McLaren Health Care headquartered in Grand Blanc, Michigan.
“As a support service, our department does not have direct authority in many areas including – but not limited to – capital replacement, user training and cybersecurity. We often have to work with other departments such as finance, supply chain, nursing and IT in a capacity where our influence is the only thing we have,” she says.
HTM has the opportunity to put protocols in place that will help smooth over relationships with other departments while keeping all of their metrics on target.
“At North Colorado Medical Center, we have a roundup in key departments throughout different times of the year — one or two depending on need. This is an opportunity for the staff to bring clinical engineering any broken equipment that they have ‘lived with’ as they are more focused on the patient,” says Tony Cody, CHTM, Tech
Management/ENTECH director at Banner Health in Colorado.
He says that the HTM team will align this with their PM schedule when possible and have them bring those items needing to be checked by HTM as well.
“We will have several technicians available for several hours to address any issue they have. This has been well received by the staff, their leaders, and it helps us get to some high usage items that are due for a PM,” Cody says.
Mending Relationships; Practicing Basics
While technical knowledge is the more obvious prerequisite for work as an HTM professional, it is also the “soft skills” that are the hallmark of a well-rounded biomed. They are key to interdepartmental tranquility.
“It can never be reinforced enough by HTM leaders that anything related to the delivery of health care is a high-touch business. This is particularly true of our business in the management of medical device assets. Just as cost to service ratio (COSR) is a common indicator of HTM program sophistication and maturity, a less common but equally important indicator is how a program connects with its constituents and how wide a net that the HTM program casts,” says Perry Kirwan, vice president of technology management at Banner Health.
He says that the first point implies that whatever the net is; do what you do very well. It doesn’t make a lot of sense to go casting for larger fish if the basics aren’t done well and to the very best of your ability.
“Basics are things like regulatory compliance, patient safety and service delivery. For HTM departments to really excel at these – we need to understand that HTM professionals are first and foremost an extension of care delivery teams,” Kirwan adds.
He says that even if biomeds don’t believe that they are; that’s how they are perceived by patient care technicians, nursing and physicians.
“And, delivering service in the direct patient care space doesn’t differ much to any other service in terms of what’s really valued. Yes, we have a product (support) and we’re expected to do it competently, however many times, we are judged by the experience we create in the act of delivery,” he says.
One hospital in Texas discovered that opening lines of communications between departments could have dramatic results.
“I am fortunate to have spent my career in the same hospital. I started here in 2010 and have worked my way up the ranks. This has allowed for a very unique vantage point to the evolution of our communication and collaborative approach that we cherish in my hospital,” says Courtney Haschke, CBET, biomedical engineering supervisor with BSA Health System in Amarillo, Texas.
She says that 11 years ago, the communication between biomed and IT, and biomed and nursing, was practically nonexistent.
“Projects were impossible to complete without major issues getting in our way and medical equipment repairs, preventative maintenance and implementation was a nightmare. The most we would get on our ‘red tags’ was ‘broke again’ or ‘keeps beeping.’ Sometimes all we would get was a piece of nurse’s tape stuck on the screen with a skull and cross bones drawn on it,” Haschke says.
She says that the last six years or so have seen drastic changes.
“Biomed and IT are now on weekly calls for any project/device implementation that requires network access. There is also a weekly meeting with biomed, IT, and corporate IT to identify and resolve any potential cyber threats with our devices on our network. The lines of communication have definitely opened up completely. Biomed knows what IT is trying to accomplish, and IT knows what biomed is working on,” Haschke says.
Metrics for Building Good Relationships
“In order to gain influence, you have to start with a good relationship. In our organization, we even include this skill in our annual technician competency assessments. Here are the specific skills/tasks that we measure so that we can assure we’re building and maintaining good relationships,” Jacques says.
She says that one of those skills that is assessed is whether or not the staff member “seeks opportunities to build effective working relationships proactively. Connects easily with new people. Puts others at ease.”
Other metrics look at whether or not a staff member “develops others and own ideas to resolve issues. Helps others have a personal win – recognizes and supports others’ objectives.”
“Reinforces others self-worth – treats people with dignity, respect and fairness. Complements others’ contributions. Shows empathy and understanding. Offers assurances about issues/concerns.”
Also, the assessment asks if the staff member shows that they can be trusted – “demonstrates openness in dealing with others, shares personal agenda, acts in a manner consistent with organizational, social and moral values, keeps words and actions consistent and keeps commitments to agreed-upon actions.”
