TechNation- March 2017

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VOL.8

ADVANCING BIOMEDICAL / HTM PROFESSIONALS

MARCH 2017

Time Management & Professional Development SMART WAYS TO GET AHEAD

18

Biomed Adventures Serious Cyclist

36

Roundtable RTLS

67

IBS Scrapbook Photos Highlighting the Conference

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TECHNATION: ADVANCING BIOMEDICAL / HTM PROFESSIONALS

36

THE ROUNDTABLE: REAL-TIME LOCATION SYSTEMS (RTLS) Real-time locating systems (RTLS) can help find “lost” pieces of medical equipment, improve hand hygiene programs and more.

TechNation reached out to RTLS experts to get their take on this technology and how it can benefit our readers.

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TIME MANAGEMENT AND PROFESSIONAL DEVELOPMENT: SMART WAYS TO GET AHEAD Experts share advice on time management and professional development. These are two areas where everybody can improve and, in doing so, advance in their careers.

Next month’s Feature article: Right to Repair

Next month’s Roundtable article: Endoscopes

TechNation (Vol. 8, Issue #3) March 2017 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to TechNation at 18 Eastbrook Bend, Peachtree City, GA 30269-1530.

TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher.

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MARCH 2017

TECHNATION

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INSIDE PUBLISHER

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Roger Bowles K. Richard Douglas John Noblitt Todd Rogers Manny Roman David Scott Cindy Stephens Steven Yelton Alan Moretti Jeff Kabachinski

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ACCOUNTING

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CIRCULATION

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EDITORIAL BOARD

Eddie Acosta, Business Development Manager, Colin Construction Company Manny Roman, Business Operation Manager, AMSP Robert Preston, CBET, A+, 2014 Salim Kai, MSPSL, CBET, Clinical Safety Engineer University of Michigan Health System James R. Fedele, Director, Biomedical Engineering Izabella Gieras, MS, MBA, CCE, Director of Clinical Technology, Huntington Memorial Hospital Inhel Rekik, Biomedical Engineer, MS, Clinical Engineer

Departments P.12 SPOTLIGHT p.12 Department of the Month: Norton Healthcare Clinical Engineering Department p.16 Professional of the Month: James Swandol, Sr., CBET p.18 Biomed Adventures: Serious Cyclist P.22 INDUSTRY UPDATES p.22 News and Notes: Updates from the HTM Industry p.26 AAMI Update p.28 ECRI Institute Update P.30 p.30 p.32 p.34

THE BENCH Biomed 101 Shop Talk Tools of the Trade

P.46 EXPERT ADVICE p.46 Career Center p.48 Ultrasound Tech Expert Sponsored by Conquest Imaging p.51 Beyond Certification p.52 Tech Savy p.54 Tech Knowledge p.56 Thought Leader p.58 The Future p.60 Sodexo Insights Sponsored by Sodexo p.63 Roman Review P.64 p.64 p.65 p.67 p.68

BREAKROOM Did You Know?

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SPOTLIGHT

DEPARTMENT PROFILE Norton Healthcare Clinical Engineering Department

By K. Richard Douglas

O

n the first Saturday in May, the eyes of the nation are upon one legendary horse track and race that takes place at the storied Churchill Downs. The grandstand is packed, and the infield is standing room only, as the thoroughbred horses take to the track. Mint juleps and extravagant hats are as plentiful at the Kentucky Derby as the “poke” that dots the landscape in eastern Kentucky. This event draws the nation’s attention to the city of Louisville every spring.

On a local level though, while the Kentucky Derby offers a brief economic impact, health care needs are ongoing.

This is where Norton Healthcare’s mission is felt. It is a mission that finds its roots in a faith-based heritage with volunteers and contributions for the establishment of the original hospitals coming from the Episcopal Church, the Presbyterian Church, the United Methodist Church, the United Church of Christ and the Roman Catholic Church.

Today, the health care system, that originated in the post-Civil War period, serves patients in Kentucky and Indiana through five large hospitals, 13 Norton Immediate Care Centers and more than 800 employed medical provider offices.

The system’s clinical engineering department handles the equipment at these sites by relying on more than 40 team members. The department includes technicians, specialists, administrative support, management, and an executive.

Several members of the group are CBETs and one person is a CHTM. “The entire CE operation is a system function with centralized leadership on the main campus and distributed team leads for each campus. There are two divisions within CE, each with a director,” explains Neil Feldmeier, MBA, director of Biomedical Engineering.

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Feldmeier says that one division is Biomedical Engineering, which services general biomedical equipment and is responsible for CMMS administration and AEM program design. The second is Imaging and Ancillary Services, which services LINAC and imaging equipment and is also responsible for medical device systems security and equipment disposition/reallocation.

The System Director of Clinical Engineering is Scott Skinner, MBA, FACHE, CHTM, CMRP. Doug Elmore is the director of Imaging and Ancillary Services.

“The executive, who reports into the system CIO, is akin to a ‘chief medical equipment officer’ and has overall responsibility for CE operations along with capital assessment and planning responsibilities,” Skinner says.

The CE directors and executive manage all service contracts.

“CE drives a very strong in-source strategy which is supported by senior leadership, including significant investments in proper service schools, tools, and test equipment,” Skinner adds.

“Our goal is to be able to perform all maintenance within the department and not just at a ‘first call’ capacity. Since 2009, CE has in-sourced anesthesia machines, sterilizers/washers, linear accelerators (LINAC), beds, ventilators,

and miscellaneous laboratory devices, among other things.”

The entire group employs one unified CMMS. Administration of CMMS, including data analytics, is performed by a coordinator who is a CBET. That person also is responsible for regulatory reporting and tracking alerts and recalls, according to Feldmeier.

ACHIEVING KEY METRICS The department stays busy with special projects. Security and cost savings have been priorities.

“We have coordinated the design of multiple physiological monitoring systems in association with multimillion dollar facility renovations. CE is pivotal to driving system-wide equipment standardization through a Clinical Equipment Replacement Plan (CERP). CE leads the organization’s alarm management project to meet The Joint Commissions’s National Patient Safety Goal,” Feldmeier says.

He also says that the department recently stood up a medical device cybersecurity function, with a dedicated Medical Device Systems Security Analyst position, and is the strategic owner of ongoing medical device IT risk assessment and mitigation. The security analyst evaluates and works to mitigate risks on existing and incoming medical equipment. Feldmeier says that this position is also a liaison between CE/IT and focuses on cybersecurity vulnerabilities.

Other initiatives the team has tackled since 2009 include improving key quality metrics from 40 percent to 100 percent and passing two full surveys

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SPOTLIGHT

“Our goal is to be able to perform all maintenance within the department and not just at a ‘first call’ capacity.” from The Joint Commission with zero clinical engineering-related fi ndings.

They have also initiated equipment standardization processes and realized over $5.5 million in capital savings.

Skinner says that the department has also “in-sourced or renegotiated service contracts resulting in over $600,000 in annual savings and has facilitated — with medical directors and other key stakeholders — the development of a long-term physiological monitoring strategy for a children’s Level I trauma/ teaching hospital.”

Additionally, the team developed and directed a system project that replaced 1,100 beds at four hospitals and secured funding, and coordinated project management, for major sterile processing equipment upgrades. Those upgrades included, but were not limited to, IUSS units system-wide; instrument washers, cart washers, and steam sterilizers for the flagship hospital; and hydrogen peroxide plasma sterilizers system-wide.

They also secured funding and coordinated vendor selection for an OR light replacement initiative system-wide.

SETTING A STANDARD “CE participates in all hospital daily safety briefi ngs (DSBs); this activity has been published as a best practice in BI&T,” Feldmeier says. “An example of something we’ve mentioned at a DSB is an incorrect internal defibrillator paddle confi guration. This catch prevented a possible adverse patient event and was lauded as a ‘Good Catch’ and published in an employee newsletter.”

The previously mentioned CERP allows the department to evaluate system-wide clinical equipment needs and work to replace technology that is obsolete or in need of replacement to obtain the latest standard of care.

“CE actually manages multimillion dollar annual funding of this program and coordinates all equipment purchases,” Skinner says.

“This program was written up in BI&T and CE received a ‘Best Practice Award’ in 2011 from AAMI in recognition of what CERP has accomplished.”

With their innovative focus, team members have not only shared their

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

experience through AAMI, but are active outside their facilities as well.

“Key team members are AAMI members. Everyone in CE is a member of the Kentucky Association for Medical Instrumentation (KAMI),” Feldmeier says. “The CE executive is board-certifi ed as a Fellow of the American College of Healthcare Executives and is a Certifi ed Materials and Resource Professional (CMRP).

Conferences attended by various persons annually include AAMI, ACHE, RSNA, Archimedes Medical Device Security, and HIMSS.” In a system with 1,837 licensed beds and more than 42,000 CE supported devices/systems, the CE department at Norton Healthcare handles a big task and still fi nds time to innovate and fi nd savings.

MARCH 2017

TECHNATION

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SPOTLIGHT

PROFESSIONAL OF THE MONTH James Swandol, Sr., CBET

BY K. RICHARD DOUGLAS

S

ome biomeds are so into what they do that they take emails while on vacation and want their department metrics to be outstanding. It may just be a little competitiveness or some leftover values instilled by military service.

Whatever the reason, James Swandol Sr., CBET, a senior biomedical technician at Baylor Scott & White in Carrollton, Texas, is among those who wants to be the best.

Swandol’s original ambition was to help people get into shape or stay in shape. Like the best laid plans, things changed and he landed in the HTM profession.

“I fell into the biomed field by luck.

After I received my honorable discharge from the U.S. Army in 2006, the plan was to be a personal trainer. I earned my certification in fitness and strength training and found a job on my first day of looking. Things were looking good, and then the economy began to turn, and I started losing clients,” Swandol says.

“I decided I needed to go back to school and I chose a degree plan in electronics, I knew one thing, I could not go wrong with that degree,” he says.

After he graduated with honors from DeVry University with an associate degree in electronics and computer technology, Swandol was offered a job during his last week of school with a company that repaired and maintained anesthesia machines.

“I had never even thought about a career working on medical equipment up until that point. Once I started working

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“When I first became the senior technician at Baylor Scott & White Medical Center at Carrollton, we had eight projects on the books; everything from telemetry upgrades to nurse call additions,” he says.

“Having that many open projects, with no progress, was overwhelming for me so I created a way to track the projects on a white board and began working hard to get them completed. I began asking questions until I had the right people moving to complete them; in a matter of eight months we had them all completed and my project board cleared,” Swandol adds. in the industry I discovered I really enjoyed it and was good at it. From there, it opened doors for me to become a biomedical equipment technician rather than a field service technician,” he says.

In addition to earning a degree in electronics, Swandol has attended manufacturer equipment training classes.

Since he did not go through a formal biomed training program, he credits his success to having good mentors.

Since entering the field, he has held the position of anesthesia field service technician, lead anesthesia field service technician, biomedical field service technician, R&D technician for implantable devices, operations manager, biomed technician II and his present position of senior biomedical technician.

He still considers anesthesia to be his area of specialty.

CHECKING THE BOXES Swandol’s get-it-done attitude helps achieve results.

DEVOTION TO FAMILY AND WORK On the home front, his family consists of his wife and two children. His son is six and his daughter is four.

“I think I lucked out to have one of each; my son is into baseball, football and video games; my daughter is my princess; she love gymnastics and cheerleading, she is 100 percent attitude.

My family has been very supportive of me with my career; when I was studying for the CBET they made sure I had my quiet time every day for six months,” he says.

Swandol keeps busy with coaching.

He coaches youth sports. The teams under his command have included kindergarten flag football, as well as soccer, football and baseball.

“I really enjoy coaching youth sports,” he says “It’s amazing, especially at that young age, to watch how much they learn and develop over the season.”

“I play slow-pitch softball every

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SPOTLIGHT

James Swandol is a leader at work and as a coach for the Celina Gray flag Football team.

James Swandol is seen with two members of the Crazy Cleats team that he coaches.

spring, summer, and fall in a couple city leagues and tournaments whenever I can.

When Swandol isn’t coaching or playing softball, he enjoys hunting.

“There is not much better than being in the woods hunting deer or in a duck blind with friends,” he says.

Asked about what readers should know about him, Swandol points to some of his roots and where some habits were instilled.

“I am a veteran of the United States Army and served two tours in Iraq. I owe my strong work habits to the Army,” he says.

“I strive to be the best, I take pride in my work, and it gets under my skin when things are not perfect. I’m also very competitive; I want my hospital to have the best biomed department and our numbers to be the best in our system.

Every month, when our productivity reports come out, I want to be number one. I am a workaholic, I cannot step away from it, even when I’m on vacation, I’m still answering e-mails and keeping tabs on what’s going on at my hospital,” he adds.

In the recognition department, his employer has demonstrated appreciation for saving the system money.

“I’ve received a Service Excellence Award from Baylor Scott & White for saving our lab money on a repair that a vendor wanted $5,000 to just come take a look. I was able to find the problem and repair it by using the service manual and speaking to technical support. Not only did it save money, but it saved the lab down time,” Swandol says.

When you want the best for your team and employer; it gets noticed. Fifty push-ups or fifty PMs, it’s all about getting something achieved.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

“I had never even thought about a career working on medical equipment up until that point. Once I started working in the industry I discovered I really enjoyed it and was good at it.”

FAVORITE BOOK:

Anything written by James Patterson

FAVORITE MOVIE: “Deadpool”

FAVORITE FOOD: Anything Italian

HIDDEN TALENT:

Making crafts for my kids, everything from Christmas ornaments to room decorations.

FAVORITE PART OF BEING A BIOMED:

“I love a challenge; I like it when something is beyond repair and I figure out a way to fix it.”

WHAT’S ON MY BENCH

• My light/magnifier glass – really comes in handy when I’m soldering • Weller soldering iron • My Biomed 101 article from the April 2016 issue of TechNation • Coke Zero always on my desk to get me through the day • “The Heart of a Leader” by Ken Blanchard – keeps me motivated

MARCH 2017

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SPOTLIGHT

BIOMED ADVENTURES Serious Cyclist

By K. Richard Douglas

F

or the average person, there may be times when they go out on a limb and leave their car keys in their purse or pocket and ride a bike to their local store.

The thought of traveling long distances on a bike is not a challenge that most people are willing to take.

Working for ProHealth Care in Waukesha, Wisconsin, is Senior Biomedical Imaging Engineer Tom Roberts. Roberts has more in common with the cyclists at the Tour de France than he does with the person who might see a ride to the store as a challenge. Long distance cycling has been a part of Robert’s life for a long time.

