Clinical Engineering Productivity and Staffing Revisited

Abstract

While debated for over 30 years, productivity and staffing continue to be a challenging topic for the clinical engineering (CE) community. At the core of this challenge is the lack of reliable indicators substantiated by actual data. This article reports an attempt to evaluate some traditional and newer indicators using data collected from 2 distinct sources. Results confirm early concerns that worked hours self-entered by CE staff are subject to misuse and thus should be avoided. In contrast, good statistical correlation was found for staffing data with several hospital indicators that are consistently collected and widely available. Good correlation with CE department indicators was more difficult to find, apparently because of the lack of reliable records and consistent accounting of all CE resources and expenditures. Although no single, easy-to-measure and easy-to-understand indicator emerged as a replacement for the worked-to-paid-hours ratio, it is shown that a multidimensional model can be built to benchmark productivity and staffing. Calculations from such a model are accurate, but not precise, so the results need to be interpreted carefully. With proper precautions, such comparisons can be used as a good starting point for a more detailed analysis of the differences that could reveal substantive causes such as service scope and strategy, organizational characteristics, and geographical challenges as well as opportunities for major productivity improvements.

Medical Equipment Maintenance: Management and Oversight

“…Nonetheless, a ballpark estimate for the necessary human and financial resources is possible using a multi-dimensional model [Wang et al, 2012]. Each hospital has apparently found a slightly different way to fund and operate its CE Department to achieve a level of service that it finds satisfactory, often blending work performed by onsite staff with assistance from manufacturers and alternative sources (see below for a more detailed discussion about service provider selection).…”

“…CE staff typically open and close a workorder after repairing the equipment, so the total elapsed time of the workorder is not an accurate measure of the downtime or turnaround time [Wang et al, 2012]. Unless it is a mission-critical piece of equipment or one that has few, if any, backup, users frequently just put a note on the equipment stating "broken" and leave it aside, instead of calling CE promptly for repair.…”

“…Unfortunately, the number of hours documented on workorders is not audited by anyone and, thus, subject to manipulation by CE staff [Wang et al, 2012]. Without proper "normalization," total CE expenses would be substantially lower than the actual amount spent on equipment maintenance and management (see Wang et al [2012], for more details and actual data). 20 One of the accounting challenges that some hospitals face is the need to "normalize" all the expenses associated with medical equipment maintenance and management from various departments to the CE Department.…”

“…First, labor expense is typically around 15-20% of the total equipment maintenance and management cost, assuming proper "normalization" has been performed [Wang et al, , 2012. Total number of operating beds 2.…”

“…Studies conducted using data collected from hundreds of acute-care hospitals indicate that on average, each hospital acquired about 15-20 pieces of medical equipment for each staffed bed, which translates into a capital investment of around US$200-400,000/staffed bed [Wang et al, , 2012. Thus, it is common for a 500-bed hospital to own more than US$100-200 million worth of medical equipment and considerably more if it is affiliated with a medical school.…”