Jacques says that “although these are quite specific, they have helped us drive the behaviors within our organization to help us build and maintain the relationships within our organization that is the foundation of our success.”
Along with metrics for biomed, there may also be a metric for nurses that relies on the HTM department’s participation.
“About three years ago, we had a wake-up call with a surveyor in our hospital. The surveyor asked one of the clinical staff, ‘How do you know that piece of equipment is safe for your patient to use?’ The nurse could not answer them. We of course have a policy in place, but the education of the policy was not reaching all staff. Soon after this incident, biomed leadership approached clinical education about joining forces and presenting at nurse competencies and speaking on key biomed safety elements to staff,” Haschke says.
She says that nurse competencies are required annually for every nurse in the hospital.
“Biomed literally gets to speak to every working nurse in our hospital on an annual basis. This has done two key things for our department. 1) We educate on how to read our PM stickers and how to properly fill out our defective tags. 2) It puts a biomed representative in front of the clinical staff to answer any question, field any complaints, and makes biomed more approachable as a department. We even offer a reward for any past due PM sticker that is found by anyone other than biomed,” Haschke says.
“This process has worked out so great for biomed. We get approached before a problem becomes a major issue, clinical staff is educated on PM stickers and are helping us find those devices that get hidden, or could not be located last PM cycle,” she adds.
Haschke says that biomed has even been asked to go to outside clinics and participate in their competency days and even just for general department education.
“We are now the department that is thought of first when problems present themselves instead of just being an afterthought,” Haschke says.
Exceeding High Expectations
Another way that HTM can build and maintain high-level relationships with other departments is simply to provide a level of service that matches expectations. These expectations have emerged out of the competitive nature of the high-tech age we live in.
“You can have the best wrench turner in the world on your team. However, if that person doesn’t show when expected, doesn’t communicate well in the moment as well as keeping the customers informed about status, and does take ownership of an issue until the problem is resolved – many times you’ll fail before you start,” Kirwan says.
Kirwan says that we are in a day and age that people expect to be delighted.
“Companies like Amazon have created the template for this. People want ease of access to service, they expect when they access it that the service will be fulfilled regardless of difficulty/coordination that has to happen behind the scenes and they want to be fully informed of what’s going on with the delivery all the way up to fulfillment,” he says.
Kirwan says that other industries have taken note and followed suit. He says that one can typically get more up to date information from UPS getting a packaged shipped to you than most HTM organizations provide. That’s the atmosphere that we must endeavor to create.
“So, how do we do it?, “ Kirwan asks.
“Does your department have metrics on what the customer can expect in terms of a response when there is a need for service? How detailed is it? Is it even written? Do you measure the performance of it and, most importantly, share the results with your customers?” Kirwan adds.
He says that measurement and the sharing of results is an important step in creating and cementing a relationship with those that you serve.
“It establishes professionality of your program and that you care about how well you’re delivering the results. Another attribute in relationship building is empathy. Patient care is an emotional business as much as it is about technical results and skills. If we don’t think about our business in both contexts, we miss an important part of the delivery. The third attribute is that we need to understand as much as we can about how our service delivery impacts the patient and those that serve the patient. This can not only be applied to service that has to happen in real-time but also in the way that we plan service, e.g. think scheduled maintenance,” Kirwan says.
As an example, he asks “Does it really make sense to PM that imaging modality during business hours and down the room when our customers need to be seen during those hours or challenging those trying to run the business and stay productive to lose resources in the prime time of their business?”
“Lastly, as we reimagine our business – we should ask what do we need to do to delight the customer? Delighting the customer is incorporating the unexpected to the service delivery to drive a greater result. We can do that in the way that we round. Looking at the environment, talking with customers, observing for unmet need and then adapting and adjusting service accordingly,” Kirwan says.
He also says that HTM can either lead or serve on committees within an organization to solidify relationships. Within his health care system, HTM is involved with a laundry list of committees from the fall reduction team to the surgical robotics utilization team, ventilator associated pneumonia task force to the mergers and acquisition team.
The development of great working relations among disparate departments must be a deliberate and proactive exercise. In an age of high service expectations, the HTM department has an opportunity to exceed expectations and strengthen relationships with clinicians and other ancillary support providers.
That begins with establishing internal metrics for this purpose and then giving every customer the confidence that HTM is the easiest and most satisfying team to work with.