“Back in the late ’70s, I was a teenager. I owned some incredibly unreliable cars — we called them ‘beaters’ back then,” Roberts remembers. “I developed a life style that required reliable transportation, and when the cars didn’t work, I jumped on my bicycle. In time, me and my other pals, with equally unreliable cars, learned that a state park 10 miles from our homes was within bicycling distance.”

Roberts says it wasn’t long before the teens decided a longer trek would be fun.

“And, why not bring lightweight camping gear and why not go for an entire week? That’s how it all got started,” he says.

LONG DISTANCE TRAINING Roberts rides a recumbent-style bike which is a model called the Tour Easy, made by a California company called Easy Racer.

“I don’t ride fast but, much like the

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“I developed a life style that required reliable transportation, and when the cars didn’t work, I jumped on my bicycle.”

Energizer Bunny; I keep going and going and going. I start in the spring with a few 15- to 20-mile rides. By the end of May I’m up to 50-mile rides.

During the month of June, I start doing 80-mile rides. In July, I load the bicycle with roughly 30 pounds of lightweight camping gear – same stuff you’d take if you were going on a 100-mile hike – and start back at 30-mile rides,” Roberts explains.

By the end of July, Roberts is up to 70-mile rides with a fully loaded bicycle.

“At that point, I’m prepared to get together with my lifelong cycling pal and take a lap around Wisconsin

Tom Roberts, a Senior Biomedical Imaging Engineer for ProHealth Care, enjoys long bicycle treks exploring Wisconsin.

without the aid of any sort of motorized back-up,” he says.

Roberts spent his teen years in Appleton, Wisconsin. That’s where the long distance, point-to-point bicycling began.

“We’d ride the 10 miles from Appleton to High Cliff State Park southeast of Appleton then ride back,” he says.

Organized rides or races aren’t Roberts’ thing. Libations should be a part of the experience.

“Those are for grandmothers and little kids,” he says. “And I don’t think those rides involve alcohol at the end of each day.”

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SPOTLIGHT

Tom Roberts puts lots of miles on his recumbent-style bicycle. He and a few friends go on a long-distance adventure to Nicolet Forrest every February.

COLD-WEATHER CAMPING While long distance cycling is, out of necessity, a spring and summer activity in Wisconsin, winter time camping is another adventure that Roberts has participated in since his teen years.

This has been an annual tradition that happens each February.

“The winter camp has its origins back in 1980 when me and my high school pals were looking for a way to elude our parents for a few days to do the nefarious things that 18-year-olds will do,” Roberts says. “It died out for a few years, then was revived in 1985. We did it for a couple of reasons. We’re all football addicts. The weekend after the Super Bowl is a time in need of extreme distraction. Then, there’s the cabin fever thing that happens in Wisconsin in February. Winter camp provides relief.

We also looked forward to testing our mettle back then. Now that we’re in our

50s, we do it because we’re afraid of what happens when we stop.”

These days, Roberts and his friends go to a deserted lake that’s located roughly 80 miles northwest of Green Bay in the Nicolet Forrest.

“It’s evolved over the years,” he says. “We’ve got a main camp site that acts as the kitchen/living room. We have a couple of cord of fi rewood delivered to the camp site to maintain a fi re much like the Olympic fl ame that never dies out for the duration of the trip. There’s a lot more than what I’ve told you but you get the idea.”

ON THE JOB After obtaining his associate degree from Fox Valley Technical College in 1981, Roberts was hired on a week-toweek basis as a contracted technician at what was then GE Medical Systems in Waukesha.

“GE hired me directly on December 28, 1981, as a Tech III in the X-ray system staging department staging MPX X-ray generators connected to

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

RFX tables,” he says.

“I was promoted to Tech IV in 1984 and did that until 1993 when GE moved production of their nuclear medicine cameras from England to Waukesha. I staged nuclear cameras from 1993 until 1997, when GE purchased Elscint and moved production of nuclear cameras to Israel,” Roberts says.

He says that for a brief time, he moved to GE’s PET manufacturing group before landing in the company’s MR staging group.

“A few years later, I was promoted to Senior Engineering Technician in an MR engineering group. In 2007, after 25 and a half years, GE very unceremoniously laid me off,” he says.

But I still had more gas left in my tank, and in October of 2008, I ended up where I am today as a Senior Biomedical Imaging Engineer at ProHealth Care.

Old habits die hard and when those habits are healthy, and include the company of friends, they are the best kind of habits.

MARCH 2017

TECHNATION

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NEWS & NOTES

Updates from the HTM Industry DEDICATED IMAGING SOLUTIONS EXPANDS SERVICES

FUJIFILM ANNOUNCES ALLIANCE WITH RENOVO SOLUTIONS TO OFFER MVS OPTIONS FUJIFILM Medical Systems U.S.A. Inc. has formed a strategic alliance with RENOVO Solutions to offer Technology Management Solutions that consist of multi-vendor service (MVS) options for the maintenance and management of medical imaging and biomedical equipment. The new alliance is the result of growing demand from Fujifi lm customers seeking to gain the benefits of a single supplier MVS relationship. The alliance opens the option of customized service delivery solutions including MVS to Fujifi lm customers – providing potential costs savings, maximizing equipment uptime, and ensuring Fujifi lm equipment is maintained to optimal performance levels, while offering an MVS strategy for OEM service that can be tailored to specific customer needs.

“Fujifi lm products and information technology solutions are an investment in the health of patients and health care practices alike,” said Martin Spence, Vice President, Service & Support Operations, FUJIFILM Medical Systems U.S.A. Inc. “We want health care providers to select an option for maintenance that fits the needs of their bottom line, while ensuring that all Fujifi lm products continue to meet OEM quality standards and stringent regulatory benchmarks, enabling the crucial work of patient care to go uninterrupted.”

RENOVO Solutions provides health care and life science technology management solutions to help reduce costs, increase quality and improve medical imaging, biomedical and research equipment performance in facilities nationwide.

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Dedicated Imaging Solutions has announced the addition of a 12x16 channel GE MRI QA Bay for testing parts and coils. This new addition will help Dedicated Imaging Solutions reach the needs of its growing customer base.

“Quality parts and service is, and has always been, our main focus and having the capability to test MRI parts and coils is going to further support this,” says Chad Fowlkes, Owner/Chief Manager. “Having the QA Bay will allow us to offer customer repairs as well.”

In addition to the new QA Bay, Dedicated Imaging Solutions offers GE CT and GE MRI training with some of the most qualified and experienced instructors in the industry.

Dedicated Imaging Solutions was created to provide dependable, cost-effective solutions that exceed customer expectations in the medical imaging marketplace.

“Our mission is to provide our customers with real time solutions to their medical imaging needs and to provide refurbished medical imaging parts and equipment that exceed industry standards,” according to the Dedicated Imaging Solutions website.

FOR INFORMATION, visit www.dedicatedis.com.

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INDUSTRY UPDATES

PARTSSOURCE EARNS ISO 9001:2015 CERTIFICATION PartsSource, a provider of medical replacement products and technology solutions, has announced receipt of the ISO 9001:2015 certification after successfully completing a yearlong project to pass the requirements of the new quality standard. This certification validates the strength of the Quality Management System in place at PartsSource, its commitment to continuous improvement and the company’s customer-centric focus.

As an early adopter, PartsSource achieved the latest ISO certification 22 months in advance of the deadline.

“PartsSource was ahead of the game for meeting ISO’s requirements,” Jina Tweed, Vice President of Quality Assurance, said. “The evaluation process to achieve this new certification can be a long one, but PartsSource moved quickly and aggressively to be among one of the fi rst companies to bring this level of certification to our customers.”

The commitment to ISO further validates the multi-layered quality assurance strategy the

company has had in place for some time.

PartsSource customers benefit from numerous quality programs including the extensive use of key performance indicators and the application of a patented Supplier Ranking Module built into its proprietary order management system.

“Every day we are relentless in our efforts to drive better evidence-based procurement outcomes for our customers,” said Philip Settimi, MD, President and Chief Executive Officer at PartsSource. “Everything we do is driven by data and enabled by our technology. The ISO 9001:2015 certification further validates that our business processes, information systems and employee training are all aligned to give our customers a single destination to access four million SKUs and the absolute assurance they’re receiving the highest quality products and services from PartsSource.”

FOR INFORMATION, visit www.partssource.com.

MRICOILREPAIR.COM MOVES MRIcoilrepair.com has been a division of Creative Foam Medical Systems, headquartered in Bremen, Indiana, since it’s inception in 2005. Having shared a space within Creative Foam Medical System’s Manufacturing Facility, MRIcoilrepair.com is ready to spread out due to growth and new opportunities in the refurbishment and replacement of MRI coils, patient positioning pads and other imaging equipment.

The latter half of 2016 was spent renovating a 20,000-square-foot facility, just a few miles from the CFMS location, into a brand new state-of-the-art refurbishment and repair facility that will serve as the new permanent home of MRIcoilrepair.com.

“We are excited for the ease at which this new facility will enable us to not only serve our customers’ wide variety of needs, but also to explore new frontiers to relieve the stress of

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repair and refurbishment of your MRI equipment,” according to an email announcing the news. “It’s official! We will begin operating at our new location on Monday, January 23.”

The new address is: MRIcoilrepair.com, 510 East Second Street, Bremen, IN 46506. The new phone number is 574-413-6862.

MRIcoilrepair.com is not leaving Creative Foam Medical Systems. The company’s billing and accounting will still be handled through Creative Foam Corporation.

Creative Foam Medical Systems will still operate at 405 Industrial Drive in Bremen.

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INDUSTRY UPDATES

ZETTA MEDICAL TECHNOLOGIES UNVEILS PRODUCT Zetta Medical Technologies has announced its new FDA cleared product – Zia. It is an iterative reconstruction solution that enables the use of lowdose CT protocols for CT Scanners. Zia is a vendor neutral product and is compatible with CT equipment from the major manufacturers. Zia utilizes standard DICOM communications protocol to receive low-dose images, processes it and automatically transfers the enhanced images to PACS. Zia was developed by Zetta to help its customers and partners obtain their goals with patient safety at an affordable cost.

Zia will be joining Zetta’s suite of creative software solutions designed and developed with hospitals and imaging centers in mind.

STAFF REPORTS

BC GROUP RELEASES PM VIDEO

BC Group International has released a new video demonstrating the Covidien Valleylab FT10 PM Procedure using the ESU-2400 Electrosurgical Unit Analyzer. This video covers the test and performance verifications detailed in the June 2016 release of the Covidien Valleylab FT10 Service Manual. The PM Procedure divides each test into steps, with detailed instructions for each step.

To perform the Covidien Valleylab

FT10 PM Procedure, users will need the Monopolar Footswitch, Bipolar Footswitch, LigaSure/Bipolar Footswitch, Standard Two-button Electrosurgical Pencil, ForceTriVerse Electrosurgical Pencil, ESU-2400 Standard Accessory Kit, UFP Port Adapter, Safety Analyzer and Ground Bond Tester.

FOR MORE INFORMATION, visit www.BCGroupStore.com.

REPORT PREDICTS TOP MEDICAL DEVICE TRENDS This year looks to be another challenging year for medical device manufacturers.

A report by Kalorama Information, a division of MarketResearch.com, has forecasted the most significant trends in the medical device industry through 2020. Some of the trends, according to “The Global Market for Medical Devices,” are: • The greater than $390 billion medical device market will grow in 2017, but the rate of growth will be modest over the next five years at 2.8 percent. The medical device user base will grow, but cost cutting will be an issue.

• Large-scale mergers and acquisitions will continue in 2017.

• Hospital consolidation will continue to drive spending toward top companies selling innovative products. However, the Federal Trade Commission may step in to slow the consolidation trend.

• Medical device prices will rise slower than other areas of health care due to group purchasing organizations, buying committees, and legislation.

• Research will continue to be a priority. Medical device companies spend an average of 7 percent of their revenue on research and development, with many increasing their spending as a percentage of revenue.

• The United States will dominate medical device revenues in 2017, in part because of challenges in reimbursement and reduced growth in Europe. The Chinese and Southeast Asian markets will grow much faster than the worldwide market as a whole.

• Cybersecurity threats will become more of an issue due to the increasing connectivity of medical devices.

• Wearable device revenues will outpace the rest of the medical device market. The global value for wearable medical devices was more than $13.2 billion in 2016.

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CONQUEST IMAGING REORGANIZES TO MEET GROWTH DEMANDS To better manage current growth and new product launches for 2017, Conquest Imaging has re-organized its account management team to assure a high level of consultative and product services for customers nationwide. As part of this reorganization, account executive Michael Lubliner will assume the critical role of National Accounts Manager in which he will be responsible for managing key national accounts and Conquest Imaging’s West Coast Regional Account Executives.

In this role, Lubliner will advise delivery facilities of all sizes on ultrasound purchasing, service and maintenance strategies. His success at Conquest Imaging and the other places he has worked has been built upon his ability to help facilities achieve higher operational ROIs and optimize the life cycle of their ultrasound parts and probes.

Prior to joining Conquest Imaging in 2015, Lubliner held positions at various organizations, including Royce Medical and The St. John Companies.

Lubliner will work closely with Laci Yocum, Senior Director of Strategic Sales, to lead the company’s current growth and manage new initiatives throughout 2017.

Conquest Imaging recently appointed Yocum to the position of Senior Director of Strategic Sales. She is taking over a vital role for Conquest Imaging as the company moves toward providing a stronger consulting role for delivery facilities nationwide.

Yocum will also be responsible for leading sales for new product development and product line expansions, such as in-house probe repair that is being planned for 2017. Since joining Conquest in 2013, Yocum has brought IDNs and major GPOs to Conquest and has excelled in strategic consulting for growth and efficiency for many customers.

Before joining Conquest Imaging in 2013, she worked at MedRad as National Account Manager where she won awards for sales growth, customer satisfaction and exceeded quotas.

She has been in the diagnostic imaging industry for 14 years.

Founded in 2000 by Mark and Jean Conrad, Conquest Imaging is an ISO 9001:2008 certified company reconditioning and reselling ultrasound parts and probes to delivery systems of all sizes throughout the U.S.

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BY AAMI

AAMI UPDATE

Mills, Grimes Explain How to Meet New TJC Maintenance Standards

W

hile meeting The Joint Commission’s (TJC) new standards on medical device maintenance may not be easy for some hospitals, it is doable.

This was the main message delivered by George Mills, TJC’s director of engineering, and Stephen Grimes, managing partner and principal consultant for Strategic Healthcare Technology Associations, LLC, during a webinar hosted by AAMI in early January.

TJC has moved to a “much more aggressive, ‘see it—cite it’ practice,” according to Mills. Under the new elements of performance (EPs), hospitals are expected to complete all planned maintenance activities in line with manufacturer recommendations or an alternative equipment management (AEM) program 100 percent of the time.

