MOUNT SINAI MEDICAL CENTER
CLINICAL ENGINEERING DEPARTMENT REVIEW
By Christopher Maloney
Abstract
A Clinical Engineering department is among the
most important support departments that a hospital can
have. Clinical Engineering is responsible for the
maintenance and repair of all medical support equipment
on a medical campus. They must use their training and
experience to be able to troubleshoot and solve almost any
problem with medical equipment that a medical staff may
encounter during the course of a day. Some of their other
responsibilities include building knowledge on the current
trends in medical equipment, as well as constantly training
to stay updated as equipment gets upgraded. All these
responsibilities can be summarized by saying that Clinical
Engineering is responsible for ensuring that medical
equipment is in good working order and helping the
hospital make important decisions on new equipment.
In order to get a detailed look at the operations of
the Clinical Engineering department at Mount Sinai
Medical Center, I was asked to perform a departmental
review. The purpose of this project was to develop a
thorough understanding of the processes of the Clinical
Engineering department to see that they are operating
effectively and if there is any room to improve. To learn
about the department, I spent six weeks shadowing
different employees to see what their different jobs were
and how they interacted with the other employees and
went about doing their jobs. The following is a detailed
report on what I was able to find during this six week
period.
Aramark
The responsibilities of the Clinical Engineering
department at Mount Sinai Medical Center are outsourced
to a company called Aramark. Aramark is a large,
international company, headquartered in Philadelphia, PA,
that provides professional services which include food
services, facilities management, and uniform apparel to
businesses around the world. ("About aramark,") These
services are provided to companies in nearly every
industry including public safety, entertainment, convention
centers, and healthcare.
The Aramark branch that Mount Sinai deals with
is the Clinical Technology Services branch. The office that
serves Mount Sinai is located in the Miami Heart Institute.
At Mount Sinai, they have two separate departments;
biomedical engineering and imaging. The biomedical
engineering department is located on the ninth floor of the
Blum building on Mount Sinai’s main campus. The
imaging department is located on the second floor of the
main building on Mount Sinai’s main campus.
Department Overview
The Clinical Engineering department at Mount
Sinai Medical Center is responsible for everything
involving medical equipment owned by the hospital. Their
two main tasks include preventive maintenance and broken
equipment repair, but their work extends beyond that.
Some of the other tasks that the Clinical Engineering
department is responsible for include new or alternative
equipment recommendations, new equipment inspections,
daily Operating Room rounds and hospital moves.
Service Calls
Service calls are the major responsibility of the
Clinical Engineering department is responsible for. Any
employee in the hospital can call the department when a
piece of medical equipment is not functioning properly and
expect that it will be fixed within a reasonable time period.
This function is especially important in the event that
equipment is not working before or during a surgical
procedure to ensure patient safety.
Preventive Maintenance
In order to prevent incidents, equipment failure,
and to meet Joint Commission standards, the Clinical
Engineering department performs preventive maintenance
on nearly all of the equipment that it is responsible for.
The first thing the employee performing the maintenance
always does is clean the equipment with alcohol wipes.
Then, they will perform tasks ranging from electrical
safety tests to checking the fluid levels of the machine. If
anything is found to be wrong with the machine during the
preventive maintenance inspection, it is fixed before the
machine can be used again.
New Equipment Recommendations
It is the job of the Clinical Engineering
department to stay up on current trends in medical
equipment nationwide so that when called upon for advice
in purchasing new equipment, they can provide sound
advice. It is also the job of the staff to evaluate the
condition of the current equipment as they perform
maintenance and make recommendations for new
equipment if the old equipment is obsolete or going to be
obsolete in the near future.
Incoming Equipment Inspections
When new equipment arrives at the hospital,
Clinical Engineering must be informed by the Shipping
and Receiving Department. Clinical Engineering then goes
to pick up the equipment and perform an incoming
inspection before releasing the equipment to the floor.
Incoming inspections usually consist of various safety tests
and giving the new equipment an asset number.
The final employee located in Miami Heart
Institute is a technician responsible for maintaining and
servicing all of the equipment at the Miami Heart campus,
as well as assisting the biomedical technicians at the
Mount Sinai campus. Due to the small amount of
equipment still located at Miami Heart, this technician
does spend about 10 hours every week assisting the
biomedical technicians at the Mount Sinai main campus.
