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CE Structure

 

Clinical Engineering Structure

Whether creating a Clinical Engineering (CE) department or managing an existing program, the clinical engineer must continuously consider and plan for the resources that are needed in order to perform the clinical equipment management services. Some of the resources that are fundamental to the clinical engineering department’s success are staffing, space, test equipment, tools, communications equipment, training, and a computerized maintenance and management system.

Different Names for Clinical Engineering Department in Healthcare Institute

In addition to above there are many names/title of the profession would be used in different organization. The name below are known to many of healthcare professions where you may find the department title as one of the following:
 

  • Bioengineering, 
  • Biomedical Engineering,
  • Biomedical Equipment Maintenance,
  • Biomedical Equipment Repair,
  • Biomedical Equipment Services,
  • Biomedical Instrumentation,
  • Biomedical Maintenance,
  • Clinical Engineering,
  • Clinical Engineering Services,
  • Clinical Equipment Management,
  • Clinical Equipment Maintenance,
  • Clinical Technology
  • Clinical Technology Management,
  • Clinical Technology Services, 
  • Equipment Service
  • Healthcare Technology Management,
  • Healthcare Technology Services,
  • Medical Engineering,
  • Medical Equipment Repair,
  • Medical Instrumentation,
  • Medical Technology Management,

In hospital setting we usually hear words like:

 

  • Biomedical Technology
  • Healthcare Technology
  • Medical Technology

More Options

it is a fundamental part of managing a clinical engineering department

Initiating a new CE Department

Hospital leaders need to look at clinical engineering related to:


  • Patient safety, 
  • Cost, 
  • Compliance and 
  • Quality.


Busy hospital leaders are often in the dark about the role played by their clinical engineering services and the value it provides.

Leadership support for clinical engineering is critical. Start with the hospital leader to negotiate the need for the department and the benefits that the hospital will gain as per above enlighten them with the advantage and disadvantage to have the service in-house or outsource from service providers.


For small size organization you may consider subcontracting the medical equipment services instead creating a department. 

Starting New Clinical Engineering Department

To create the workspace for your CE department, there are several questions to consider:


  • Where is the CE today and where will it be in 10 years?
  • How do I design space to meet that future functional need? 
  • Where is the department located to other support services? 
  • Is there hospital department responsible for medical devices technical support? 
  • How big is it? Staff? Budget? Responsibilities? (Scope of Work)?
  • Is there a need for a dedicated CE department? or within the maintenance department?  
  • What would be the department structure? Reporting mechanism within the organization?

Estimating Department Staff

Calculating the adequate or sufficient number of biomedical staff for a clinical engineering department is never straightforward assumption and it is not simple estimation.  It is differ from one organization to another organization depends on several factors such as but not limited to:


  • Type and location of the healthcare institute  
  • Size - number of beds, number of inventory  
  • Type of medical equipment  
  • Availability of resources - training, service manuals, spare parts, vendors  
  • Budget - operation  
probably others more ....  


There have been a number of rules of thumb that have been reported and used for many years.

  • One such approximation is one BMET per 1,000 pieces of medical equipment.
  • Other approximations include 2.6 full-time employees (FTEs) per 100 beds.

The definition of Full-Time Equivalent (FTE) is the number of working hours that represents one full-time employee during a fixed time period, such as one month or one year.


An FTE of 1.0 means that the person is equivalent to a full-time worker, while an FTE of 0.5 signals that the worker is only half-time or part-time.


Example:

An FTE of 1.0 (40 hours/week x 52 weeks/year = 2080 / year) equal to 8 hours a day.


The 2080 figure can be called into question, since it does not include any deductions for holidays, vacation time, sick time, and so forth. Alternative measures of FTE that incorporate these additional assumptions can place the number of hours for one FTE as low as 1680 hours per year. 


FTE Calculation:

FTE calculation is a two-step process that determines how many hours of work there are in a department and how many hours one full time employee works. The total workload hours are then divided by the working hours of one employee. This calculates the number of full time equivalents that are needed.


The number of FTE needed = workload hours / the working hours of 1 FTE in your organization

Modifications to the workload and/or productivity will precisely forecast how many FTEs will be required.

Job Titles

Some of common used Job Titles for Clinical Engineering Staff:
  • Director
  • Manager
  • Chief
  • Senior Engineer
  • Engineer
  • Supervisor
  • Specialist Supervisor
  • Senior Equipment Technician
  • Equipment Specialist
  • Equipment Technician
  • Specialist
  • Team Leader
  • Systems Support Specialist  
Others ……...

Department Structure

Most of Clinical Engineering structures are almost similar with minor differences from one organization to another one which depend on the scope of work (functions and duties) of the department and reporting mechanism within the organization.


The Clinical Engineering Department report to different administration as per the organization structure. It would report to Director of Engineering (a “traditional” approach), Director of Information Technology (the “trend”) or other divisions (e.g., Administrator of Support Services, Operations and/or Medical Division). Also reports indirectly to Safety Committee (interdisciplinary group responsible for hospital safety … including technology management elements)


The ideal reporting mechanism would be the Director of Support/Technical Services where all Engineering Department would report to. It is recommended to have all engineering department heads report to one director for operational requirements and efficient workflow.


Here is an example of Clinical Engineering Department structure would look like:

The below organization structure links shows different types of structures as a guidelines for different size of healthcare institutes:


Small organizations (100 - 150 Beds)

Clinical Engineering Manpower

Be concerned about the following Clinical Engineering Staff category depends on the size of the organization and scope of work. The clinical engineering department would be a mixture or a combination of the following: 


  • Administrative:
  • Director
  • Manager
  • Administrative Assistant
  • Department Secretary
  • Technical:
  • Chief 
  • Engineer
  • Supervisor
  • Specialist
  • Technician
  • Support Staff:
  • Safety Officer 
  • Training Officer
  • Data Entry
  • Material Specialist
  • Supply Coordinator
  • Library Technician

Staffing and Workload Issues May Compromise Patient Safety

If a clinical engineering department has concerns that established staffing levels and/or skill inappropriate for the workload they are employed to manage such that patient safety may be, seriously compromised.

Managing Staffing and Workload

 
  • Workload measurement and management system needs to be able to respond to increase or decrease in workload requests.
  • Availability of 24 hr service, there needs to be sufficient trained and qualified staff available at all times.
  • Identify key indicators such as inputs, outcomes and resource consumption when evaluating the risk of a service that is considered to have insufficient or inappropriate staff.
  • Any reconfiguration of staff numbers and skill mix must take into account the need to comply with statutory, regulatory and quality standards.
  • When attempting to identify the appropriate staff number and skill mix required delivering a service, raw workload statistics alone are insufficient.
  • The other essential elements that need to be factored in are those of quality and audit, health and safety, training, leadership and management.
  • Training and development is an essential and integral aspect of a biomedical service. It is an ongoing feature of continuing professional development and as such has a direct relationship with quality of service.