Previously, TJC had drawn a distinction between high-risk and non-high-risk equipment in terms of the 100 percent rule. But following efforts to streamline its standards and input from the Centers for Medicare & Medicaid Services, the federal agency that administers several government health insurance programs, the expectation for all equipment – regardless of risk – is now the same.

During the webinar, which was attended by nearly 1,000 healthcare technology management (HTM) professionals, Mills provided the example of changing the oil in a pump, saying that you have to do all

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the steps to complete the job. “You’ve got to do those. No negotiation there,” he said.

The leeway comes in crafting an AEM program and departmental policies, as well as in determining the frequency of the required maintenance activities. Mills stressed the need to start with the recommendations from the device manufacturer and then use real-world evidence to decide if deviations can be made without reducing the safety of the equipment.

He repeatedly underscored the need to create a comprehensive program that reflects an understanding of possible questions and challenges down the road.

“It does take some thought and time,” Mills said of developing a strong AEM program. He added that it is vital that HTM staff can explain and defend their policies when asked about them. “It always goes back to: ‘Can you defend the decision you make?’” Mills said.

Mills and Grimes emphasized that maintenance activities covered by the

new 100 percent rule don’t apply to equipment that is either in use with a patient or missing. The key point, the two men indicated, is having the ability to document that: • HTM staff did indeed determine the equipment was either in use or could not be located.

• There is a clear policy in place that details what will be done once the equipment becomes available or remains missing for a specified period of time.

For large health care systems with multiple facilities, both men said there is a need to recognize that some adjustments are likely necessary in AEM programs and policies to best meet the needs of each individual facility. “One size doesn’t fit all in this case,” Grimes said.

A recording of the one-hour webinar and PDF versions of the slides are available in the AAMI Store, www.aami.org/store. On-demand access is free for AAMI members and $85 for non-members.

AAMI FOUNDATION TO TACKLE PURCHASE AND USE OF COMPLEX HEALTHCARE TECHNOLOGY With a recognition of the increasing complexity of modern medicine – and all the challenges that go with that – the AAMI Foundation is poised to

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WEBSITE ADDRESS SPELLING GRAMMAR The Foundation is assembling a diverse group ofLOGO experts PHONE NUMBER to serve on the National Coalition to Promote the Safe Use of Complex Healthcare Technology, which kicks off April 12-13 in Annapolis, Maryland.

Given the inherent risks involved in using complex technologies to diagnose, monitor, and treat patients, the primary goal of the coalition is to build a repository of best practices that addresses: PUBLICATION • Selecting and purchasing complex technology MEDICAL DEALER • Educating and training clinical users of healthcare BUYERS GUIDE technology • Assessing profi ciency of use MONTH

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Those best practices will apply across care settings and J FwillMbe the A M units, as well as device types and brands. This Foundation’s fi fth patient safety initiative.

“We believe that bringing the right people together from across the health care and medical device community is the best way to address the complicated challenges that hospitals and clinicians face today,” said Marilyn Neder Flack, executive director of the AAMI Foundation and senior vice president of patient safety initiatives at AAMI. “All stakeholders should join this effort because as devices become increasingly complex, the probability that clinicians will lack some vital knowledge of when, why, or how to use these products with patients grows, and positive patient outcomes are at risk.”

Healthcare technology management professionals interested in learning more or sharing best practices from their hospitals can contact Jim Piepenbrink, the AAMI Foundation’s deputy executive director, at jpiepenbrink@aami.org.

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BY ECRI INSTITUTE

ECRI UPDATE

The Challenge of Cleaning Complex Reusable Instruments

T

he use of contaminated medical instruments can lead to disabling or deadly patient infections or instrument malfunctions. Outbreaks associated with the use of contaminated duodenoscopes – such as those that caused headlines in recent years – illustrate that mistakes or oversights can be fatal. But duodenoscopes are not the only devices that warrant attention. ECRI Institute has received reports involving a variety of contaminated medical instruments that have been used, or almost used, on patients.

The severity of the consequences associated with instrument contamination and reprocessing failures, combined with the persistence of the problem, prompted ECRI Institute to once again include this issue on its annual list of the top health technology hazards. The topic appears as the number 2 hazard in the organization’s Top 10 Health Technology Hazards for 2017 report.

THE IMPORTANCE OF SUCCESSFUL REPROCESSING Every day, health care facilities clean and disinfect (or sterilize) thousands of reusable surgical instruments and devices so that they can be used for subsequent procedures. When performed properly, this reprocessing removes residue and potentially infectious materials (e.g., tissue, body fluids, other organic material) and disinfects or sterilizes the instrument so that it can be safely used on the next patient.

When reprocessing is not performed properly or successfully, however, patient cross-contamination is possible, potentially leading to the transmission of infectious agents and the spread of 28

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disease. In 2014 and 2015, for example, attention focused on a series of fatal carbapenem-resistant Enterobacteriaceae (CRE) infections associated with the use of duodenoscopes that had not been successfully disinfected between uses.

(CRE is a multidrug-resistant infectious agent, and thus can be extremely difficult to treat.) The duodenoscope example highlights a key point: The issue goes beyond the need for reprocessing staff to meticulously follow instructions, device manufacturers also must develop and communicate effective reprocessing procedures for their instruments.

Duodenoscopes were found to be very difficult to clean even when hospital staff followed recommended procedures.

While deaths that can be directly attributed to inadequate reprocessing are rare, the highly publicized cases of CRE infections illustrate the significant harm that can result when contaminated devices are not cleaned effectively during reprocessing.

“Complex, reusable instruments – such as endoscopes, cannulated drills, and arthroscopic shavers – are of

particular concern,” notes Chris Lavanchy, engineering director for ECRI Institute’s Health Devices Group.

Components such as lumens, hinges, cannulated blades, stopcocks, and O-rings can make a device difficult to clean and then disinfect or sterilize between uses. Furthermore, the complex design can make the presence of any lingering contamination on, or in, such instruments difficult to detect.

ECRI INSTITUTE’S INVESTIGATIONS As director of ECRI Institute’s Accident and Forensic Investigation group, Scott R. Lucas, Ph.D., has helped numerous hospitals identify – and correct – weaknesses in their reprocessing functions.

“Typically, a health care facility will contact our investigation group when there has been an incident, such as bioburden remaining on surgical instruments received in the OR,” Lucas states.

The causes, of course, may be unique to that incident or that facility. But Lucas identified a few problem areas that he and his colleagues commonly encounter over the course of their investigations. These include: • Poor communication between OR staff and staff in the central sterile processing (CSP) department • Insufficient reprocessing policies in the OR and CSP departments, or poor compliance with the policies that exist • Insufficient staffing or scheduling to meet workload demands • Insufficient reprocessing equipment WWW.1TECHNATION.COM

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“Complex, reusable instruments – such as endoscopes, cannulated drills, and arthroscopic shavers – are of particular concern.”

These challenges exist for all reusable surgical instruments, notes Lucas, but when nuances such as small diameter lumens and retractable, hinged, or otherwise moveable parts are added, “the difficulty of reprocessing increases dramatically.”

KEY RECOMMENDATIONS ECRI Institute’s Top 10 Health Technology Hazards for 2017 report includes detailed recommendations to help health care facilities institute more reliable processes for cleaning complex reusable instruments.

One critical step, as stressed in the report, is to preclean instruments immediately after use.

“Appropriate precleaning at the point of care makes the job of cleaning and disinfecting (or sterilizing) an instrument easier and more effective,” notes James Davis, senior infection prevention analyst at ECRI Institute. Without precleaning, instrument reprocessing can be compromised, sometimes irreversibly, by dried debris and biofilm formation.

“When contaminated instruments are presented for use,” adds Lavanchy, “the cause can often be traced to an operational failure involving the instrument cleaning steps, including precleaning at the point of use.”

In many instances, clinical staff should be responsible for precleaning because they have the most timely access to instruments immediately after a procedure.

Close coordination between the OR and CSP is likewise important for the successful reprocessing of surgical instruments.

“In our experience,” notes Lucas, “hospitals with the most successful reprocessing functions have CSP and OR departments that have a mutual respect for, and appreciation of, each other’s role in surgical equipment maintenance and reprocessing.” To achieve this, Lucas adds: “hospital leadership and staff must take ownership of this complex system issue.”

Continuing with the theme of communication and cooperation, Lavanchy describes the value of involving CSP staff before new types of surgical instruments are purchased.

“It makes sense to spend a few minutes up front, reviewing new instrument instructions with people who really know how reprocessing is done, rather than discovering after an instrument has been purchased that the cleaning process may prove to be exceptionally challenging,” Lavanchy says.

Additional recommendations described in the report include verifying

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that comprehensive reprocessing instructions are available to relevant staff and that all steps are consistently followed. Device manufacturers play an important role here: In addition to developing and validating effective cleaning procedures for the products they sell, manufacturers should familiarize hospital staff with the intricacies of their instruments, disclose any cleaning challenges, and detail the appropriate measures for addressing them.

STAY TUNED, as more hazards from the list will be uncovered in the next issue of TechNation.

THIS ARTICLE supplements ECRI Institute’s Top 10 Health Technology Hazards for 2017.

An Executive Brief of the report can be downloaded from ECRI Institute as a free public service. The full report, which includes detailed problem descriptions and recommendations for addressing the hazards, requires membership in certain ECRI Institute programs or separate purchase. For more information, visit www.ecri.org/2017hazards, or contact ECRI Institute by telephone at 610-825-6000, ext.

5891, or by email at clientservices@ecri.org

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THE BENCH

BY CHRIS SCANLON

BIOMED 101 5S and Lean in Biomedical Engineering 5S

and Lean are business concepts derived from the Japanese automotive industry that seek to organize the work environment so that problems are clearly visible. These concepts also find unnecessary process steps or waste that can be eliminated. Instituting these concepts in biomedical engineering will help create a smooth and efficient workflow, reduce waste, decrease turnaround time and improve the bottom line of biomedical equipment management companies.

5S focuses on eliminating clutter in the work environment and promotes the maintenance of an orderly environment where everything that is needed has a place and there is a place for everything that is needed. It promotes the concept that care and thought must be brought to bear to determine what is truly necessary, ensuring that such things are always easily accessible, while everything else is put away, reflecting the fact that they are needed only infrequently.

In the case of a biomed, this would ensure that the tools and parts needed for a particular job are always within arm’s reach. Properly labeled and color-coded bins should be used for frequently used parts. Where bins are not practical, well-engineered solutions need to be developed and deployed.

The 5 “S” principles of Sort, Set, Shine, Standardize and Sustain promote the notion that developing a clean and orderly work environment is a team effort. Every individual who works in the environment needs to participate in defi ning the standards and developing the tools necessary to maintain and sustain the standards established. 5S is a journey that never ends. Organizations need to understand that 5S is not housekeeping. It is the constantly evolving process of upgrading the work environment that is led by employees and supported by management. Its focus is the identification and elimination of

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CHRIS SCANLON

Clinical Engineering Manager at Quality Medical

inefficiencies in the workplace.

Lean is simply defined as the elimination of waste. The simplest way to think about this is to consider the 8 turns of a screwdriver that turn the screw as waste and only the ninth turn that actually tightens the screw as useful work.

The Lean journey is the examination of existing processes to understand where waste exists and how to eliminate it by streamlining processes that remove unnecessary steps. In an HTM environment waste is also found in the administrative processes surrounding the decision processes to send equipment for service, the massive

amounts of paperwork needed to match a unit being returned from service and the fi ling and tracking paperwork needed to ensure all regulatory requirements are being met.

The process of waste elimination needs commitment from the organization’s leadership. Questions need to be asked about every step of every process to ensure that each step is truly necessary. If the step is not adding value every effort must be made to eliminate it. Implementing Lean also requires the ability to measure the current processes so you understand the impact of making improvements.

Conceptually, 5S and Lean are common sense steps and seemingly easy to accomplish. In reality, they are difficult concepts to master and even more difficult to implement in a large organization. Often, the organization will attempt small steps and secure those wins before making other small wins. A larger, more comprehensive program implemented in small steps can be a good strategy to secure long-term sustainable gains.

HTM organizations, and especially companies focused on service and repair, need to develop more competitive business processes to remain relevant in their customer environment (hospitals, HME companies, EMS, etc.). The least controversial way is to use 5S and Lean principles to fi nd a competitive advantage within the organization and pass on the advantages of faster turn-around, seamless cloud-based interactions and excellent customer service to customers.

CHRIS SCANLON is the Clinical Engineering Manager at Quality Medical in Largo, Florida.

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SHOP TALK

Conversations from the TechNation ListServ Q:

In a recent HTM staff meeting the topic of BMET career development and job descriptions led to a good discussion and debate on what separates a Tech II or Tech III (depending on department structure) from a Senior BMET. Aside from years of experience, what specific skills and attributes does it take to become a Senior BMET?

A:

My working definition was always that a BMET III was a fully independent technician that could handle any situation that they encountered. They possess the skills, talent and experience to tackle anything, and know who to contact if it was beyond their capabilities. A Senior BMET was always a supervisor, a BMET III who additionally was able to supervise 2 or 3 BMETs. Some others may use a different definition.

A:

In my program structure, we do not have BMETs and Imaging Engineers. We have one structure with 5 levels that accommodates the spectrum of skill-sets from entry level to senior professional. The first two levels do not require ACI certification or other identified certifications. The final three steps do require ACI certification or another certification identified for the program such as CCNA, CCENT, CCNP and others since my program also covers biomedical device integration (BMDI), patient monitoring networks, PACS networking and configuration, etc.

As mentioned, my top tier job title Senior Medical Systems Engineering Technologist (Sr. MSET) requires leadership skills since these team members are identified for future

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leadership opportunities within our system. Please note, I purposely steered clear of college degrees, i.e. BS, MBA, MS, etc. I have found in my career that discriminating potential personnel based strictly on a college degree eliminated many very qualified and competent professionals. Of course, there is a level of required education for personnel to earn to be part of our program, but it is not the first thing that is looked at in the hiring process. Experience is the initial discriminating factor depending on the open role to be filled.

We have tried to eliminate the “us” versus “them” between Imaging Engineers and BMETs. I have found in my career that structures with BMETs and Imaging Engineers breeds hate and discontent among the staff. I am trying to build high-performing teams that deliver value and safety for exceptional patient care.

I hope I have helped you and provided some “food-for-thought.”

A:

We have tried to eliminate the ‘us’ versus ‘them’ between Imaging Engineers and BMETs. I am a Healthcare Technologist. What does that mean?

It means that I (personally) repair and maintain steam sterilizers, infusion pumps, endoscopy towers, surgical tables, surgical lights, ESUs, diagnostic ultrasound, surgical and ophthalmic lasers, medical gas systems and dental systems.

