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David and Jahnke: Planning Medical Technology Management in a Hospital

multidisciplinary team has a similar approach toward • the lack of integration of technology forecasting into
the creation of definition of needs, scope and objectives the strategic planning of the hospital
for a specific type of technology, such as the equipment. • limited opportunities for interdisciplinary exchange
between engineering-related and clinically-related
The question is no longer whether a medical technology
professionals
management plan is worth the effort, but rather can we
afford not to implement it, and do we have the adequate To address these issues a technology assessment plan
tools to execute it? If we do then the hospital will be able was initiated with the following six objectives: (1) Accu-
to make informed decisions regarding deployment of new mulate pertinent information regarding decisions about
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technology as well as monitor its utilization. medical equipment. (2) Develop a multi-year plan for
The need for clinical engineering involvement in such a technology replacement and associated costs. (3) Com-
team became evident when the following problems were municate replacement selection criteria that is supported
repeatedly encountered: by users. (4) Create an ongoing assessment methodology
with outcomes measurements. (5) Improve the capital
• recently purchased equipment not sufficiently used
budget process by integrating the status of current tech-
• ongoing user problems with equipment
nology with long-term needs relative to surgical-medical
• excessive downtime and ownership cost services goals. (6) Integrate the competency of clinical
• lack of compliance with accreditation agencies and engineering into patient safety goals.
regulations Because the program provides for both the management
• high percentage of equipment failing and awaiting of the existing inventory of medical equipment aiming at
repair the lowest reasonable life-cycle cost, and for the recom-
mendations relating to procurement, it is mandatory to
• maintenance costs emerging as a large single expense
integrate trended operational and utilization information
• medical equipment upgrading, replacement, and with the projected budget strategy into the technology
planning are not intertwined
management plan.
• use errors and near-miss events
At the Texas Children’s Hospital, the Biomedical En-
A further analysis of these symptoms using a system gineering Department has been accumulating pertinent
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performance analysis technique would likely reveal. : information and has developed indicators for measuring
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• a lack of a central clearing house to collect, index and medical equipment performance. A Medical Technology
monitor medical technology performance for resolv- Evaluation Committee (MTEC), which is chaired by the
ing current issues and for future planning purposes Director of Biomedical Engineering, began developing
analytical selection criteria and life-cycle costs information.
• the absence of strategy for identifying emerging
The membership of the committee includes representa-
technologies for potential integration
tives of the medical and nursing staff, high-tech users,
• the lack of a systematic plan for conducting technol-
administration, equipment planning, risk management,
ogy assessment, thereby not being able to maximize
safety, and materials management departments. Another
the benefits from prioritization of the deployment
clinical engineer from the same department with nursing
of available technology
training experience serves as the committee’s designated
• an inability to benefit from the organization’s experi-
coordinator for all evaluation tasks. Once the commit-
ence with a particular type of technology or supplier
tee accepts a request for review (RR), it identifies other
• the random replacement of medical technologies, users who may have an interest in it and authorizes the
rather than a systematic protocol based on a set of coordinator to assemble a task force of users specified
well-developed criteria by the committee. This task force then serves as an ad
hoc committee responsible for the evaluation of the

J Global Clinical Engineering Special Issue 1: 23-32; 2018 28