Daily Rounds
Every morning around 7:30, one technician is
sent to make the daily rounds. This entails going to the
main Operating Room, the Ambulatory Center, Central
Services, and the Operating Room overflow area to make
sure that all of the equipment is working as well as it is
supposed to in order to make sure the cases can all flow
smoothly throughout the day. When the Clinical
Engineering department gets itself back to being fully
staffed, they plan on doing rounds on every floor at least
once during the week.
Mount Sinai Medical Center Biomed Department
The Biomed Department of Clinical Engineering
has gone through some major staffing changes. At the
moment, they are understaffed as they have lost some
employees to military obligations and relocations. When
fully staffed, the Biomed Department consists of seven
technicians. Of these seven technicians, one constantly
works on preventive maintenance and repairing equipment
in the shop. The rest of the technicians spend time doing
preventive maintenance as well as taking service calls.
Additionally, one technician every week is designated as
the on-call technician who must be available 24 hours a
day for that week in case some essential equipment
malfunctions during the night time or weekend hours.
Currently there are five technicians on staff.
Three of the technicians are rotating between working on
preventive maintenance and service calls. One technician
is working primarily on preventive maintenance and
repairs. One technician was recently hired and is doing
preventive maintenance as he learns his way around the
hospital. After he has become more familiar with where
everything in the hospital is located, his responsibilities
will grow to include taking service calls as well.
Hospital Moves
When a department moves within the hospital,
Clinical Engineering is called upon to move and set up any
medical equipment that is required in the new location.
They then monitor the equipment to make sure it is
functioning properly as the patients are moved to the new
location.
Other Tasks
Among the regular tasks listed above, Clinical
Engineering also is responsible for projects that come up
periodically. Some of the projects they worked on during
the observation period included replacing batteries in
monitors with newer models after the failure of some older
models, assisting vendors with possible recalls, and
teaching hospital employees how to use certain equipment
functions.
Staffing
Miami Heart Institute
At Miami Heart Institute, Aramark has 4
employees. The first employee is the supervisor in charge
of the Clinical Engineering operations at Mount Sinai. His
responsibilities are all business related and he
communicates with headquarters, his district manager, as
well as Mount Sinai executives. He has experience in the
biomedical field and has moved into a management role.
Also employed in the office at Miami Heart are
two clerical employees. These two employees are
responsible for directing phone calls, payroll, basic
accounting, printing work orders for preventive
maintenance, filing all work orders, and maintaining their
equipment database. They appear to be very busy at all
times and have very crucial jobs to the functionality of the
department.
Mount Sinai Medical Center Imaging Department
The Imaging Department of Clinical Engineering
consists of 2 employees. The first of these employees is a
supervisor. His responsibilities include hospital related
tasks such as maintaining equipment, managing service
contracts with outside vendors, coordinating service and
preventive maintenance with hospital department
supervisors, and making recommendations for new
equipment purchases. Additionally, the supervisor is
involved in two committees outside of Mount Sinai
Medical Center. The first is the Quality Standards
Committee and the other is the Imaging Sub Committee of
which he is the president. Both of these committees’ goals
are to improve the quality of service Aramark provides its
customers and to create standard practices in the imaging
departments nationwide.
The second employee in the imaging department
is more of a technician. His main job is to repair and
perform maintenance on equipment. He is also responsible
for helping outside service vendors when they come to the
hospital to repair equipment.
-2-
Staff Personalities
The members of the Clinical Engineering
department all seemed to interact well with hospital staff.
They all seemed to have a “patients come first” attitude
about everyday issues that they faced, and this attitude was
reinforced by the supervisors whenever necessary. The
technicians all seemed to have a sense of pride about their
work and would not put a piece of equipment out on the
floor unless they knew for a fact that it was going to be
functional.
Policies
Staffed Hours
The department is responsible for having
technicians in the hospital from 7:00 A.M. until 5:00 P.M.
Monday through Friday. In addition, they must have an
employee on call 24 hours a day to cover any non-regular
hours. The employees come in for work at different times
ranging from 7:00 A.M. to 9:00 A.M. to cover their time
window. They are expected to work eight hours a day with
a one hour break for lunch, although most of the time they
stay beyond the eight hours to make sure the equipment is
maintained on time.
Preventive Maintenance
All preventive maintenance work orders are
issued on the first day of a particular month. The
department goal for all preventive maintenance is to have
the work order completed within 30 days of being issued.