Ohh, and by the way, I also repair and service rad-fluoro suites, nuclear medicine systems, C-arms, PET-CTs. And did I forget to mention Dental PACS Sysadmin and Anesthesia ARK Sysadmin?

I’m a freakin’ Biomed, people … and

you should be, too.

The more we specialize, the more we fragment … and the less valid (and valuable) we are. Be a specialist, if that’s all you can be. But can you be more?

And don’t you owe it to your employer (and your patients) to do more?

Q:

We have over 100 VersaCare beds in our facility. I constantly have to go unlock them. The side rail controls will lock up and you cannot operate anything on the rails? Hill-Rom says they do not know about the problem but, will gladly sell me boards on a daily basis! Can anybody help?

A:

Here is the bad news: in my time in the field, and now with the 100 at my work, I have never ever seen, heard of, or come across this issue. I am afraid to say this is a user (nursing staff) issue.

All it takes is one to do it often to run you ragged. The only off record issue with that side rail is it can become non operational due to a loose chip that gets added pressure from torque and twist.

You can even re-set that chip simply by pressing in the correct spot on the caregiver side of the side rail. However, there are no lock out issues. I hope this helps at least a little. Just in case, contact Hill-Rom for any new issue.

A:

Every one of my VersaCare beds has experienced this problem at least once. Sometimes you can reseat the chip by pushing on the right spot (you can hear the chip snap back into place), and sometimes you have to open the side rail to reseat the chip. This has always remedied the problem, albeit for various periods of time before the chip will once again unseat. Some of the

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THE BENCH

nurses have witnessed me pushing on the side rail to reseat the chip and have started doing it themselves and reporting to me if they had success.

A:

So, we are talking about the same thing; not the nurse “lockout” then. The side rail mold has a ridge inside that contacts that chip. The only fi x I found for that is when I would do a call on this issue I would simply cut out a small part of the area that interfered with the chip. Pain, I know.

See if Hill-Rom will cover the expense for repairing this defect.

A:

Oh yes, Hill-Rom does know about this issue. When I was an employee, it was discussed in my training class (almost 3 years ago) on the VersaCare. Don’t get me wrong though, VersaCare and all of Hill-Rom products are excellent compared to its competitors, in my opinion.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

A:

Our Hill-Rom service guy showed me a trick. Some of the VersaCare side rail PC boards have a IC chip that needs to be reseated. You can remove the cover and fi nd the chip, then gently partially remove and reseat it. Sometimes you can also push on the cover in the area of the chip and that will solve the issue, albeit sometimes just temporarily.

Hill-Rom did send our facility some replacement boards free of charge, depending on serial numbers. Newer boards have the chip soldered into the board.

A:

We have about 300 of these beds. At one point, Hill-Rom came out and replaced all the side rail PC boards in our VersaCare beds with the latest revision in which that chip is soldered into the board so it can’t work its way back out.

THE SHOP TALK ARTICLE is compiled from TechNation’s ListServ and MedWrench.com. Go to www.1TechNation.com/Listserv or www.

MedWrench.com/?community.threads to find out how you can join and be part of the discussion.

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STAFF REPORTS

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ROUNDTABLE Real Time Locating Systems R

eal-time locating systems (RTLS) can be viewed as an amazing technology, but have also been the topic of some frustrating stories. However, once the growing pains subside RTLS can be of great benefit to an HTM department.

RTLS is described as a technology that can be used to automatically identify and track the location of objects or people in real time, usually within a building like a hospital. This technology can help find “lost” pieces of medical equipment, can help with hand hygiene programs and more.

TechNation reached out to RTLS experts to get their take on this technology and how it can benefit our readers. The members of the panel participating in the roundtable article are ZulaFly Managing Partner, Stephanie Andersen; CenTrak Chief Commercial Officer, Wil Lukens; Versus Senior Product Manager, Brett McGreaham; and Sonitor Technologies Vice President of Marketing and Commercial Operations, Sandra Rasmussen.

Q: What are the latest advances or significant changes in RTLS in the past year?

Stephanie Andersen Andersen: Health care has moved from RTLS asset management being the first application being implemented to patient workflow. Asset management provided a hard dollar ROI to fund additional RTLS projects, but facilities now are putting the emphasis on taking better care of their patients, seeing more patients in the same timeframe and therefore increasing their bottom line. RTLS has also evolved past just locating assets or people. RTLS is an extremely strong data analytics tool with a powerful rules engine to help build better process and help a facility become more efficient. The new software vendors with patient workflow are extremely advanced utilizing the RTLS technology Lukens: The interoperability of Healthcare IT as a whole has made a significant impact on RTLS solutions as well. With multiple applications working together, including systems like nurse call, electronic health records, capacity management, bed management, asset/inventory management, and computerized maintenance management, RTLS is able to provide actionable location and condition data across a health care enterprise. In addition to system connectivity, newer technologies are begin-

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ning to play a role in RTLS such as Bluetooth Low Energy (BLE). The combination of RTLS and BLE technologies enable solutions such as wayfinding and other event-based triggers that may help streamline numerous clinical processes. The complexity of locating assets, patients and staff to improve efficiencies in the health care environment is beginning to require a fully integrated combination of diverse technologies. BLE is just one piece of the puzzle used to support the utility of a facility’s enterprise location services strategy. Across a health care organization, varied use cases for RTLS involve a different level of location accuracy; from simple estimated location all the way through to clinical-grade room-, bed-, bay-, or chair-level requirements. As mobile health continues to introduce innovative ways to help health care facilities engage patients and improve outcomes, we have seen RTLS grow to integrate these solutions and achieve maximum benefit.

McGreaham: Decisions for RTLS are being driven by multi-functional teams who are evaluating the technology for hospital-wide impact on patient care, not just department-level initiatives, such as asset tracking or temperature monitoring.

Hospitals and even whole IDNs, are looking to standardize on a technology that can provide multiple RTLS use cases – full solutions for asset management, patient flow, smart hand hygiene, etc. – including software, hardware, and consulting services for performance improvement. Technology-wise some multi-platform capabilities include Wi-Fi locating as well as wireless sensors. Facilities can use their current infrastructures to locate assets, staff and patients on a general level (e.g., third floor, west wing) with the precision locating where necessary to drive par-level asset management and patient flow applications.

The next generation of hardware features a USB power port, which can be used, for example, to create a battery-free BLE wayfinding network.

Rasmussen: The biggest advances in RTLS are in its adoption beyond asset tracking and more holistically now across the continuum of care. Through their own and their peers’ experiences, health care providers better understand the value RTLS brings to operational efficiency, patient care and satisfaction and ultimately their financial bottom line. As a result, they are proactively looking for ways to fully leverage the indoor positioning and event related data RTLS delivers to not only track assets but, more importantly, to improve the quality of care being delivered, increase staff workflow efficiency, improve the

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ROUNDTABLE

overall patient experience and cut costs. Another significant advancement is the ability to deploy wireless RTLS and to use standard D cell batteries to power location transmitters. This facilitates maintenance of the system and reduces device maintenance cost significantly.

clinical engineering teams. Our clients who use par-level asset management, which alerts distribution when inventory runs low on units like ICU, report that nurses no longer “hoard” or hide equipment. That means no more searching ceiling tiles or cabinets for IV pumps and other highly used assets.

Q: How will those changes impact equipment maintenance?

Rasmussen: As more and more use cases become the norm, scalability, total cost of ownership and aesthetics become critical attributes that can significantly impact maintenance. For example, in some cases existing infrastructure can be used to go from room to sub-room level accuracy.

Andersen: Clinical engineering departments/biomed and rental companies can now find the equipment much quicker to PM when it has been tagged, especially if they choose to integrate the preventative maintenance info to the RTLS system. Now those performing the PM, not only have their list to PM, but know where it is. This is a huge time saver. RTLS can also trigger alerts and notify staff if a piece of equipment that is past it’s PM date, has entered a patient room. Battery life of a tag is also lasting longer, so that they are now getting changed every 1-2 years at a minimum. This enables the battery to be changed when it is PM’d – now just touching the device once instead of twice.

Wil Lukens Lukens: The evolution of RTLS to a larger enterprise location services initiative, enabled by a multitude of technologies and system integrations, not only allows equipment that is due for maintenance, testing or inspection to be located quickly but also transforms the process from reactive to proactive via real-time alerts on imminent maintenance or upgrade requirements. RTLS also provides historical maintenance and utilization reports, allowing teams to strategically schedule maintenance procedures during off-peak hours – decreasing equipment downtime that is likely to impact the clinical teams.

McGreaham: The benefit of the multi-platform sensory network is that you immediately have enterprise-wide visibility into your equipment fleet via your existing Wi-Fi network, which will narrow the search for equipment. By adding precision locating in certain areas, your search time is virtually eliminated, allowing for higher up-time, lower cost on preventive maintenance, and lower risk for non-compliance. We’re seeing clients drastically reduce their capital spend and equipment inventory, by as much as 40 percent, because RTLS allows the hospital to better utilize a smaller fleet. This means less equipment to maintain for

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Q: How can a HTM department benefit from a RTLS? Andersen: When they get a call for “I need to order more pumps,” they now can do a quick search and see if there are any that are already available without walking the floor and before ordering more. They can quickly understand the utilization rates of equipment they have, thus being able to budget more accurately and spend money wisely.

Lukens: RTLS allows clinical engineering to focus on core functions rather than administrative tasks like searching for equipment. Additional efficiencies are realized as equipment utilization rates are improved which reduces the number of redundant assets needed. Less equipment translates into less time spent monitoring uptime and current status as well as a reduction in storage and maintenance costs. From a patient safety perspective, HTM can be confident that the equipment in-use has been properly cleaned and is not currently due for maintenance or part of an active recall.

Brett McGreaham McGreaham: Facilities are being asked to do more with less, and the more efficiently they can run their operations, the better HTM staff can do their jobs, the more satisfied they are.

With RTLS, clinical engineering no longer spends inordinate amounts of time doing rounds searching for equipment.

Location data can be integrated into their current software system for the management of preventive maintenance dates and recalls, so everything clinical engineering needs is in one system.

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ROUNDTABLE

systems. Integrations to asset management systems, and even EMRs, are becoming essential in today’s health care landscape.

Sandra Rasmussen Rasmussen: Know how to right-size their inventory to get the most out of their assets and minimize the number of lost or missing equipment by knowing the exact location of each and every piece of equipment. Reduce the risk of fines and/or avoiding the cost of non-compliance by the exact disposition and status of each and every piece of equipment.

Q: What are the most important features/technologies to consider when purchasing RTLS for a health care facility?

Andersen: A stable platform that is designed for growth, flexibility and future-proofed. Vendors that not only provide a great software solution, but have a user interface that is easy to use, detailed reporting out of the box, and the knowledge that they should work with the customer to build new features that are needed. Work with vendors that are constantly updating and revolutionizing their product. They are using the latest and greatest technologies and always listening to their customers and adding new features. Pay close attention to the new up and coming software solution providers. RTLS has been in the health care market for approximately 15 years with only a 15-20 percent penetration rate. These new software companies have looked at what is missing in the market and have built solutions to fill those gaps and beyond.

Lukens: There are a number of items to consider when purchasing RTLS that can handle the rigors of today’s health care environment. I recommend a focus on location accuracy, update speeds, reliability of tags and infrastructure, scalability, and integration capabilities.

McGreaham: First and foremost, understand the long-term goals your hospital has for this technology. RTLS has many applications beyond asset tracking. Your health system is, no doubt, looking for ways to improve operations and enhance the patient experience. With RTLS-driven workflow applications in the emergency department, operating room and inpatient units, hospitals can improve the delivery of patient care, increase capacity, and enhance the patient experience. Different RTLS technologies offer different levels of locating precision, and not all lend themselves to these additional applications, which require a high level of reliability and accuracy. You’ll want to ensure the system you purchase is scalable for multiple applications. For example, start with the relatively low investment of tracking assets with Wi-Fi, then expand your location precision in areas where you want par-level asset management or patient flow applications. You’ll also want to consider an RTLS that is interoperable with other

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Rasmussen: The key features include accuracy, location update rates, reliability, scalability and aesthetics.

Q: What else do you think TechNation readers need to know about RTLS? Andersen: You do not have to be a large hospital or senior care facility to implement RTLS. Hardware costs continue to come down and most companies are offering subscription or financing options to help all sizes of facilities. Understand what your goal of implementing an RTLS system is, and prioritize the phases of a new solution. It will help staff buy-in if rolled out at a pace that is not overwhelming so that they see the value, and help build the business case for continued RTLS expansion. Senior leadership needs to promote RTLS and the continued use of wearing tags by staff and/or patients, and tagging equipment so it does not become “optional” and no longer utilized once implemented.

Lukens: RTLS is more than a way to “find your stuff.” Enterprise location services are becoming a health care utility that enables true data intelligence gathering to increase workflow efficiencies, improve patient care and reduce costs.

McGreaham: We encourage any facility considering RTLS to think about the total cost of ownership (TCO) for the system. It’s important to understand not only the initial price, but also what it will cost to implement additional infrastructure for advanced applications. TCO can also include batteries, battery waste, and staff time to manage the RTLS network. And, don’t neglect to do due-diligence with references. Talk with other RTLS users about their experiences, and request on-site visits to see exactly how the technology works. Request a return on investment (ROI) analysis and ask what kind of ROI other hospitals have achieved with the technology. Finally, the choice to purchase RTLS can often be made easier when clinical engineering teams position the technology as one that enhances patient care. The right RTLS vendor can help you explain how the technology improves patient safety and supports nursing for improved patient satisfaction.

Rasmussen: Hospitals will continuously need to innovate and look for opportunities for continuous improvement in their processes and their quest to deliver the best, comprehensive care and patient experience. RTLS and other medical technology providers will need to outpace these requirements to deliver value. We believe there is still a long run way of innovation for ultrasound-based RTLS and that many more use cases will be uncovered as the technology evolves and, therefore, it is well positioned to best meet current and future health care needs.

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Time Management & Professional Development SMART WAYS TO GET AHEAD

By K. Richard Douglas

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F

rom housewives to salespeople to CEOs, time management is an important, and sometimes critical, component of every day. Because there are only so many waking hours in a day, making the best use of every minute can spell the difference between accomplishment and squandering time. Time is a resource that cannot be replaced. For people in the workplace to be effective they have to make the most efficient use of time. There has to be priorities and a system in place to guide them in how they allocate every minute.

As important as managing time is to the success of an employee, department or organization, managing one’s career, and having a roadmap in place, is just as crucial to success. Career success has to include a regular increase in knowledge and skills so that the perceived value of an employee is recognized upon evaluation. This professional develop-

more crucial when trying to balance training, after-work classes and a full-time job. Problem solving, decision making and ethics all combine with time management to further career progression and advance a person’s career success.

