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Accreditation and Clinical Engineering
Clinical engineers are professionals who support or advance patient care by applying engineering and management skills to health care technologies. They are best suited to design and support the interfaces between the equipment and patients, users, maintainers, and administrators. It is hard to justify the need for CEs when their roles can be performed by technicians and nonengineers. The survival of CEs in hospitals during the next decade depends primarily on their ability to support clinical information systems, and on secondarily on their ability to support the equipment/management interface for their administration. They must establish a demand for their services based on legal imperatives and standard of care.
This paper presents a technology assessment process based on systems engineering methodologies used in the aerospace and defense industries. Systems engineering, defined in the U.S. military manual for engineering management, is a logical sequence of activities and decisions transforming an operational need into a description of system performance parameters and a preferred system configuration. Like systems engineering, technology assessment is driven by a single, clear need. The objective of systems engineering is to design a new system configuration; technology assessment assesses existing technologies to address this need. A six-step technology assessment model based on systems engineering principles is presented, including: (1) needs assessment; (2) clinical feasibility analysis; (3) systems assessment; (4) approval; (5) implementation; and (6) follow-up/CQI.
Budgetary performance and responsibility have become as important to many clinical engineering departments as their technical performance. A spreadsheet software package operating on a personal computer is an ideal way to help prepare a budget and to track actual budget performance. The spreadsheet can also become an excellent means for communicating, and possibly justifying, the department's actual budget performance to administration.
This paper describes, in chronological order, the steps taken to install productivity measurements and controls within the Clinical Engineering Department of a large teaching hospital. Motivation for this project involved both preparation for going "for profit" and the need to resolve an over-budget condition of labor cost. The project steps included current hospital management reports, database adequacy, supervisors' time logs, computerized budget spread sheets, testing changes on a financial simulation model, developing labor task standards, and departmental labor performance reporting. The project yielded significant positive results for the department's performance versus budget and also led to growth in supervisory and management skills.