Life support equipment is required to be completed within
those 30 days. All other equipment must be completed
within 60 days.
The equipment in the hospital is all assigned a
priority for completion of preventive maintenance. All life
support equipment is listed as urgent. All other equipment
that requires regular preventive maintenance is listed as
regular. Anything that does not require regular preventive
maintenance is listed as deferred.
If a work order calls for maintenance on
equipment that is being used by a patient, they have to
decide whether to temporarily place them on a substitute of
that equipment or to come back at a later time when that
patient is moved to a different room. Many times, the
technicians consult with the nurses on the floor to make
this decision.
Service Calls
When a technician is paged by the office for a
service call, they must respond to that page within 10
minutes. From there, it is the department goal to physically
respond to the service call within 15 minutes of its receipt.
Priority for responding to service calls always goes to life
support equipment, but many times it is up to the
technician to decide which call is most important.
Unable to Locate Equipment
During the course of a month, the technicians
may receive work orders for equipment they cannot locate.
When this occurs, they are required to do a reasonable
amount of searching which includes spending the last few
days of the month looking for lost equipment. If they are
still not able to locate the equipment, they change the
status in their computer system to UTL and turn the work
order in to their supervisor. The supervisor then turns the
UTL work orders into the office and they make note of it,
stamp the work order, and return it to the supervisor. He is
responsible for keeping it for 120 past the original due date
before the equipment goes on the official UTL list.
Many times a piece of equipment is found after
being placed on the UTL list. If this is the case, they
perform the required maintenance and complete the work
order. If a piece of equipment has been put on the UTL list
twice, it is no longer tracked by clinical engineering.
Work Orders
There are three possible ways for a technician to
accumulate work orders. These include preventive
maintenance cycles, service calls, or miscellaneous jobs
given by the supervisor. Technicians are expected to fill
out and update these work orders with accurate
information within a reasonable time of doing work on the
equipment. Technicians must be able to account for at least
36 of the 40 hours they work during the week in the work
orders.
Software
In order to track and maintain information about
all of the equipment that they are responsible for, the
Clinical Engineering department uses software called
ISISpro. ISISpro was developed by Aramark with the
purpose of tracking medical equipment and providing
useful equipment histories, labor tracking, purchasing
information, and reports. ("Aramark healthcare: fact,")
The most common uses of the software for
Clinical Engineering were for work orders. Work orders
were printed at the beginning of the month for all
equipment that needed preventive maintenance and
throughout the month for all equipment that was serviced.
Whenever there was a change in the status of the
equipment, a new part purchased, or a new problem found
in repairing the equipment, the technicians updated ISIS.
When the work was completed on a work order, the
technician would go into ISIS to complete the work order
and provide as much detail as possible to what the problem
was with the equipment, any issues faced, and how the
problem was resolved. Other relevant information included
when completing the work order was the name of the
technician that serviced the machine, the date and time of
the service, and any parts purchased.
The other most useful feature of ISIS was its
extensive reporting ability. The system has a large number
-3-
of pre-written reports that the users can open and run
quickly. Users also have the ability to create their own
reports based on any fields tracked in the system. The most
common reports run by ISIS list the equipment that is due
for preventive maintenance and the current UTL list. Any
of the information contained in an ISIS report can also be
sent to Microsoft Excel which can be useful in
communicating with people outside of the department.
Overall, ISIS is very complete software that has
very few limitations. It is very user friendly which is
crucial in a shop of technicians that are not always great
with computers and also limits the time needed to train
new employees in it.
Overall Preventive Maintenance Process
This flow chart describes the preventive maintenance
process from the very beginning of the month when the
preventive maintenance work order is printed out to the
filing of a completed preventive maintenance work order.
It looks into the process department by department to show
how the information flows.
Procedures
The following flow charts represent the everyday
processes performed by the Clinical Engineering
technicians:
Overall Service Call Process
This flow chart describes the service call process from the
call to the office to the filing of the completed work order.
It gives a look at what each department does and how the
information flows from one department to the next.
Technician Service Call Process
This flow chart describes in greater detail the service call
process from the technician’s point of view. It is
supplemental to the Overall Service Call Process flow
chart.
Technician Preventive Maintenance Process
This flow chart describes in greater detail the preventive
maintenance process from the technician’s point of view. It
is supplemental information to the Overall Preventive
Maintenance Process flow chart.