Among many other things, the English philosopher, Francis Bacon, is known for his quote; “knowledge is power.” Knowledge can be a powerful stimulant for career development.

Budgeting is a reality in every department of every hospital. Changes that were a part of the Affordable Care Act brought both new costs and thinner margins to hospitals. A form of trickledown economics meant that everybody got to share in the new realities of health care in the modern age. Watching the bottom line while taking steps to trim costs and operate efficiently are a concern for CE departments and their counterparts. While controlling costs is a good thing in the macro sense, it can be

on the job can increase productivity and minimize non-productive periods.

“Improvements in technology have led society to become so fast-paced that it’s easy for small details to slip through the cracks. Along those lines, the rise of social media — that is, the ever-present connection with our family and friends — has created around-the-clock distractions for us,” says author and speaker Daniel Bobinski, M.Ed. “It’s become common to see people interrupting their tasks-at-hand to check Facebook or text messages. All this gets in the way of task achievement, interferes with our attention-to-detail, and slows down our progress,” he says.

Bobinski is the author of “Workplace Training,” “Creating Passion-Driven Teams,” “Living Toad Free” and “The Really Simple Way to Hire, Train, and Retain Great Employees.” He is also the president of Leadership Development Inc. He says that time management cannot be addressed with a cookie-cutter

“ It’s become common to see people interrupting their tasks-at-hand to check Facebook or text messages. All this gets in the way of task achievement, interferes with our attention-todetail, and slows down our progress.”

Daniel Bobinski, M.Ed

ment is achieved through coursework, conference attendance, association participation, degree and credential attainment, workshops and informal learning.

These initiatives allow an employee to remain competitive in their profession and maintain an edge in the workplace.

Time management is a component of professional development and becomes

challenging at the department level where resources can be tested.

Measuring Minutes

In 1964, the Rolling Stones first sang “Time is on my Side.” That might be true in the life of a rock star, but in the metric-focused workplace, time is at a premium. With tightening hospital budgets, every ounce of efficiency has to be squeezed out of every employee.

Making the most of work hours is a big topic for employers. Any modifications, to behavior, that optimize the time spent

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

approach. In an article for Management Issues, Bobinski characterized time management as being “like an ink blot: every person views it differently.”

That approach can also hold true for the field or profession that the employee works in. The HTM profession finds technicians being pulled in several directions throughout the day. Some pre-planning often helps make the most efficient use of time.

“In our profession, you really have to be a master of multi-tasking, you also have to be supremely flexible in the

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understanding that you may not get to everything you had anticipated that day.

I probably couldn’t tell you the last time my day went completely as planned,” says Jennifer DeFrancesco, DHA, MS, CCE, CHTM, Veterans Integrated Service Network (VISN) 10 chief biomedical engineer.

She says that in general, to best manage her time she tries to plan ahead and not wait until the last minute on tasks as something else will inevitably come up.

“This involves being scheduled and purposeful and trying to get ahead of anything that may come your way,” DeFrancesco says.

In addition to pre-planning, prioritization is an important tool, according to Benjamin Lewis, director of Clinical Engineering GA/FL for Adept Health Inc. “Time management for technicians and engineers is a challenging aspect of our business. Healthcare Technology Management in a large facility is always busy. Prioritizing work appropriately is the first step in time management. Patient and staff safety issues take the highest priority, followed by business impact items that interrupt work flow, and then comes non-distinct items like IV pumps and SCDs. Training staff to recognize priority and change gears accordingly will allow your operation to flow more smoothly. Prioritization levels should also be built into your CMMS,” Lewis says.

“I recall going through time management concepts with my technicians. Most didn’t like to do PMs (planned or preventive) maintenance.

Subsequently, they would push off doing them until the last week of the month.

That meant pushing aside all their CM (Corrective Maintenance) so they could get their PMs done and meet their completion requirements,” says Al Gresch, vice president of client success for Mainspring Healthcare Solutions in Boston.

“This has the potential to reduce the quality of the PMs being done because they are rushed and increase turnaround time on the repairs that are sitting,” Gresch says.

Just as DeFrancesco explained,

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vendor service and get those scheduled ahead of time 4. Require that they complete their high risk PMs in the first 2 weeks of the month to insure 100 percent completion 5. Require that they complete a minimum of 25 percent of their assigned PMs each week.

Jennifer DeFrancesco

Veterans Integrated Service Network (VISN) 10 chief biomedical engineer.

“ There are many unknowns in our field, and in health care, so it is important to be as prepared as possible, as diligent as possible and as flexible as possible.” pre-planning has an important place in the HTM field as a catalyst for getting the best results when time must be allocated efficiently. Gresch agrees with this concept and has applied it to PM completion.

“The better approach was to plan ahead.

1. Get the scheduled PMs to them in advance to allow them to plan ahead; 2. Have them determine which PMs required parts or PM kits and get them in advance 3. Determine which PMs required

This approach also gave them greater ability to locate items and get to equipment that might be in use before the month was out,” he adds.

Gresch says that “time is like money; either you manage it or it manages you.”

“When I’m helping individuals improve time management, I begin with Stephen Covey’s ‘7 Habits of Highly Effective People,’” says Jason Crawford, president of Block Imaging Parts and Service in Holt, Michigan.

As a good starting point, Crawford cites Covey’s habit 3, to “put fi rst things fi rst.”

“Most people spend their time working on urgent and important activities. Getting control of our lives involves spending time on non-urgent, but important things. It took me years to discover that most of the urgency in my life was ultimately self-inflicted,” Crawford says.

“I was leading a team in such a way that the problems always ended up back on my desk. Leadership involves empowering others. Everyone in an organization, regardless of their position on the org chart, has the ability to empower others to be successful,” he adds.

Gresch says of the HTM profession, “unfortunately, in our industry, we tend to do way too much firefighting and use that as an excuse to not employ good time management practices.” He agrees with Crawford that Stephen Covey nails the time management conundrum. He also cites Covey’s book as a source of guidance in this area.

“In it, the section on time management goes over the four quadrants of things where we spend our time; Quadrant 1: those things that are both urgent and important (the fires),

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“Training staff to recognize priority

and change gears accordingly will allow

your operation to flow more smoothly.

Prioritization levels should also be

built into your CMMS.” Benjamin Lewis

Quadrant 2: those that are important but not urgent (strategic and developmental initiatives); Quadrant 3: those that are urgent but not important (phone calls, emails, meetings); and Quadrant 4: those that are neither important or urgent (checking Facebook or Twitter or anything else that doesn’t provide real value to our day),” Gresch says.

DeFrancesco says that it is really important to set some work-life boundaries for yourself as well.

“After working myself into burnout at one point, I created standard ‘rules’ for my time; I leave work by 5:30 p.m. if there isn’t an emergency issue or something due tomorrow that isn’t complete. Also, I – in general – do not review emails after 7 p.m. or before 6 a.m. as I receive and triage emergency calls if something requires immediate attention during these hours,” she says.

She explains that these rules make it possible to greatly reduce the time she was spending at work and on work during her personal time by establishing a stop time.

“These boundaries may look different for each person based upon their responsibilities and organization, but it is definitely worth thinking through,” DeFrancesco says. “There are many unknowns in our field, and in health care, so it is important to be as prepared as possible, as diligent as possible and as flexible as possible.”

During those hours you are on the job, Boblinski suggests setting short goals during the work day to accomplish more.

“To improve one’s time management, which is really action-management,

because what we’re really doing is managing our actions in the time we’re given – everyone gets 24 hours each day – we must become purposed and disciplined to ignore the lure of social media distractions. To aid in this effort, establishing a ‘by when’ for each task we have helps. I’ve seen several research papers that found, if we set deadlines, we are likely to accomplish much more than if we don’t,” he says.

Well-Rounded Professional

Taking ownership of career advancement and direction is up to every employee.

There are a number of ways to achieve this and many require some time investment, or some conceptual thinking, to achieve results. The intrinsic value in putting these concepts into action is that they can benefit the employee and the employer.

“AAMI has developed a great number of resources in this area, including the Career Planning Handbook, Leadership Development Guide, Core Competencies Handbook, and HTM Levels Guide. In addition, AAMI has developed a mentorship program to pair people up with a well established HTM professional,” Gresch says. “There are likely resources available from your employer in this area. One can also seek out a mentor who is a leader in your own organization. I have several books I’ve read over the years, but my favorites are written by John C. Maxwell, such as ‘Developing the Leader Within You’ and ‘Developing the Leaders Around You.’” When thinking about professional development, the emphasis is most often put on what can be added to a résumé in

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Director of Clinical Engineering GA/FL for Adept Health Inc.

terms of training and education. There is another element, that may be overlooked, in the successful development of an individual or department. At an MD Expo last year, Crawford presented a class titled: “Moving Your Team from Conflict to Trust.”

“One of the most significant factors slowing organizations down today is unhealthy conflict (and yes, there is a healthy form of conflict),” Crawford says.

“When a team does not have the trust necessary to resolve conflicts, they fester.

Individuals spend more and more of their day trying to work around their coworkers, or spend their days working to protect themselves. Contrast that with teams that have high trust,” he says.

“In high-trust environments, people can quickly and easily share what they think. They can throw out ideas without concern for who gets the credit.

High-trust teams see the best in each other, and that inspires each individual to bring their personal best to the

TWO OF THE AAMI RESOURCES

mentioned can be found here: • Career Planning Handbook: /www.aami.org/productspublications/content.aspx?ItemNumber=2943 • Leadership Development Guide: www.aami.org/productspublications/content.aspx?ItemNumber=2944

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workplace,” Crawford adds.

DeFrancesco says that the emphasis for putting one’s career path on track is to be concise about creating a set of goals and making certain that they conform to the goals set by the organization.

“The cornerstone of professional development is the personal development

Every new team member joining Block Imaging participates in two ‘book clubs’ in their first few months,” Crawford says.

“The first is ‘Leadership and SelfDeception’ by the Arbringer Institute. An awesome way for teams of any size to understand how we build trust on a team.

The next is ‘5 Dysfunctions of a Team’ by

end of month reports? ‘Read’ them?

‘Send’ them? What? The more specific the verb, the more likely the action will be accomplished,” Bobinsi adds.

“The other factor, like I said, is time-of-completion. ‘Write end-of-month reports before Thursday at noon’ creates

“ Leadership involves empowering others.

Everyone in an organization, regardless of

their position on the org chart, has the ability to empower others to be successful.”

Jason Crawford President of Block Imaging Parts & Service

plan (PDP). This PDP takes your personal goals, aligns them with organizational goals and creates a mechanism to set a timeframe to achieve these goals and track them,” she says. “As much as it may sound cliché, it is really the most effective way to operationalize and implement training in alignment with the department and the organization’s goals that I’ve used to date.”

DeFrancesco says that, in this way, professional development is a marriage between an individual’s goals and interests and their intersection with the organization’s needs. She adds that there is a wide range of ways that one can achieve goals including formal training, degrees and certification as well as on the job training or webinars.

A consistent theme is the usefulness of reading books that provide insights into personal development, team building and leadership.

“As the old adage goes; ‘In five years, you’ll be the same person you are today except for the books you read and the people you spend time with,’ ” Crawford points out.

“I encourage everyone in my organization to read. We promote books to co-workers, offer lunches to highlight communication skills and team building insights that others might benefit from.

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Patrick Lencioni. His books highlight the need for healthy cultures at work, and how to get there.”

The goal setting aspect, that DeFrancesco mentioned, can be achieved through a very scientific and methodical method that makes goal-setting effective and life changing. Bobinski breaks down this approach by using an acronym that puts the elements of effective goal-setting into an easy-to-understand and memorize plan. It is the SMART goal formula.

“Goals should be Specific, Measurable, Action-Oriented, Realistic, and Time-Bound. Creating specific time factors is the most neglected component of SMART Goals. To improve time management, it helps to identify a ‘by when,’” Bobinski says.

To ensure every goal is SMART, we can ask several fundamental questions: 1. What is the specific action required?

2. What is the specific measurability?

3. What is the specific date or time the task should be accomplished?

4. Are these all realistic?

“Starting each action with a verb – the action required – is key. So many people write general phrases, such as, ‘end of month reports.’ The problem? It lacks a verb. What action is required? ‘Write’ the

a deadline and is a catalyst for improving our focus,” he says.

Budgeting Plan

In a household budget, the formula is easy; there are expenses and there is income. The income side of the equation must be larger than the expense side and every effort must be made to ration the income so that it covers all expenses.

In a health care setting, the formula is more convoluted than that. The principle is the same, but the considerations are extensive.

“We develop our budget for the department in a very methodical way by ‘reverse engineering’ my costs. First, we start with the medical equipment and health information system value that my department supports. I then calculate my total budget to be 4-5 percent of this number annually,” DeFrancesco says.

“For example, if a program supports $100 million in medical equipment, my total budget for that department should be $4 to $5 million annually including salaries, contracts, parts, glassware and vendor services as well as an estimation of the costs for our space for our department and utilities. We then use

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prior year benchmarks, evaluate our contracts and develop a plan within the 4-5 percent including a robust training plan for technical, professional and certification courses for the department,” DeFrancesco adds.

“Being a contributing member on your capital planning committee is one of the best ways to keep your budget in line. One of the quickest ways to take a hit on your budget is have a big ticket item land on your door step that you didn’t plan for. Follow up by meeting with all of your clinical directors during budgeting season to make sure that nothing was missed,” Lewis says.

Additionally, do a search in your CMMS system for equipment added over the past 24 months as a “triple check” to ensure you’ll have no surprises, Lewis says. If all of your facility’s clinical maintenance goes on your HTM budget, he advises using a policy that states that any non-budgeted service contracts go against the owning department’s budget until the following budget year.

Al Gresch

VP of Client Success for Mainspring Healthcare Solutions

“This means that you go over your budgeted equipment with each department to ensure that you have them ‘covered’ and if any expense comes to light on new equipment that you were not alerted to during the following budget year, the owning department will have to cover. Explaining this to your clinical directors will get their attention and will reduce the likelihood that you will be surprised by a department’s

purchase,” Lewis adds.

“Also, communicate with your team about any one-off big ticket purchases that should be considered like test equipment, big battery purchases, or high-use tubes. Replacing batteries in your portables or IV pumps is a considerable expense that does not happen in every PM cycle but is a large enough expense that these should be considered in your maintenance budget,” Lewis says.

The compelling theme for career advancement is that the person who wants to grow in their career must make the initiative. It takes action and knowledge to get there and attention to how we use the time allocated in every workday. Being mindful of budgets and organizational concerns will show a focus aligned with employer goals as well. Setting goals, and more importantly, achieving those goals, can turn a HTM job into an HTM professional career.

