Fixing What’s Wrong

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By John Garrett

The on call Field Service Engineer (FSE) gets an after hour page because an X-ray room is down. After a short discussion it becomes apparent that the Automatic Exposure Control (AEC) is not functioning properly. After further discussion, it becomes obvious that the tech working that shift does not know how to enter technique manually.

Another late call comes in for our faithful FSE for a down CT. This time the problem is the computer hasn’t booted up. During a discussion, the tech insists that the unit is down and the FSE needs to come fix it. The FSE shows up 45 minutes later, having come from home, and presses the “on” switch for the computer monitor to fix the problem.

Finally, a call comes to our good mannered FSE with a complaint of no worklist. After calling IT the FSE finds out there is a server issue that will require IT to fix the problem. Yet the tech insists that the system is down because they do not know how to manually add a patient and match it in PACS.

If you have been in the industry for any length of time you have probably experienced something along these lines. There is little any FSE can do to solve any of the previous issues. There is a concern of liability if they take on the role of an Applications Specialist. There are techs that will not do anything manual. This may be from lack of knowledge and/or ability. It might be due to a sense of entitlement that they shouldn’t have to deal with anything out of the ordinary. Sometime, something as simple as checking to see if the monitor is on is seen as troubleshooting that a tech should not have to do.

In these cases there are two competing problems. The first is that the tech is not properly trained on the equipment. There is an operator’s manual that covers the work done by those operating the equipment. This includes basic checks to make sure the unit is on and that it is working. It includes the steps to bring the equipment down and restart it when something seems to be wrong. Yet, too many techs are taught by someone that was taught by someone that was taught by an Applications Specialist. This is actually a result of the second problem.

The second problem is the culture of too many imaging departments. They do not invest in applications training for off shift employees that actually cover practical use. There is a resistance to perform even a basic shutdown, often because they are unsure how to do anything other than line up a patient and push a button on a specific unit. It is a result of trying to save money that is misguided.

So, what can be done? First, encourage proper Applications Training. Second, when you shut down the unit show the person operating the system. Every time you shut it down, show someone. Educate them on what to check. Share your knowledge. Do not attempt to teach anything clinical. Simply show them how the machine works, every time. This won’t fix every problem, but it might get a tech to at least check the power button on a monitor.

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