Salim Kai: Be a Partner in Patient Safety

The evolving science of patient safety in today’s hospitals and other healthcare facilities is about protecting patients from injury and death while they are being treated for illnesses or other conditions. Over the past two decades, patient safety has gained quite a bit of attention, recognized worldwide with new strategies and recommendations being outlined all the time.

Why is this important you may ask? How does patient safety relate to the healthcare technology management (HTM) professional? Today, patient safety practices are a “must have” in every hospital that wants to sustain its mission, vision, and values. Specific to the HTM professional, patient safety is about learning a new field and new language. We must keep up with the ever-changing world of healthcare delivery and team up with the clinicians. Getting involved and providing what we do best gives us visibility. Our voice becomes part of the team solution and organizational goals, and this participation bolsters us as individual professionals and the field we are so proud of.

We are learning new terms that may not have been part of our educational curriculum: adverse event, safety huddle, root-cause analysis, failure-mode effect analysis, plan-do check-act, and continuous quality improvement are just a few examples.

Back in the ‘70s, ‘80s, and ‘90s, the biomed tech would fix a piece of equipment or take care of PM, often in the shop, and then return the equipment to clinical use.

Today, patient safety improvements are taking place at the bedside, in the clinical care areas, and not at the bench. This is where we need to be. HTM professionals are proud to roll their sleeves up and help. We know that the job will get done better when we are involved.

Today, we do a lot more than fix the equipment. We are being asked to serve on numerous committees, interdisciplinary in nature with varied stakeholders. For example, it is not unusual to see representatives from IT, nursing, risk management, quality, capital purchasing, plant engineering, and others serving on the same committee to tackle challenges and overcome barriers. We are the technology management assessment experts!

Technology’s use in the hospital is part of an ecosystem. It cannot be managed well if separated from its system. We have to understand how it is being used, how it connects to a patient, and where the risks are when using it. We do not exist in a vacuum, as we are part of the healthcare team.

More and more, we are seeing equipment being connected to hospital networks, and we are being asked to weigh in with technical recommendations that directly affect patient care or the organization. The focus of the discussion could include any of the following: looking for ways to save on costs, attempting to mitigate risk elements in a particular technology use, sharing information to standardize processes, purchasing decisions, or launching a new technology.

Hospitals will continue to look for technology solutions to find efficiencies, save on costs by eliminating waste, and reduce unnecessary steps—all in the name of improving the safety, quality, and reliability of care to patients. A good example of a technology solution is the smart infusion pumps that seek to minimize medication infusion errors. HTM professionals are playing a key role in their implementation and use. Hospitals continue to encourage staff to report events that could compromise safety, monitor equipment recalls, ensure that the corrective remediation is completed, and request and analyze data related to equipment failures.

It takes time to build a safety culture. This fact necessitates a willingness to learn new things. We have to be flexible, solution-oriented individuals who accept change. We have to be part of the patient safety movement at our hospitals. We have to raise awareness about its importance and incorporate it in our daily activities. It is no longer enough to know and master our roles in managing technology; we have to understand the roles of other members on our team. To succeed, we have to partner with clinicians.

One of the ways to do this is to serve on quality improvement committees. For example, we could be part of a daily safety huddles to update staff on ongoing equipment issues that could affect patient admissions or transfers. We could talk about items such as the following:

  1. We have the needed staff to provide adequate technical support, or we don’t have enough staff since one person called in sick, but we are able to cover.
  2. During our morning rounds, we continue to find infusion pumps that are not plugged in. Please inform staff to continue to plug in infusion pumps.
  3. Missing equipment. Broken equipment. Shortage of equipment. Environmental issues such as “room too warm,” plumbing issues, telemetry out for repair, beds are being repaired, blanket warmer not working, a mattress with bed bugs while doing PMs, and so on.

Another way we can promote a culture of safety is by setting an annual goal to improve on equipment issues and report back to hospital leadership with clear metrics. What could we track?

  1. Safety notifications and recalls, as well as our process for communicating such information to staff, and how we handle field corrective actions and/or modifications.
  2. Patient falls or patients at risk of falls. Are they related to equipment or nurse call/communication?
  3. Infection control. Are infection prevention professionals concerned about issues with reprocessing of equipment? Have there been reports related to a higher rate of a particular strain of infection involving equipment?