C O M E G RO W WIT H US Build Your Career at Crothall Healthcare Technology Solutions H O W FA R CAN YOU GO? Career opportunities abound when you are part of a growing Team.

Crothall Healthcare Technology Solutions (HTS) has grown 373% in just the last 5 years and an amazing 20 times over in the last 10 years.

With growth comes new jobs and new opportunities.

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ISN’T IT TIME FOR YOU TO FIND OUT MORE? Come grow with us. Please contact: Come see why Crothall has earned Modern Healthcare’s Best Places to Work four years in a row.

Theresa Howell Talent Acquisition Manager Theresa.howell@compass-usa.com

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MARCH 2017

TECHNATION

45

EXPERT ADVICE

BY JENIFER BROWN

CAREER CENTER Today’s Workforce and Their Generational Differences

W

hen the Bureau of Labor Statistics released its 2010-20 employment projections, health care and related services dominated the list. According to BLS employment projections, health care support occupations are projected to grow 34.5 percent overall in this decade. Personal care related service occupations at 26.8 percent with health care practitioners and technicians at 25.9 percent. This is due to the large aging Baby Boomer population and health care reform.

JENIFER BROWN CEO and Founder of Health Tech Talent Management

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MARCH 2017

For the medical equipment service industry, the higher demand for diagnostics means more equipment has to be serviced and maintained. To cover this staffi ng demand, there is a larger number of very diverse generations working together.

Surveys state that there are major differences in what each generation is looking for in careers. This hot issue was covered at the ACHE Conferences, in mainstream publications/books, to corporations even changing their career ladders.

Here is a look at the workforce population’s generational differences: • Silent Generation: Born 1925-1945: 38 million people who make up 5 percent of the workforce. Known as Traditionalist that grew up during the Great Depression, these people are very hard working and remain loyal to the same company. They are used to specific direction and support.

• Baby Boomers: Born 1946 to 1964: 78 to 80 million people who make up 40 percent of the workforce. These individuals grew up during prosperity and applied a strong work ethic toward their careers rather than a company. They want two-way interaction and to be involved in the decision-making process.

• Generation X: Born 1965 to 1979: 46 to 60 million people who make up 40 percent of the workforce. They grew

up with their parents living to work with little time for family. Consequently work/life balance is more valued.

Sometimes called the “Squeeze” generation, because they are trying to find the most efficient way to handle work, meet financials needs, and still have quality family time. They value education and independence more than direction.

• Generation Y: Born 1980 to 2001: 76 to 90 million people who make up 15 percent of the workforce. Known as the Millennials, they are ethnically more diverse than any other generation in our nation’s history. They are the “connect me” generation because of their need to communicate through texting, Twitter, Facebook and email.

THE VALUE OF UNDERSTANDING THESE DIFFERENCES Whether it be interviewing or working with these different generations, you can communicate and engage more effectively if you understand their values and work ethics. To be a successful manager in today’s workforce reality you need to have an understanding and sensitivity of these differences as well as be open to mentor and “share your experiences.”

For personal career advancement, this will be beneficial in obtaining a position and career advancement. Remember, more people get selected or advance in their careers due to their interpersonal skills rather than their tactical skills.

JENIFER BROWN is the President/Owner of Health Tech Talent Management LLC. She has more than 20 years of experience in talent acquisition and placement in technical fields.

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EXPERT ADVICE

BY MIKE DAVIS

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Ghosting a Drive – Reduce Your Downtime

O

ne of the most critical points of your ultrasound system is the hard drive. After all, the hard drive holds the operating software, application software and the user defined presets, as well as all of your option keys for the system. Performing periodic backups and a printout of the settings is mandatory in the event of a system crash.

As long as you have the software and the backups you can fully restore the system. But what if you do not have the software or cannot be down for an extended period of time?

The best solution is to have an emergency replacement drive available. Just plug in the drive and you are all set. This is accomplished by backing up or “ghosting” a drive. Ghosting a drive is the most effective method of insuring your downtime is minimal. Simply remove the old drive and install the ghosted drive, power up the system and you are up and running.

There are several methods available to ghost a drive.

Conquest Imaging recommends using a hard drive duplicator. When used in accordance to HIPAA regulations, this small piece of low-cost hardware allows you to clone the original drive onto a secondary drive with the push of a button.

First, you need to ensure the drive you are writing to is the same size or larger than the original drive. A hard drive duplicator has two ports, one for the original and one for the duplicated drive. Most duplicators use SATA connections however many offer IDE

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MARCH 2017

adapters. Slide the original drive in the fi rst port and the new drive into the second port. Insure that the duplicator is set to copy mode and press start. The ghosting can take several minutes to several hours depending on the size of the drives. Once fi nished reinstall the original drive in the system and put the ghost drive in a secure location until needed. Remember that this process will duplicate everything on the drive, so ensure that all patient data is removed prior to duplication.

Another method of ghosting your system’s hard drive is to use your laptop and duplicating software (we recommend Acronis) to create an image of the original drive and ghost it to your drive. While this method is slower, it allows you to back up to a DVD or to a server on your network for long-term storage. You will need at least one USB to SATA/IDE adapter and a copy of ghosting software. Connect the original drive to the adapter and launch the program. There will be several options

MIKE DAVIS Technical Support Specialist

to choose from. If you are going directly from drive to drive, select the cloning option. Otherwise select the archive option. If archiving, you will have the ability to select where the fi le will be stored. I recommend either a blank DVD drive or a network storage system.

Remember, all patient data must be removed to protect yourself and the hospital from a HIPAA violation.

Using any of these methods will reduce your downtime and make you the hero!

FOR MORE INFORMATION, please call Mike Davis, Technical Support Specialist at 866-900-9494.

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EXPERT ADVICE

BY DAVID SCOTT

BEYOND CERTIFICATION W

e are now a few months into 2017. A lot of people like to set goals at the beginning of each year based around what they would like to accomplish for the year. Sometimes your workplace helps by suggesting goals they would like to see you accomplish before your next annual review. If one of your goals is to get your CBET certification now is a good time to start!

The fi rst CBET test of 2017 is in May. The next one is in November. My advice is to try for the May test. Don’t put it off until November. That way, if you don’t pass the fi rst time (which happens often) you have the November test as a backup plan. Then, you can still meet your goal of getting your CBET certification before your annual review.

I know it can be frustrating not to pass on the fi rst try, but it happens. I have seen it happen to people I thought for sure would pass the fi rst time. It is not a reflection on the person. The fi rst time taking the test can be a little overwhelming. That’s why I recommend the backup plan only six months later.

There are also some distinct advantages.

One advantage is that you have seen the test and the layout of it. There will be fewer surprises the second time around.

Two, you studied like crazy the fi rst time and just missed passing but now you have your test results back and know the areas you need to brush up on. The people who I’ve seen take the test multiple times are the people who wait too long before taking it again.

Now, no one wants to take the CBET test more than once. So, what is the best

game plan to avoid that? The testing window this year is May 1 through May 15. Start studying at least six weeks out from the test. Plan on studying at least an hour each day. You can study more on weekends if needed. If you are starting to understand and remember the items studied, then maybe skip the weekends or just do a little on weekends. You don’t have to do the entire hour of studying all at once.

Break it up. You have two 15-minute breaks and a half hour lunch at work, maybe you can use some of that time for studying. Then whatever part of the hour you don’t get in at work you can do at home. Maybe you’ll really get into it and study more. Those are usually the people who get the highest scores on the test. I know people have lives outside of work, family and kids that take up a lot of time from studying. If you don’t get your hour a day during the week then plan on studying on the weekend to make up the time.

Study someplace quiet or where you can concentrate with minimal interruptions. Look at the outline for the test and break it down each week by the test subjects. There are six areas to the

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

DAVID SCOTT CABMET Study Group Organizer, Children’s Hospital Colorado

test. Take at least six weeks to study. The last week will be your review week to go over everything and put it all together.

Plan on taking the day before the test off for a final review. Then take the day of the test off. Even if the test is only three hours, you deserve to take the whole day off. I suggest taking the test in the morning when your mind is clear.

Here are some helpful study resources: • www.aami.org/ professionaldevelopment • www.my.aami.org/store • www.cabmet.org/study-group • www.htmcertifications.com Best wishes and let me know the results!

MARCH 2017

TECHNATION

51

EXPERT ADVICE

BY JEFF KABACHINSKI

TECH SAVVY

OSPF Hanging In There – Part One

T

he Open Shortest Path First (OSPF) network routing protocol has been around a long time in IP networking terms. While version 2 was released in 1998, it is still the preferred routing protocol especially for border gateways. Terminology note – originally (in the 1960s) computers that acted as routers came under the term “gateways.” As time wore on and routers became more specialized, use of the term “router” was used for gateways specialized in packet routing. In modern times, the old gateway term still shows up especially when referring to border gateways as we’ll see.

In this issue, Tech Savvy starts to look into the OSPF protocol. This is a two-column series. This time we’ll set the scene to explore how network paths are determined and routing tables are created to be seen in Part Two.

ROUTING TERMS AND UNDERLYING PROTOCOLS There is some routing language to get used to before we dig in to OSPF. Here are a few of the most often used terms: • Autonomous System (AS) – an autonomous system is a “stand alone network.” More officially: within the Internet, an AS is a collection of connected Internet Protocol (IP) routing prefi xes under the control of and on behalf of a single administrative entity that presents a common, clearly defi ned routing policy to the Internet.

• Border Gateway Protocol (BGP) and Internal Gateway Protocol (IGP) essentially say that they use OSPF to make connections to other networks.

• Default Gateway – as noted above, originally routers came under the generic term of gateways before the router term came into general use. As routers proliferated, they received the distinction from gateways as routers.

However, routers must still specify what is known as a “default gateway.”

When a router receives a data packet identifying a network ID that is not in their routing table, the unknown network ID packet gets sent to its

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MARCH 2017

default gateway – as in “Hey pal see if you can figure this one out.” If that default gateway doesn’t recognize the network ID, it gets forwarded to its default gateway and so on. To save the day and not let a packet with a bogus network ID run around the network forever, there’s a Time to Live counter embedded in the IP header. Each time a default gateway gets a bogus packet it decrements the Time to Live count by one. The last default gateway simply throws the packet away when this count reaches zero.

THE BOTTOM LINE OSPF is a routing protocol for Internet Protocol (IP) networks. It uses a Link State Routing (LSR) algorithm and, as stated earlier, it falls into the group of interior routing protocols, operating within a single AS. In terms of border gateways, it also can interface between ASs. THE MAIN IDEA (COSTS VS. HOPS) The Link State, or sizing up your connections to the network, is based on assessing a cost to use rather than how many router hops it needs as in Routing Information Protocol (RIP). The cost

JEFF KABACHINSKI Senior Director of Technical Development, ITD

metric is based upon the link’s network bandwidth. The higher the available bandwidth, the lower the cost to use that link.

HOW OSPF ROUTERS COMMUNICATE As shown below, an IP address includes the network ID and the node ID. There are three main types of addressing. A unicast address is intended for a particular network node. If you’re on a network, you see your unicast address by running the ipconfig command. In a Microsoft based operating system hit the “windows” key (usually to the left of the spacebar) and the letter “R” to open a run command window. Type CMD in the open box to open a command line screen. Here, type in ipconfig and you’ll learn your IP address, see your subnet mask and your default gateway.

The second type of IP addressing is called a broadcast address. All the bits in a broadcast address are set to 1 resulting in 255.255.255.255 as the IP broadcast address. Each network node looks for packets with their unicast

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MRI and CT Parts address or a broadcast address intended to be read by all.

Finally, a multicast address is intended for a specific number of nodes. In our OSPF examination we’ll fi nd that OSPF routers use 224.0.0.5. Therefore, if you’re programmed to also listen to a particular multicast address you’ll also read 224.0.0.5 addressed packets. This is how OSPF routers share their routing tables and network maps. The routers will use this multicast address only for updates to the routing information as they come up. This helps keep extraneous network traffic to a minimum.

THE IPV4 CLASS SYSTEM The last item for Part One of this column series is to review how the routers recognize which portion of the IP address is the network ID.

Main IPv4 Address Classes

IPv4 Class Ranges

Class A

1 – 126.X.X.X

125

> 16 million

Class B

128-191.0-255.X.X

16,002

> 64,000

Class C

192-223.0-255.0-255.X

~2 million

254

Internet Protocol version 4 (IPv4) addresses have three main classes and are four bytes in length, with each byte written in decimal notation and separated by a period. The table above defines the main classes. Their class reveals the number of bytes in the network ID and, therefore, how many addresses are available for nodes to use for unicast addresses. A Class A address, for instance, uses just the first byte for the network ID. Routers and other interested parties will know to use the value of the first byte to determine the network ID. A value between 1 and 126 indicates a Class A address and just the value of the first byte is the network ID. An example: 112.0.0.0. (The node locations are set to zero to give the network its numerical name.)

Class B addresses are determined by the value of 128 through 191 for the fi rst byte (e.g. 176.38.0.0). If the fi rst byte has a value within this range, the router will know that the fi rst two bytes are to be used to identify the network.

Finally – you guessed it – Class C networks use the leading three bytes to identify the network. If the value of the fi rst byte falls between 192 and 223, the router will know it’s a Class C address (e.g. 221.108.16.0). The table above summarizes the IPv4 class system. Note that in the address range column, an X represents a node identifying number, which can range from one to 254 (as 255 falls into the broadcast address).

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TECHNATION

53

EXPERT ADVICE

BY GEORGE HAMPTON

TECH KNOWLEDGE

The Dynamics of Cost Reduction

A

t the risk of sounding like “Captain Obvious,” the health care industry as a whole is struggling financially. Everyone is being called to task for savings and clinical technology programs are certainly no exception. Perhaps your program has flown under the “cost cutting” radar in the past. I know that many organizations don’t have a real grasp on what they are spending on clinical technology, but many have an impression that whatever they are spending is probably too much. This impression, whether real or imagined, leaves the director of the Clinical Technology Program in a challenging position. If you are exercising cost saving measures, are you able to show the results, or if you’re not actively cutting expenses, where do you start?

The situation certainly sounds bleak, however there can be ways to make it a positive. Let’s discuss some of the variables of cost reduction in the hope that we can construct a clear vision that will help you get started or validate your current efforts.

THE VARIABLES Obviously, there is no “model” program that would necessarily fit every application. A CT program’s expenses can be simplified into four basic categories: Contracts, Parts, Outside Labor, and Salaries (I know, more Captain Obvious stuff). This is management 101 stuff for a leader in the CT industry. However, my experience has taught me that the understanding of the interdependency of these expense categories is less common.

