Findings:  The amount of diagnostic and therapeutic equipment was far greater than most hospitals of this size because of the large emergency services.  The existing Biomed department had long been ignored by previous Administrations and was operating according to guidelines and standards of the early 1980's.  The Biomed Department had 3 Biomedical Equipment Technicians (BMET's).  The emphasis for Biomed efforts was the accomplishment of electrical safety testing of cardiovascular devices (monitors, defibrillators, external pacemakers, etc.) on a 3 month inspection interval.  Record keeping for maintenance and preventive maintenance was an old style manual cardex system.  The BMET staff was resigned to their department and duties as "status quo."  Clinical personnel gave mixed reviews as to the level, quality, and quantity of support for the repair of  medical devices.  The majority of medical equipment was serviced by outside vendors as managed by various clinical departments.  There was no central record keeping for overall medical equipment support - the documentation was distributed by departments and did not have a consistent basis.

CE Work:  The first task was to create an accurate inventory list of all medical equipment.  This was accomplished by sorting the capital equipment list maintained by the accounting department and transferring the data into a spreadsheet.  The list was field verified and edited as required by directing hospital staff.  The computer list was used to generate medical equipment control files that were back-filled with data from the various departments into a  centralized system.  A review of the data was used to prioritize the equipment and redirect the preventive maintenance program using the BMET staff and outside agencies.  Before the next JCAHO inspection, the hospital had upgraded the records and could ensure that functional (not just electrical safety) preventive maintenance was accomplished according to relevant standards.  Once the JCAHO inspection had passed (and the hospital had been properly certified), a detailed set of recommendations was forwarded to Administration to improve the in-house Biomed program.

Outcome:  The hospital followed the report recommendations and hired a qualified clinical engineer who assumed management of the Biomed staff.  He then reorganized the department with additional BMET staff and modified outside service contracts that were centrally managed.  The Clinical Engineering program has subsequently provided greatly improved medical device support with large cost reductions to the hospital operating budget.

Relevance:  The hospital has today an excellent Clinical Engineering program that has proven cost effectiveness and is widely supported by Administration.  All relevant JCAHO medical technology standards are met.  Additional support for clinical staff education as well as Clinical Engineering support for new facility development has been very successful.  Other hospitals should take note.

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