Work Sampling
In order to get a better understanding of where the
majority of the technicians’ time was being spent, a work
sampling was performed. Because of the nature of the
biomedical technician job and the large territory that they
cover on any particular day, the work sampling was
performed by following one non-service call technician
around for a day and making an observation about their
activities every five minutes. After three weeks 853
observations were made, thus giving a pretty sound
statistic into what a technicians’ time is used for. The
following categories were used to describe the
observations:
-4-
Productive Walking
Productive walking occurs when the technician is walking
to perform work and they have a definite knowledge of
where they are headed. Examples of productive walking
would be going to pick up a package from shipping and
receiving, walking to the Operating Room to talk with one
of the supervisors, or returning equipment to the floor after
it has been repaired in the shop.
Value Added: Yes
Locating Equipment
Very often towards the end of the month, a technician has
a group of work orders that they cannot find the equipment
that requires maintenance. In order to locate equipment,
technicians usually have to go from floor to floor and
department to department to try and locate the equipment.
They must make their best attempt to find it somewhere in
the hospital before it gets added to the Unable to Locate
list.
Value Added: No
Responding to Page
When a technician gets paged from the Clinical
Engineering office, they are often informed about a
problem that they need to address. Anytime the technician
was on the phone finding out this information from the
office it was classified as responding to page.
Value Added: No
Maintaining Equipment
Maintaining Equipment is the category used to describe
any time a technician physically had their hands on a
machine to work on it. Maintaining equipment could apply
to preventive maintenance, repairs, inspections, or setting
up equipment.
Value Added: Yes
Personal Break
This category was used anytime the employee was using
the restroom or if they had any downtime.
Value Added: No
Filling out Work Orders
When a technician is finished working on a piece of
equipment, the work order must be updated. This applies
to regular preventive maintenance as well as unexpected
repairs. Filling out work orders involves the physical
action of filling out work orders as well as writing down
the essential information for a work order that they may
not have access to at the time.
Value Added: Yes
Helping Other Technicians
Many times a technician would come across a problem that
they needed some assistance in solving. This could be
because they needed someone else’s perspective on the
problem or because they just did not have the experience
on a certain machine to know what the problem was. In
this case, the other technicians were very helpful and
provided assistance in any way they could.
Value Added: Yes/No
Typing Work Orders/P.O.’s
When a technician is looking up a work order, checking on
the status of a work order, completing a work order, or
writing a purchase order it goes in this category.
Technicians spend a large part of their day on the
computer filling out paperwork for changes in a piece of
equipment’s status, updating ISIS, and writing purchase
orders.
Value Added: Yes
Waiting
Whenever the technician had to briefly wait on someone to
do something, it was put in this category.
Value Added: No
Productive Talking
Productive talking occurs any time the technician is
speaking with another person about job related issues.
Some examples of this would be talking to their
supervisor, discussing how to fix a piece of equipment
with another technician, instructing an outside vendor on
where to find equipment, and updating floor supervisors
about work done on their equipment.
Value Added: Yes/No
Unproductive Talking
Unproductive talking occurs when the technician is talking
with someone else about non work related issues.
Value Added: No
Looking up Equipment History
If there was a discrepancy between paperwork or if there
was a question about the last time a piece of equipment
was repaired, the tech either looked up the equipment
history themselves or called the office to have them look it
up.
Value Added: No
Checking Email
The technicians usually checked their email first thing in
the morning and very rarely accessed it again during the
day.
Value Added: Yes/No
Unproductive Phone Call
This category was used for any non work related phone
conversation.
Value Added: No
-5-
Accessing Equipment
On rare occasions the technicians had to empty out closets
or move other equipment to access something that needed
maintenance.
Value Added: No
Observation Sheet
A sheet with the following format was used to record
observations of the technicians’ activities in a day.
Activities
1
2
3
4
5
6
7
8
9
10
Productive Walking
Productive Phone Call
A productive phone call occurred when the technicians
were either giving or receiving important work related
information. It is different from “Responding to Page” in
that a productive phone call was not a request to go to a
certain floor to perform service. Some examples of
productive phone calls included calling a vendor to
schedule maintenance, calling a company about billing
questions, and calling a floor supervisor to update them on
the status of their equipment.