From a forensic standpoint, the efficacy of a CT program can be diagnosed by looking at the proportionality of these expense categories. From an adaptive perspective, the performance of the CT program can be modified by strategically adjusting the proportionality of these expense categories.

GATHERING DATA Let’s set up a consulting scenario. I am called in to determine the efficacy of a CT program in an average metropolitan hospital. The CT program has four techs and one manager. My fi rst task would be to determine the total CT spend. My team would scrub all the fi nancial data from the hospital to establish the total CT spend from all the possible originators. We would be

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careful to accurately determine the four main category expenses. With this data gathered, we would draw a conclusion by looking at the magnitude of the relative categories (Contracts, Parts, Outside Labor, and Salaries).

would also come into consideration for whatever changes we would recommend. The total contract spend would also be considered. A high contract spend, as a percentage of the total budget (70 percent or greater), would indicate a heavy reliance on contracts.

Low parts spend against a high contract and outside labor spend would indicate heavy use of outside repair sources or depot repair. As mentioned before, heavy reliance on contracts and outside labor would call into question the use of the internal staff. Are they just doing periodic maintenance? Why aren’t the internal technicians doing the majority of the repairs? As an example; if I have a tech fully trained on my cath lab, I would expect to see him do 80 percent of the work or greater. As I said in the beginning, no model fits all, but the critical eye of someone evaluating a program will be drawn to extremes.

DRAWING CONCLUSIONS The data gathered is used as a basis for a conclusion. We would look at the staffi ng levels and the specific training of the staff. We would determine if the four techs in this scenario are enough to support the CT program in its current form. Inevitably, the staffi ng levels

USING DATA TO MAKE CHANGES Ultimately, the point of this article isn’t to scare you or increase your stress. The point is to encourage you to make necessary changes in your expense categories and protect yourself from analysts by being aware of the interdependency of these factors. I would

GEORGE HAMPTON President of Tech Knowledge Associates

WWW.1TECHNATION.COM

EXPERT ADVICE

recommend starting with your staff. Establish a plan for training that will deliver a highly effective program. Additional staff can be justified when you have a plan to reduce contract expenses. Set a target for contract reductions. When contract spend decreases the CT program is taking on more financial risk. Risk is not a bad thing here; it just means we are paying for what we need, as opposed to the “insurance” against expense that contracts provide. As contract expense decreases parts spend should go up, as the in-house techs are doing more of the work and buying the parts necessary for that work.

Outside labor might increase slightly but should be the smaller expense overall. Remember we want to do as much work in-house as possible. Lastly, monitoring financials and benchmarking is critical. You must be able to show the PROOF APPROVED CHANGES NEEDED financial benefits of your program. Many programs use Cost/ Value SIGN–OFF: as a benchmark. The Total Cost of the equipment CLIENT

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Office supplies to MRI contracts). Highly effective programs can achieve Cost-to-Value scores of five percent or less.

Wisdom is the application of knowledge – If you are a leader who understands all this and your program is on the ball, your knowledge and experiences can make a great difference for your peers, please share. If you are in a CT leadership role and this is new information to you, don’t despair! You can do this! Just take it step by step. Gather data, analyze data, make a plan, and monitor effectiveness.

GEORGE HAMPTON is the president of Tech Knowledge Associates, a clinical technology management provider that was formed to bring unique value to its clients by guaranteeing savings, capping their expenses and protecting them from catastrophic failures. For more information, visit www.ii-techknow.com.

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TECHNATION

55

EXPERT ADVICE

BY ALAN MORETTI

THOUGHT LEADER Knowledge Is Power

“K

nowledge is power” has been heard within many circles and can be traced back to 1597 and Sir Francis Bacon, an English philosopher, statesman, scientist and author. Bacon published this philosophical phrase and its supporting meaning in his book, “Meditationes Sacrae and Human Philosophy.”

ALAN MORETTI Healthcare Technology Management Advisor

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TECHNATION

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Knowledge is a powerful factor that empowers people to achieve great results. The more knowledge a person gains, the more powerful he becomes.

There is no end to knowledge. There is no limit to what a person can learn.

Even big problems can be solved if we have the knowledge of solving it. By knowledge of science, man has learned how to survive and proposer in nature.

Development is possible by knowledge and not by physical strength. No individual or nation can prosper in life without knowledge. Think about it – could a teacher without thorough knowledge teach a student well? Would a student without any knowledge of the subject matter be able to pass a quiz or test? The answers to these questions are a simple “No.” For HTM professionals, the concept of “knowledge is power” resides in their everyday duties and assignments within the hospital setting. The ability to perform a range of tasks to successful completion relies upon the acquired knowledge and experiences received through various levels of training and formalized education. These precise abilities can elevate HTM professionals and set them apart depending on their inherit talents coupled with “knowledge” that ultimately will make them powerful. Think about it a little bit – how does one person work as a CT

engineer and another person service infusion pumps? What makes these two areas of expertise and the people involved different? Well “knowledge” would be an obvious difference. Would it be safe to assume “power” could then be defi ned as the marketability of that person and the compensation that it brings them?

So, as an HTM professional, you may ask yourself, how do I drive this “knowledge is power” concept to best serve the development and growth of my career? What methods and tools do I have in my toolbox today? What do I still need to acquire? These are great questions and a powerful pathway to answers can be achieved through developing your personal HTM networking web. Connecting with colleagues and making new relationships via social media groups such as LinkedIn and attending regional biomedical association meetings and conferences will enrich your career and its prosperity.

Other nuggets of “knowledge” can be cultivated via various resource groups.

Their content provides a “knowledge” framework that can be gleaned and provide a level of “power” when pursuing marketability rankings.

The key to unleashing the “power of knowledge” and reaping all of its benefits, as Sir Charles tells us is you!

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THE FUTURE

Regulations, Regulations and more Regulations

I

have been teaching a BMET program since the fall of 1992 and after 25 years of teaching I still consider myself a Biomed Tech or BMET. So just about anything I learn in my career as an educator I’m always relating it back to my background as a Biomed Tech. The first day back to school after the holiday break this year was a training session held by a Washington lawyer with the Department of Education. This training was about websites and distance learning and some of the federal regulations which must be adhered to for compliance with the Office of Civil Rights (OCR). I’m sure I knew the OCR was a part of the Department of Education but for the life of me I could not remember that. But, it’s true, the Office of Civil Rights is under the Department of Education.

It’s apparent once you read the OCR’s mission statement which reads: OCR’s mission is to ensure equal access to education and to promote educational excellence through vigorous enforcement of civil rights in our nation’s schools.

JOHN NOBLITT, M.A.ED., CBET

58

TECHNATION

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Many reading this may have much experience in dealing with federal codes and standards. The reason may stem from another mission statement from a federal department. The U.S. Department of Health & Human Services (HHS) mission statement is to enhance and protect the health and well-being of all Americans. We fulfi ll that mission by providing for effective health and human services and fostering advances in medicine, public health, and social services. I must say when you read this mission statement it’s hard to not agree with what it says. It seems easy enough to enhance and protect the health and well-being of all Americans. However, we all know in the HTM field that fulfi lling this mission statement is very difficult. Exactly how do you enhance and protect the health of all Americans?

It starts with ensuring the equipment is safe, reliable, and accurate. Of course, we all know that as we strive to fulfi ll these statements it seems to get increasingly difficult.

As I sat in my training session I began to think about how difficult it was going to be to implement all the requirements I was listening to. I began to think about something Ode Kiel once told me about

Joint Commission regulations, “Say what you do and do what you say.”

Sounds simple until you must implement this into the workings of a large organization such as a health care facility or an institute of higher learning.

Like many regulations, the fi rst reaction is “This is crazy, why do I have to do this?” I have been teaching online classes for many years and fi nd many resources to use in the classroom including different YouTube videos.

However, our presenter shared with all in attendance that all websites should be designed to be accessible to individuals with disabilities. So, what did this mean to me? All YouTube videos must be captioned to be used in the course. I must caption the videos or take them down because a disabled student could fi le a discrimination case. Many of the educators in the room felt this did not apply to them because they did not have a disabled student in their class. Our presenter quickly noted that all websites should be designed to be accessible to individuals with disabilities. Some of the instructors had very reasonable arguments to some of these regulations, including an instructor from the speech language pathology program. The

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videos must be captioned so students with partial or complete hearing loss can understand what the video is talking about. The instructors were insistent that a student with hearing loss could not progress in the program because you must be able to hear the sounds a patient/client is making to help them with their language skills. The presenter said it’s OK for the student not to progress because of a disability; however having disability accessible websites is still a law we must abide by.

I kind of stewed about this for a day or two as I’ve never known a BMET to be blind or deaf. But, after a few days thinking about it I did come to realize that a blind person could make a great technician as a phone support personnel.

Yes, certain accommodations would have to be implemented such as brail schematics etc. but one could possibly perform as a BMET in a little different role than a BMET in the hospital environment. We may see government regulations as nothing but a hindrance but they are actually in place for good reasons. So, the next time you encounter a regulation or a rule that doesn’t make sense to you, step back and take a look from a different angle.

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TECHNATION

59

EXPERT ADVICE

BY DAVE FRANCOEUR

Sponsored by

SODEXO INSIGHTS What is with the TIONS?

W

ords ending with the suffix “ -tion” indicate state, condition, process or result. The suffix changes the action we are attempting to achieve into a noun we hope to accomplish. Tions are prevalent in Healthcare Technology Management as seen in the following examples.

HEALTH CARE Consolidation/Systemization: According to the American Hospital Association (AHA), hospital numbers have decreased to 5,564 over the past 30 years. The remaining facilities have aligned, merged or been acquired by other systems wanting to become larger. Health care organizations need to grow. The current vehicle to achieve this goal is to obtain more “covered lives.” Sodexo has coined a phrase calling this activity systemization.

Systemization created many new challenges in the Healthcare Technology Management (HTM) profession. If you are an in-house HTM professional, you are very concerned your organization may be integrated into a larger system and not know how this will affect you.

The same is true if you are employed by a manufacturer or even a third-party company, it’s becoming more and more challenging to find health care facilities you can align with. You may have a great relationship in your current situation only to have it terminated because the facility you have been successfully working in has decided to integrate with another facility which uses another service provider. The same can be said for manufacturers. You can have a great working relationship where they have utilized your products and services forever, and now they are choosing to go another direction, blocking you entirely.

60

TECHNATION

MARCH 2017

take more rigorous actions by individuals to document and track their actions in order to present evidence that they are maintaining the established standards.

DAVE FRANCOEUR, MM, CHTM, CBET Clinical Technology Management Senior Director at Sodexo

All of this causes uneasiness in our profession.

FDA Qualification/Validation: There are certain segments of our industry that are reviewing the value in questioning the abilities/ credentials of individuals performing activities in our profession. Depending on which way this goes, it could have a significant impact on our industry. This could potentially drive additional levels of qualifications for each individual contributing in this profession and likely some sort of ongoing validation to those qualifications/abilities.

AAMI Certification/Verification/ Recertification: The Association for the Advancement of Medical Instrumentation (AAMI), through AAMI’s Credentials Institute (ACI), has recently changed the recertification process. While the changes appear to be more standardized, and they have attempted to simplify the process, it will

TJC Regulation: The Joint Commission (TJC) has implemented new “REFRESH” strategy. Two of the bigger changes that will have an impact on our day-to-day business are the following: 1.EC.02.04.01 [EP4] Note 3 [(corrected language coming)] & EC.02.04.03 EP3 Note (current language) a.Note 3: Scheduled maintenance activities for non-high-risk medical equipment in an alternative equipment maintenance (AEM) program inventory are to be 100% completed.

AEM frequency is determined by the hospital AEM program.

2. EC.02.04.03 [EP2] a. Note 2: Required activities and associated frequencies for maintaining, inspecting and testing of medical equipment must be completed in accordance with manufacturers’ recommendations with a 100% completion rate.

Above are a few tions showing examples of things changing in our industry. In many cases they drive standardization and improve quality. The question becomes, at what cost, which is not meant strictly in the financial sense.

DAVE FRANCOEUR is the Sodexo Clinical Technology Management Senior Director of Brand and Quality and has been in HTM for over 33 years.

This article is the first of 12 written by Sodexo associates as they share their perspectives, knowledge and passion for the industry

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Avoid technology hazards.

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EXPERT ADVICE

BY MANNY ROMAN

THE ROMAN REVIEW Problem, Opportunity or Challenge

S

omebody, somewhere, decided for the rest of us that we should never say the word “problem.” The word has such negative connotations that some managers actually get angry with anyone who uses that nasty word. We are required to substitute “opportunity” for the “P” word. Opportunity is supposed to reframe the situation into a positive, thus we are happy that the situation showed up.

This reframing can be a great thing. It allows people to maintain a positive attitude and drive toward a solution. The drive toward the solution is performed without regard for the cause of the “opportunity.” The focus is on driving ahead with a forward-looking attitude.

An opportunity is a great thing. We all love opportunities. They are everywhere. In business, these are the gold nuggets we look for in order to grow and prosper. They are to be taken advantage of with great delight. We even feel that we can create opportunities. Long live opportunities.

Problems are bad. They cause anxiety, frustration and high blood pressure.

They are to be avoided and prevented.

They are not to be discussed or even mentioned. They must be converted into an opportunity. Death to problems!

A true opportunity tends to have an easily discovered and visualized condition. It is as if, “There it is, let’s go for it.” We are truly happy when an opportunity shows up.

A problem will normally have a cause, and often it will be a hidden cause. Hiding a problem with the “opportunity” word may make people feel better for a while. Is anyone really happy when a problem shows up, even a

disguised one? Does anybody really believe that a problem is actually an opportunity in disguise? It may be, but only after analysis and due consideration.

I believe in calling a problem a problem. You see, if you insist on calling it an opportunity, you are going to be forward-looking to fi nd the good in it. This is not bad in itself as long as you are not deluding yourself and others in the process. Sure, problem sounds negative, however calling it what it is causes us to view it in reality. We then understand that there exits a cause.

Problems have causes.

Ascertaining the cause of a problem is a backwards process. We look back to see what happened not forward while ignoring the cause. If we defi ne the problem well, we will see the cause well.

We then can correct the cause as well as the problem. Thus preventing the re-emergence of the problem in the future. We are not treating only the symptoms. We are implementing a cure.

We fi x problems and take advantage of opportunities. My concern is that I see leaders refuse to see problems for what they are: caused by something.

That “something” needs to be addressed. The “If we don’t acknowledge it, it doesn’t exist,”

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attitude has never worked well.

Oh, you know what? Why not reframe it, not as an opportunity but as a “challenge.” Yeah, that is much more positive and not as disconcerting. A challenge implies that there may be some obstacles to overcome, however we can overcome them.

