By K. Richard Douglas
Sitting just south of Salt Lake City, Utah is the city of Midvale. Part of Salt Lake County, it is a city of more than 33,000 and close to the Great Salt Lake.
Midvale is the location for the clinical engineering department for Intermountain Healthcare and its imaging program.
Headquartered in Salt Lake City, Intermountain Healthcare consists of approximately 1,400 employed primary care and secondary care physicians. The not-for-profit health system has hospitals in Utah and southeastern Idaho. In 2017, Intermountain Healthcare had four hospitals on the Truven Health Analytics top 100 hospitals list.
“The clinical engineering department at Intermountain Healthcare consists of 125 personnel, covering 23 hospitals, over 185 clinics, and all homecare equipment,” says Mike Busdicker, MBA, CHTM, system director of clinical engineering for Intermountain Healthcare.
“The Imaging Equipment Service (IES) Program is managed by Jeff Koford and has a total of 17 imaging service engineers. These service engineers cover imaging equipment within a geographic area and will cross over lines of responsibility to assist in the repairs and service of equipment. The IES Program operates as a separate program within the overall function of Clinical Engineering Support Services,” Busdicker says.
The IES Program includes 50 CT scanners, 40 MRI units and over 3,500 individual pieces of imaging equipment.
Busdicker says that the imaging service engineers are divided up into modality specialties that include general X-ray, ultrasound, ancillary equipment, CT scanners, mammography and nuclear medicine.
Beyond covering all of these modalities, he says that the groups do not presently service linear accelerators, cardiac cath labs or MRI units.
“Our program was a brand-new start up in 2012 and we did not have any imaging service engineers on the team. Since that time, we have added 17 service engineers, reduced contracts by over $10 million and built cooperative relationships with internal and external customers,” Busdicker says.
“Much of our success is ensuring we move at the right speed in taking on the service of the imaging equipment. It is a process involving all the right personnel to include organizational leadership, clinical caregivers, finance, frontline service personnel and our suppliers,” he adds.
The 17-member service team has to keep up their training skills to service such a broad spectrum and large inventory of imaging equipment.
“We have built solid relationships with suppliers that provide the training needed for this type of equipment. Our collaborative relationships include manufacturers, independent service organizations and other training institutions,” Busdicker says.
“Each year, we provide organizational leadership with a report demonstrating the value the in-house staff brings to Intermountain Healthcare through the training of our in-house staff. This includes financial savings and cost avoidance, but just as important, we document value brought to the treatment and care of patients,” he says.
He says that the imaging service program is sure to track response times, repair times, uptimes, service repairs impacting patient care and caregiver satisfaction.
How involved is the team in the purchase, planning and construction of the system’s radiology/cardiology equipment?
“The IES Program is very involved in the life cycle management of the imaging equipment. Each year, imaging services comes together for a five-year capital planning strategy and our IES program director is a vital part of the committee,” Busdicker says.
“They provide data and information on asset history, performance, serviceability, reliability and supplier collaboration. Also, the IES program director takes part in the modality evaluation teams and provides a service perspective on the equipment being evaluated,” he adds.
The clinical engineering department has a medical equipment service contract specialist. Busdicker says that this person is involved with the contract and purchasing process for all suppliers – general medical and imaging equipment.
“The contract specialist reviews terms and conditions, the payment process, renewals, initial contract discussions, participates in quarterly business reviews, tracking of performance in relation to contract terms and validation of contract value,” he says.
Crunching Data for Improvement
The imaging team at Intermountain is continuously seeking to hone the process of maintaining equipment and providing maximum uptime.
“The IES Program has instituted a process to perform a root-cause analysis (RCA) on all equipment downtimes deemed excessive,” Busdicker says.
“The RCA involves all individuals and companies associated with the down equipment. This can include the frontline caregivers, service engineers, IES Program leadership, suppliers, supply chain and continuous improvement. The goal of the RCA is to positively impact the repair process, improve reliability and limit equipment downtime. Results of this project include the local stocking of high-usage parts, increased monitoring of equipment performance, enhanced training of service personnel and a better team approach to the service of critical and non-critical equipment,” he adds.
Beyond the good work they do during business hours, the imaging team, and their larger contingent of CE colleagues, stay involved.
“The Clinical Engineering Department at Intermountain Healthcare is actively involved as an institutional member of AAMI and ACCE. Also, department personnel are involved with NH-ISAC, MD Expo, ICE, ACHE, AHRA and HIMSS,” Busdicker says.
With the large inventory of imaging equipment and the many facilities to service, the relatively young service group accomplishes a lot to serve the patient population in Utah and southeastern Idaho. Their self-assessment process means continuous improvement.