Value Added: Yes/No
Locating equipment
Filling out Work Order Info
Typing Work Orders
Productive Talking
Unproductive Talking
Responding to Page
Maintaining Equipment
Personal Break
Helping Other Techs
Waiting
Looking up equipment history
Checking email
Unproductive phone call
Accessing equipment
Productive Phone
Picking up Broken Equipment
Whenever a technician had to take a piece of equipment
back to the shop for repair it went in this category.
Value Added: Yes
Ordering Parts
This category covered everything involved with ordering
parts from physically talking on the phone with the vendor
to looking up a part online.
Value Added: Yes
Picking up Broken Equipment
Ordering Parts
Other Productive
Locating Parts in Shop
*Observations Made Every 5 Minutes
Notes:
Results
The following are the results of the work sampling:
Results
Other Productive
Any work related tasks not covered by one of the other
categories went here.
Value Added: Yes/No
Locating Parts in Shop
Sometimes the technician had to try and find a part to fix a
piece of equipment or find a misplaced piece of
equipment. Anytime they had to locate a part or equipment
before using it, it went in this category.
Value Added: No
Observations
% of Time
Productive Walking
98
11%
Locating equipment
41
5%
Filling out Work Order Info
12
1%
Typing Work Orders/P.O.'s
100
12%
Productive Talking
83
10%
Unproductive Talking
7
1%
Responding to Page
24
3%
Maintaining Equipment
247
29%
Personal Break
4
0%
Helping Other Techs
23
3%
Waiting
10
1%
Looking up equipment history
7
1%
Checking email
19
2%
Unproductive phone call
2
0%
Accessing equipment
1
0%
Productive Phone
39
5%
Picking up Broken Equipment
11
1%
Ordering Parts
29
3%
Other Productive
86
10%
Locating Parts in Shop
10
1%
Total Observations
853
-6-
Percent of Time Spent on Activities
real sense of pride about their job and putting the patients’
needs first.
Productive
Talking
10%
Locating
equipment
5%
PM Analysis
Maintaining
Equipment
28%
Productive
Walking
11%
Productive Phone
5%
Typing Work
Orders/P.O.'s
12%
Unproductive
Activity
2%
Other Productive
27%
Analysis of Results
Looking at the results, there are a few activities
that have different percentages than expected. Maintaining
equipment is surprisingly low at 28% since the purpose of
the Clinical Engineering department is to keep the
equipment maintained. However, productive walking,
typing work orders and purchase orders, and productive
talking are surprisingly high.
Unfortunately during observations, it did not
seem as though any of these areas have any real potential
for improvement. Productive walking is always going to be
a large portion of the employees’ time in a medical center
the size of Mount Sinai. Since the department is located on
the ninth floor which can only be accessed by one elevator
that is also used for a large amount of patient
transportation, most trips take the employee a minimum of
five minutes of travel time. Typing work orders and
purchase orders seems especially high as well, but there is
no real way to decrease the amount of paperwork that has
to be done. Almost all of the paperwork the technicians do
is required by the Joint Commission and must be
completed for the department to remain compliant.
Productive talking will always be a large portion of time as
well since the technicians must update their supervisor,
floor supervisors, technicians, and outside service vendors
on changes in equipment status as well as get updates on
what work needs to be performed on equipment.
The encouraging statistic that came from this
work sampling is the small percentage of time spent on
unproductive activities. The hospital can feel confident
that the technicians were working hard at all times to get
the equipment functioning properly in the fastest way
possible. Another encouraging observation was that if a
technician happened to come across a piece of equipment
that was being used, but did not look right, they stopped
what they were doing and fixed it on the spot. The staff of
the Clinical Engineering department did seem to have a
The following information came from a report run
in ISIS. This information shows the number of preventive
maintenance work orders by status and priority from
January 1, 2009 through December 31, 2009. A cancelled
work order occurs after a piece of equipment is on its
second UTL or the department does not want the
equipment anymore. Remove from service is the work
order issued to remove the equipment from the active
assets in the system.
The numbers show that the department is very
reliable when it comes to finishing their work orders on
time. Only two percent of the routine work orders were
completed after their due dates. This is most likely caused
by the technicians not being able to locate a piece of
equipment until after its due date. The rest of the
equipment however was completed exactly on time.