If I “challenged” you to a duel, you will focus on ensuring that you aim well, not on what caused me to present the challenge. Again, the cause may wind up ignored because we are looking forward, not backward.

So, in closing, do not fear the “P” word. It allows us to look for the cause and the solution. If you have a problem with anything I have said, turn it into an opportunity to define why. But don’t challenge me about it. It’s your problem not mine.

MARCH 2017

TECHNATION

63

BREAKROOM

TRIBUTE NEWS SERVICE

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64

TECHNATION

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BREAKROOM STAFF REPORTS

THE VAULT

D

o you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your chance to prove it! Check out “The Vault” photo. Tell us what this medical device is and earn bragging rights.

Each person who submits a correct answer will be entered to win a $25 Amazon gift card. To submit your answer, visit 1TechNation.com/vault-March-2017. Good luck!

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Indiana Biomedical Society

T

he Indiana Biomedical Society celebrated its 26th anniversary at its annual conference held at the Sheraton Indianapolis City Centre Hotel. The conference was well attended and featured the keynote address “Medical Device Cybersecurity: An Applied 10 Year Perspective to Achieve Safer Patient Environments” by Dr. Dale Nordenberg. The exhibit hall featured industry leaders showcasing their products and services. Voting for the IBS Board of Directors took place. Also, Chris King was recognized as the IBS Professional of the Year and Ken Reese was named the Lifetime Achievement winner.

1.

2.

3.

6.

4.

5.

7.

8.

1 Photo by Dave Meeker Bringing Technology to You LLC 2,3 Photos by Mark Waninger

1. Acoustic Imaging Solutions owners (from left to right) Brandon

Giger and Scott Jones along with Director of Operations Robert Broschart man the company’s booth at the 26th annual Indiana Biomedical Society conference. This was the first time the company has had a booth at an expo.1

2. MD Publishing Account Executive Chandin Kinkade is excited to

see a T-shirt from the MD Imaging Expo – the predecessor of the Imaging Conference and Expo.

3. The Indiana Biomedical Society Conference was the first stop on the 2017 TechNation Tour.

4. Chris King (right) shows his IBS Professional of the Year award to a colleague.2

5. Southeastern Biomedical founders (from left to right) Greg

Johnson and Boyd Campbell await attendees at their booth in the exhibit hall.

6. Dave Carlson from Pronk Technologies (left) and Gopher Medical’s Steve Ziegenhagen visit during the 2016 IBS Conference.

7. Attendees and exhibitors network in Indianapolis following the TechNation Tour cocktail party.

8. Dr. Dale Nordenberg with the Medical Device Innovation, Safety, & Security (MDISS) Consortium discuses safe digital infrastructures during his keynote. 3

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MARCH 2017

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BREAKROOM

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new resource where medical equipment professionals can find all the information needed to help them be more successful! The easy to navigate Bulletin Board gives you access to informative blogs, expos and events, continuing education opportunities, and a job board. Visit www.MedWrench.com/BulletinBoard to find out more about this resource.

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MARCH 2017

TECHNATION

69

INDEX

ALPHABETICAL INDEX A.M. Bickford ………………………

53

Global Medical Imaging ……………… 2

RSTI …………………………………

31

Ampronix, Inc.………………………

15

iMed Biomedical ……………………

27

RTI Electronics ……………………

50

BC Group International, Inc ……… BC

Injector Support and Service ………

61

Sodexo CTM ………………………

49

Biomedical Equipment Services Co. IBC

Interpower …………………………… 6

Southeastern Biomedical, Inc ……

55

Cadmet ……………………………

25

J2S Medical…………………………

33

Conquest Imaging …………………

11

KEI Med Parts ………………………

53

Southwestern Biomedical Electronics, Inc. ……………………… 7

Cool Pair Plus ………………………

50

Maull Biomedical Training …………

20

MedWrench ………………………

59

MinXRad ……………………………

47

Crothall Healthcare Technology Solutions ………………

45

ECRI Institute ………………………

62

Elite Biomedical Solutions …………

21

Engineering Services, KCS Inc ……

39

PRN/ Physician’s Resource Network ……………………………

FOBI ………………………………

61

Pronk Technologies, Inc. …………… 5

GE Healthcare………………………… 3

“I had a wonderful time. This was my first MD Expo experience and I hope to attend again. I really enjoyed the seminars and the chance to network.”

Katherine C., Biomedical Equipment Technician

Pacific Medical ……………………… 8

Rigel Medical, Seaward Group ……

27

Stephens International Recruiting Inc. 47 Summit Imaging ……………………… 4 Technical Prospects ………………

20

Tenacore ……………………………

66

Tri-Imaging Solutions ………………

57

USOC Bio-Medical Services ………

14

35

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April 9-11, 2017 Check out the Preshow Planner to learn more WWW.MDEXPOSHOW.COM/IRVINE

70

TECHNATION

MARCH 2017

WWW.1TECHNATION.COM

INDEX

SERVICE INDEX P

USOC Bio-Medical Services 855-888-USOC(8762) www.usocmedical.com

14

P P

P P P

Injector Support and Service 888-667-1062 • www.injectorsupport.com

61

P P

Maull Biomedical Training 440-724-7511 www.maullbiomedicaltraining.com

20

Contrast Media

Auction/Liquidation J2S Medical 844-342-5527 • www.j2smedical.com

Cadmet 800-543-7282 • www.cadmet.com

25

P

J2S Medical 844-342-5527 • www.j2smedical.com

33

P P

27

P P

47

P P

21

P P

FOBI 888-231-3624 • www.FOBI.us

61

P P

J2S Medical 844-DIAL-J2S(342-5527) • www. j2smedical.com

33

P P

USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com

14

P P

Ampronix, Inc. 800-400-7972 • www.ampronix.com

15

P P

31

P P P

BC Group International, Inc 314-638-3800 • www.BCGroupStore.com

BC

Crothall Healthcare Technology Solutions (800) 447-4476 • www.crothall.com

45

P P

PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com

iMed Biomedical 817-378-4613 • www.imedbiomedical.com

27

P

Hand Switches

Sodexo CTM 1-888-Sodexo7 • www.sodexousa.com

49

MinXRad 417-597-4702 • www.minxrad.com

Calibration

Infusion Pumps Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com

35

Infusion Therapy

Cardiology Southeastern Biomedical, Inc 828-396-6010 • www.sebiomedical.com

55

P P

Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com

7

P P

Cardiovascular Technical Prospects 877-604-6583 • www.technicalprospects.com

P

Endoscopy

33

Biomedical

Rigel Medical, Seaward Group 813-886-2775 www.seaward-groupusa.com

TRAINING

53

57

SERVICE

A.M. Bickford 800-795-3062 • www.ambickford.com

Tri-Imaging Solutions 855-401-4888 • www.triimaging.com

PARTS

Anesthesia

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

Mammography

20

Computed Tomography Injector Support and Service 888-667-1062 • www.injectorsupport.com

61

P

RSTI 800-229-7784 • www.rsti-training.com

KEI Med Parts 512-477-1500 • www.keimedparts.com

53

P P

Monitors/CRTs

RSTI 800-229-7784 • www.rsti-training.com

31

P P P

Ampronix, Inc. 800-400-7972 • www.ampronix.com

15

P P

RTI Electronics 800-222-7537 • www.rtigroup.com

50

Bio-Medical Equipment Services Co. 888-828-2637 • www.bmesco.com

IBC

P

Technical Prospects 877-604-6583 • www.technicalprospects.com

20

Tenacore Holdings, Inc 800-297-2241 • www.tenacore.com

66

P P

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

P P

MARCH 2017

TECHNATION

71

INDEX

53

MinXRad 417-597-4702 • www.minxrad.com

2

33

MedWrench 866-989-7057 • www.MedWrench.com

59

P P

27

P P

61

P P

15

P P

Bio-Medical Equipment Services Co. 888-828-2637 • www.bmesco.com

IBC

P

Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com

21

P P

J2S Medical 844-342-5527 • www.j2smedical.com

33

P P

Pacific Medical 800-449-5328 www.pacificmedicalsupply.com

8

PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com

27

P P

Southeastern Biomedical, Inc 828-396-6010 • www.sebiomedical.com

55

P P

Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com

7

P P

Tenacore Holdings, Inc 800-297-2241 • www.tenacore.com

66

P P

USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com

14

P P

MARCH 2017

P P

RSTI 800-229-7784 • www.rsti-training.com

31

P P P

Technical Prospects 877-604-6583 • www.technicalprospects.com

20

P P

Sodexo CTM 1-888-Sodexo7 • www.sodexousa.com

49

Stephens International Recruiting Inc. 870-431-5485 • www.bmets-usa.com/

47

39

P

A.M. Bickford 800-795-3062 • www.ambickford.com

53

P

FOBI 888-231-3624 • www.FOBI.us

61

P P

J2S Medical 844-342-5527 • www.j2smedical.com

33

Respiratory

P

31

Ampronix, Inc. 800-400-7972 • www.ampronix.com

TECHNATION

15

Engineering Services, KCS Inc 888-364-7782x11 • www.eng-services.com

P P

Patient Monitoring

72

Ampronix, Inc. 800-400-7972 • www.ampronix.com

Replacement Parts

PACS RSTI 800-229-7784 • www.rsti-training.com

P

Recruiting

Oxygen Blender FOBI 888-231-3624 • www.FOBI.us

6

Radilogy

OR Tables PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com

P P

Interpower 800-662-2290 • www.interpower.com

Online Resources J2S Medical 844-]342-5527 • www.j2smedical.com

47

Power Systems

P

Nuclear Medicine Global Medical Imaging 800-958-9986 • www.gmi3.com

TRAINING

KEI Med Parts 512-477-1500 • www.keimedparts.com

SERVICE

50

PARTS

Protable X-ray

P P

MRI Cool Pair Plus 800-861-5956 • www.coolpair.com

Company Info

AD PAGE

TRAINING

SERVICE

14

PARTS

USOC Bio-Medical Services 855-888-USOC(8762) www.usocmedical.com

AD PAGE

Company Info

Telemetry Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com

21

J2S Medical 844-342-5527 • www.j2smedical.com

33

Pacific Medical 800-449-5328 www.pacificmedicalsupply.com

8

P

Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com/

7

P P

Tenacore Holdings, Inc 800-297-2241 • www.tenacore.com

66

P P

USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com

14

P P

P P

Test Equipment A.M. Bickford 800-795-3062 • www.ambickford.com

53

WWW.1TECHNATION.COM

INDEX NETWORKING

5

Rigel Medical, Seaward Group 813-886-2775 • www.seaward-groupusa. com

35

RTI Electronics 800-222-7537 • www.rtigroup.com

50

Southeastern Biomedical, Inc 828-396-6010 • www.sebiomedical.com

55

EXHIBIT HALL

FUN

TRAINING

Pronk Technologies, Inc. 800-609-9802 • www.pronktech.com

SERVICE

BC

PARTS

BC Group International, Inc 314-638-3800 • www.BCGroupStore.com

AD PAGE

Company Info

EDUCATION

P P Irvine, California April 9-11, 2017

P P

Training ECRI Institute 1-610-825-6000 • www.ecri.org

62

RSTI 800-229-7784 • www.rsti-training.com

31

Technical Prospects 877-604-6583 • www.technicalprospects.com

20

Tri-Imaging Solutions 855-401-4888 • www.triimaging.com

57

P

Advancing the Biomedical/ HTM Professional

P

Tubes/Bulbs Cadmet 800-543-7282 • www.cadmet.com

25

P

Tri-Imaging Solutions 855-401-4888 • www.triimaging.com

57

P P

Ampronix, Inc. 800-400-7972 • www.ampronix.com

15

P P

Conquest Imaging 866-900-9404 • www.conquestimaging.com

11

P P P

Global Medical Imaging 800-958-9986 • www.gmi3.com

2

P P

J2S Medical 844-342-5527 • www.j2smedical.com

33

PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com

27

P P

Summit Imaging 866-586-3744 • www.mysummitimaging.com

4

P P P

Ultrasound

X-Ray

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Engineering Services, KCS Inc 888-364-7782x11 • www.eng-services.com

39

P

RSTI 800-229-7784 • www.rsti-training.com

31

P P P

RTI Electronics 800-222-7537 • www.rtigroup.com

50

Technical Prospects 877-604-6583 • www.technicalprospects.com

20

Tri-Imaging Solutions 855-401-4888 • www.triimaging.com

57

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

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P P P P P

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TECHNATION

73

BREAKROOM

PARTING SHOT

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74

TECHNATION

MARCH 2017

WWW.1TECHNATION.COM

WHY BUY AN ESU-2400?

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ESU-2400H

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HERE ARE A FEW REASONS YOU MIGHT NEED AN ESU-2400: The ONLY all-in-one analyzer validated to Covidien ForceTriadTM factory requirements and PM ± Meet the Spec: The ESU-2400’s DFA Measurement Technology makes it the only all-in- one device that meets the specifications for testing the Covidien ForceTriadTM • 1% Accuracy – Twice the accuracy of competitive devices • Crest Factor of 500 – 25 times the capability of competitive devices • Don’t take our word for it – See the ForceTriadTM Service Manual section 6-11 ± Save Time: Automated PM Procedure for the ForceTriadTM and Covidien Valleylab FT10 cuts time to perform the PM in half • Watch the video: esu.bcgroupintl.com ± Measurement Range up to 5500 mA needed to calibrate the ForceTriadTM ± Tissue Response testing available to measure and graph the current delivered during the tissue sealing process using the optional TRL-2420 ± Only Analyzer that can communicate with the DUT ± Uses factory stipulated Current Measurement Method

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± Measures pulsed mode ESU generator output ± Provides Duty Cycle and Pulse vs RMS measurements ± Upgradable to the ESU-2400H, future-proofing for next gen pulse generators

The BEST all-in-one ESU Analyzer in the world ± Generates PDF test reports - Saves to internal memory, flash drive or network drive ± Waveform graphing for debugging and output analysis - No Oscilloscope Required ± Remote control capability for display function and SCPI command protocol is standard ± 3 USB Ports allow for the connection of a barcode scanner, keyboard, mouse or storage device Any of the trademarks, service marks or similar rights that are mentioned, used or cited within are the property of their respective owners. Their use here does not imply endorsement or affiliation with any of the holders of any such rights.

Copyright © 2014 Covidien. All rights reserved. Reprinted with the permission of the Surgical Solutions business unit of Covidien. Copyright © 2014 Conmed. All rights reserved. Copyright © 2016 Olympus. All rights reserved.

Conmed System 5000TM

Olympus ESG-400TM (Plus numerous other models and manufacturers.)

Phone: 1-888-223-6763 Email: sales@bcgroupintl.com Website: www.bcgroupintl.com ISO 9001 & 13485 Certified ISO 17025 Accredited