By K. Richard Douglas
Just west of Dallas, in north central Texas, sits the city of Fort Worth. It was once a trading post for cowboys. Today, it is much different. From the Kimbell Art Museum to the Fort Worth Zoo, the city offers things to do for Tarrant County residents and visitors.
For more than 100 years, the JPS Health Network has provided medical services to the residents of Tarrant County. The level 1 trauma center also offers comprehensive stroke and cancer care.
With more than 40 primary and specialty health centers (578 beds) and 370 emergency visits a day, the JPS Health Network is the eighth largest employer in Fort Worth.
JPS currently has two MRIs (one more will be installed pending construction completion), 16 portable X-rays, 16 rad rooms, four trauma bays with a rad system in each, three nuclear medicine cameras, six CTs, one EP lab, one cath lab, one hybrid OR (pending installation), five C-arms, five mini C-arms, over 50 ultrasound units and multiple dental X-ray units.
To keep the diagnostic process of treatment working for all patients, the health network’s clinical engineering department has four of it 25 employees dedicated to imaging. The imaging team services general and portable X-ray, fluoro, dental, ultrasound and nuclear medicine.
The imaging service professionals are well trained through hands-on experience with their own equipment and training negotiated at the time of capital purchases.
“We set aside annual budget dollars to help cover the cost of training. Additionally, we work with our vendors to come up with creative ideas on how to get training,” says Joshua Virnoche, MBA, CBET, manager of clinical engineering.
“Recently, purchasing/negotiating training in with the capital purchase of equipment has worked really well. We’ve also had on-site training in our facility using our own equipment, which allows us to train multiple technicians for around the same cost as sending one,” he says.
Virnoche says that the team does not currently service MRI/CT/invasive labs in-house.
“JPS is a level I trauma center in Dallas-Fort Worth. We are also a comprehensive stroke center and have the AMI and Sepsis Gold Seal of approval. In critical situations, our vendors can have parts to the hospital within a few hours, where it would take quite a bit longer if we had to purchase parts ourselves,” Virnoche says.
“Additionally, with just four staff members, they would be stretched incredibly thin to cover these items, and the training is cost-prohibitive when we’re considering stewardship of our taxpayer’s money,” he adds.
The team takes an active role in the purchase and planning for new equipment.
“We are involved in the capital procurement process in terms of life cycle planning. Over the last few years, we have worked really hard to gain a level of confidence and trust from our internal customers who now consult us for nearly everything,” Virnoche says.
He says that the team has a standing meeting with the design and construction department to keep abreast of all the upcoming projects.
“Additionally, we often review blueprints of installations before final approval. The clinical engineering department owns all service level agreements in the organization, and we work closely with the equipment owners to leverage service and capital costs to ensure we get the best cost for our organization,” he says.
Virnoche says that on anything that is not covered by a service level agreement, they source parts and perform most repairs themselves.
“Our team is fully trained on all of our ultrasound devices, general rad rooms, nuclear medicine, contrast media injectors, portable X-rays, dental X-rays, C-arms, as well as a few other lower acuity items. Over the next few years, our service model will develop into a completely first call/first look agreement, where we lean on our internal team to address and assess all issues, with critical backup labor supported by the vendors. Currently, we just provide vendor management on all MRI/CT/IR modalities,” Virnoche says.
Ultra Stable Ultrasound
The group has learned that taking on a new project can be a learning experience.
“We work on the de-installation and decommissioning of old equipment, as new capital is purchased,” Virnoche says.
“Recently, our team was able to work with one of our vendors on the installation of a new nuclear medicine camera. This particular camera was tucked away on the third-floor of our main campus, so the old equipment had to be navigated through many small corridors and elevators, and around patient care areas to get the equipment out,” he says.
He says that the installation equipment had to go the same route and that the total installation took nearly three weeks.
Raul Rosado, the imaging team lead, says the thing that stuck out most about the project was, “you get to learn about the function of the equipment, and how it all goes together, before it’s ever even turned on. During installs you get to see places in the hospital you’ve never seen before, and learn about the structure of the buildings before you drill into it.”
“Additionally, we have worked over the last few years with the upgrade from HDD to SSD for our ultrasound equipment,” Virnoche says.
“We had run into issues where the HDD were failing constantly causing equipment failure, slow boot speeds and lost data. We went from HDD issues 1-2 times per month, to 1-2 times per year. The upgrade to SSD has made the ultrasound much more stable, with much quicker boot speeds, improving the quality of life for end-users,” Virnoche adds.
He says that the imaging team also took on a project to upgrade all of the ultrasounds to wireless rather than wired. The project took nearly a year, but allows the end-user to download images wherever they are, rather than having to return to “home-base” to plug in and download.
“Another huge quality of life upgrade for our users,” Virnoche says.
And, that is what the imaging team at JPS Health Network does; they contribute to a better quality of life for patients and clinicians.