Cancelled
Urgent
Routine
Deferred
Completed
Urgent
Completed w/in 24 hours
Completed w/in 30 days
Routine
Completed w/in 5-8 hours
Completed w/in 24 hours
Completed w/in 30 days
Completed w/in 60 days
Completed w/in 90 days
Completion time exceeds 90 days
Deferred
Completed w/in
No specified priority
Completed w/in
Completed w/in
Completed w/in
Completed w/in
Completed w/in
Remove From Service
Routine
Unable to Locate
Routine
No specified priority
30 days
2 hours
2-4 hours
5-8 hours
24 hours
30 days
Total
Year
539
28
507
4
4177
309
4
305
3753
12
24
3632
18
12
57
8
8
105
50
1
5
40
9
49
49
83
82
1
Percentage
11%
1%
10%
0%
86%
6%
0%
6%
77%
0%
0%
75%
0%
0%
1%
0%
0%
2%
1%
0%
0%
1%
0%
1%
1%
2%
2%
0%
4848
Completed On Time
Urgent
100%
Routine
98%
Deferred
100%
Not Specified
100%
Challenges Faced
Locating Equipment
The biggest challenge by far for the Clinical
Engineering department in meeting their goal is locating
equipment on the hospital floors. All equipment tracked by
the department has its assigned location stored in their
computer system, however many times the equipment
moves and the department is not notified. When the time
comes to perform preventive maintenance on this
-7-
equipment, the technician has to spend time at the end of
the month walking from floor to floor in the hospital
checking in every room trying to locate the equipment.
They must give their best possible effort to find the
equipment to make sure it does not get used without first
getting its preventive maintenance done. Locating the
equipment can waste a whole day of a technician’s time
that could be spent working on other equipment.
Equipment Abuse
Much of the time, especially in the Imaging
Department of Clinical Engineering, the repairs that are
needed on equipment are caused by abuse. This abuse is
not intentional, but people sometimes get careless with the
equipment and damages arise out of their carelessness.
Shown below are two pictures that display
examples of equipment misuse provided by the Imaging
department supervisor. Picture 1 shows an OEC Uroview
2600 table underside that was damaged when a table with
a patient on it was lowered onto another piece of
equipment
during
a
procedure,
thus
creating a
large dent
in
the
metal.
Picture 2 is
an example
of
an
ultrasound
probe that
was forced
into
its
system with
Picture 1
the
locks
closed
instead of
open. Five
probes
were found
in
this
condition
with three
of
them
resulting in
a $300 cost
to
the
hospital
Picture 2
each. The
other
two
have not yet been replaced or repaired because the cost
was estimated to be around $4,500 each. Simple moments
of carelessness can have a huge impact on the cost of
equipment maintenance for the hospital as it can take a
long time for the Clinical Engineering staff to fix the
machinery as well as cost a large amount of money for
new parts.
Staffing
As previously mentioned the staffing issues
Clinical Engineering has faced have been a difficult
challenge to overcome. The constant fluctuation of
employee numbers as well as having to familiarize new
employees with their new setting not only creates stress on
the employees, but makes it harder for them to work on the
equipment in need of repair.
Recommendations
Improve Equipment Tracking
The biggest challenge that the Clinical
Engineering department consistently faces in performing
their job is finding equipment. Many times there is
equipment that is given out by Central Services that could
be located anywhere in the hospital and it is constantly
moving. When a technician has to try and locate that piece
of equipment, they have to repeatedly check rooms
because of the possibility that it got reassigned since the
last time they looked for it. When technicians cannot
locate equipment, it creates problems in that the equipment
does not get serviced on time or it is not able to be found at
all. Equipment that is not serviced on time will most likely
still be used by hospital employees and is a liability to the
hospital if something were to happen to a patient after use.
The ideal situation would be if the individual
floors had a method of tracking the rooms that their larger
equipment is assigned to and where their smaller
equipment is stored. This way Clinical Engineering could
have a window on their computer system that allowed
them to look up a piece of equipment and find out which
room it was in. However, this solution is not only very
expensive, but it would also be hard to maintain. The
nursing staff is already very busy helping patients and this
additional tracking would most likely not happen.
Instead, the most feasible method for improving
equipment tracking would be just to focus on the current
system Central Services uses to track their equipment.
Clinical Engineering could be provided a window into the
Central Services system that would allow them to see what
room a particular piece of equipment is located in. The
only thing that they would need to provide is a serial
number and Aramark identification number for all of the
equipment distributed by Central Services which could
easily be provided through ISIS. Due to the limited amount
of equipment distributed by Central Services, making this
change would not make a dramatic change in the amount
of equipment on the UTL list or the amount of time spent
locating equipment, but it would help. This change would
be relatively simple and would not involve any extra work
by Central Services.
