Jim Piepenbrink: How Do You Handle Tough Healthcare Technology Challenges?

At the AAMI Annual Conference & Expo last month, I was very fortunate to participate in a workshop on alarm management that was presented by the AAMI Foundation and the Healthcare Technology Foundation. At the beginning of the workshop, all of the AAMI Foundation’s patient safety initiatives were profiled. A new one is set to begin later this year to develop methods to improve the training of clinicians on complex medical systems.

In listening to the presenters discuss their excellent work on alarm management, it occurred to me that we are talking about a complex “system” challenge, one that requires structure, further discussion, and research so that a best practice model might be created.

Patient monitoring systems are indeed a complex system, even more so when you add middleware solutions. Managing change requires a baseline understanding of the ecosystem for the staff so that subsequent changes and processes can be disseminated and evaluated in a way that ties the present state to the future state. These changes, seemingly simple on paper, directly impact staff workflow. We have a responsibility to arm staffers with the knowledge as to what the cause and effect will do for them (opposed to “to” them) and the patient environment.

Toward that end, I have prepared a series of questions that I ask that you to complete and return to me at jim.piepenbrink@bmc.org. Your answers will help create a baseline for discussions about how we can do things better.

  1. What are the typical methods your organization uses for training staff on the use of medical technology or systems? They could be methods such as classroom lessons, learning lab/simulation, and virtual training.
  2. If you have instituted an alarm management program, did you leverage the above learning methods or handle this in a different way? If you used a different method, why? What did you learn from it? Would it change how you handle the item cited in the first question?
  3. How involved are you and your HTM department in training clinicians to use physiological monitors and middleware?”

My hope is to identify common themes of what works well, what doesn’t, and seek further input from those who have succeeded so that we all can learn.

The National Coalition for Alarm Management Safety is doing great work. It has a growing list of resources geared to managing defaults and improving the management of change. It seems natural that we look for examples of excellence to better manage the utilization of technology.

Jim Piepenbrink is director of clinical engineering at Boston Medical Center in Boston, MA.

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