Another way to promote safety and show leadership is for HTM to a policy and procedures that standardize how technology is being acquired. Is HTM included in the planning phase? Our involvement would promote safer and smarter technologies.

We can also help our organizations on the cybersecurity front. Catalog all network parameters for all network-enabled equipment. Team up with the IT team at your hospital to plan on how best to mitigate the risks of cybersecurity.

Patient safety is evolving every day, and we need to be an active and engaged partner in the movement. Take action and participate. Get to know other team members at your hospital.  Ask questions, improve on your communication skills, and look for answers based on evidence. Make recommendations to improve how equipment and technology is being utilized. Become an HTM patient safety champion!

Salim Kai, MSPSL, CBET, is the biomedical engineering manager with Kettering Health Network in Kettering, OH.

14 thoughts on “Salim Kai: Be a Partner in Patient Safety

  1. Bravo for calling out the need to catalog all of your equipment’s networking parameters. Taking this a couple steps further, also ask your IT peers how they would prefer your gear connects to the network; what’s missing that would help secure, identify or assure its performance. Then ask the OEMs that build the devices to provide these capabilities.

  2. Good call out to begin including networking parameters as part of asset management procedures. In addition, ask you networking and InfoSec peers what they wished equipment would do to securely, safely attach to the network. Then roll those into requests to OEMs who make the gear.

  3. Vincent and Amalberti have a new book on this topic that goes well beyond anything I read before and well beyond the ideas in this blog. It is a free download. Search on “Vincent and Amalberti Safer Healthcare; Strategies for the Real World.” I reviewed the book for Frontiers, The review is also a free download. Search on “Lintern Frontiers Book Review: Safer Healthcare; Strategies for the Real World.”

  4. I have read quite a few AAMIBlog posts over the years. For me, this is one of the best I have read. It hits all the right points. It sums up what today’s BMETs and CEs should be doing in real life. Work ethic, safety, people, and technology: it’s all connected. Great way to put it writing, Salim.

  5. With respect to recalls, one issue in the medical equipment domain which needs rethinking is the process of how we circulated these in organizations – especially to nurses and support staff. They tend to be treated like consumable and accessory recalls. Once they have been processed the documentation it is filed, never to be seen again. However, many equipment recalls are directed at users and use: hoists, theater tables, and beds regularly have recalls released which should be available for the duration of those devices’ functional lives.

    Under-reporting by users is well documented. At the same time, there tends to be a lack of transparency within the recall process. Nurses entering the industry have grown up in a tech heavy world, but when it comes to medical equipment we are not really much closer to working with them. In the BI&T March/ April 2004 magazine, there was an article published by a nurse: “The Collaboration of Clinical Engineering and Nursing.” It’s worth a read.

    • George,
      Yes, great points you raise regarding the management of recalls. It can definitely be improved. For a start, there should be a policy outlining how recalls are managed by the organization along with who does what (all the involved departments’ roles and duties to close the loop every time). It is a team approach where all need to contribute to keep patients safe and equipment up to date, as well as good documentation, auditing, communication, coordination, etc …
      I appreciate the thoughtful reply.

  6. Nice job, Salim, characterizing how far beyond break-fix we have moved, but I encourage employers not to expect many of these skills from graduates of associate degree programs. I believe these are baccalaureate-level skills. Barb C

    • Barb,

      Many of the skillsets required to achieve what is mentioned here can be learned on the job and with the right coach and mentor. Also, the culture of the organization is key and how well they value the HTM workforce.
      Thanks for the feedback.

  7. Salim,

    I loved this post as I am a firm believer that we in the HTM community have a strong voice in patient safety issues. We need a seat at the table of these multi-disciplinary committees and more than that we need our voices heard. We are very integral persons in the healthcare chain, and we need to stand up and be willing to help with these complex issues of Patient Safety and IC.

    Great job, Salim.

    • darmstr, Thanks. I appreciate the reply and agreed. We should engage others, like-minded professionals who are willing to partner with us to show the value we bring to the organization.

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