-8-
Eventually the system could be expanded to
include all of the equipment in the hospital. Currently
Ricardo Abella from Project Management and Duran
Whilhite from Purchasing are working on setting up a
database with a listing of all of the equipment the hospital
owns, and what floor it is located on. If this database
remains updated when equipment moves from floor to
floor, giving Clinical Engineering a window to view this
information would once again be helpful to at least narrow
down the search area for an individual piece of equipment.
Once again, all that Clinical Engineering would need to do
is provide a spreadsheet with the Aramark identification
number and the serial number and the database would
update itself. Then when they needed to locate a piece of
equipment, they would type in the I.D. number and be able
to see what floor the equipment is assigned to. A database
that requires the floors to update equipment moves would
be far more reliable making Clinical Engineering track the
location because currently, the floors rarely communicate
with Clinical Engineering when equipment moves. Instead,
that information is updated whenever a work order is
issued for a machine and the technician finds it in a
different location than is listed.
Locating equipment is always going to be an
issue faced by any Clinical Engineering department, but
providing them with as much information as possible
about the location will help improve their reliability.
Improved reliability means improved patient safety by
preventing the use of out-of-date equipment.
More Detailed Work Order Status Information
It would be helpful for going back and looking at
the response times to service calls if the technicians were
more detailed in reporting the times on a work order.
Currently the times that are recorded are the time a
technician opens a work order, the times when the
technician updates the status of the work order, and the
time the technician closes the work order. Ideally, the time
a call came in, the time the technician responded to the
caller, and the time the equipment was fixed would be
tracked in order to build statistics about response times.
This would give the department a better idea of whether
they are reaching their goals or not. This added detail
would be very helpful and be a limited amount of
additional work.
Establish a Capital Expense Committee
One idea that the Imaging department supervisor
repeatedly brought up during my time with him was the
idea of having a Capital Expense Committee. This
committee would consist of employees from multiple
departments and would be responsible for making
decisions on the higher priced medical equipment. Having
people from the different departments would be beneficial
because it would provide one meeting place for people
with different expertise’s to discuss a purchase that is a
major expense to the hospital. Insight from the different
employees could prove to be very valuable because new
ideas that wouldn’t normally be thought about could come
up. Having large equipment purchases go through a
Capital Expense Committee seems like a logical step so
the hospital gets the equipment it actually needs and gets
the most out of the money spent.
Conclusion
Overall, it appears that the Clinical Engineering
department at Mount Sinai Medical Center is very reliable
in their work and open to any possible changes for the
better. After reviewing the department for six weeks and
getting an in depth look at their operations, I feel that the
only significant improvements that can be made are in
improving the equipment tracking in the hospital, getting
more detailed status information on work orders, and the
creation of a Capital Expense Committee. Other than these
three recommendations, it seems that the department is
very thorough in their work and should continue to operate
with their current methods.
Acknowledgements
Special thanks to Ben Davis and Angel Palin for
giving me an opportunity to work and Mount Sinai and
gain valuable experience. Thanks to Tamara Ali and Perry
Fontanilla for providing assistance and guidance on the
project. Thanks to Dr. Nina Miville for helping set up my
internship opportunity and providing invaluable guidance
to the University of Miami chapter of the Institute of
Industrial Engineers.
References
1) About aramark. (n.d.). Retrieved from
http://www.aramark.com/aboutaramark/
2) Aramark healthcare: fact sheets. (n.d.). Retrieved
from
http://www.aramarkhealthcare.com/UtilityDetail.
aspx?PostingID=705&ChannelID=343
About the Author
Christopher Maloney is a senior in Industrial
Engineering at the University of Miami who will be
pursuing a graduate degree starting in January of 2011. He
is currently involved as the webmaster with the University
of Miami chapter of Institute of Industrial Engineers and as
the treasurer for the National Society of Black Engineers.
This paper was written during his time as a Hospital
Administrative Fellow intern at Mount Sinai Medical
Center in Miami Beach, FL as a project to review the
activities of the Clinical Engineering Department. In
addition to Mount Sinai, he did an internship with Dueco,
Inc. in Waukesha, WI.
-9-