Calendar of Events

March 8 - Meeting at MEDIQ/PRN. Presentation will be a ventilator primer, given by Puritan Bennett.

April - We are working on a really great presentation, but do not yet have all the details. A mailing will follow.

Message from the President

You are holding in your hands now the first bi monthly issue of the PAMIA Newsletter. We will be trying an experiment over the next year that we feel should work well. Two upcoming PAMIA meetings will be announced in each of six PAMIA Newsletters. With budget constraints in hospitals, it's becoming more difficult for departments to xerox and/or provide postage for PAMIA mailings. So, we've decided on fewer mailings with more content in each. We should have all the bugs worked out by April.

Have YOU been to a PAMIA meeting lately, or at all? More PAMIA members are finding it's worth a couple hours of their time on Monday nights. Average attendance is nearly double what it was a year ago. The event of the year, the Annual Hewlett Packard Meeting, used to average 60 members, with typical meetings from 25 35 members. Lately, most meetings are attended by 50 60 members, while last year's HP meeting tallied over 100! Meeting attendees have frequently commented on the improvement in presentation content. Now more than ever, the PAMIA Newsletter provides means to understand better what upcoming events entail, and what has happen recently at PAMIA Meetings.

Also inside this issue, you'll find the PAMIA Financial Report, an article on receiving faxed service bulletins (unless your fax machine runs out of paper, of course!) the latest installment of PAMIA Pheedback, and more. Though the efforts of many, PAMIA is changing for the better. Do YOUR part. Get involved. Our potential is limitless.

Lou Schonder 1993 PAMIA President

PAMIA MEETING SUMMARIES

December

30 plus PAMIA members attended a BMET Roundtable on Career Path Trends, and were welcomed by Lou Schonder and Ira Tackel. There was a brief discussion about NIBP simulators. None of the people present were using these units at their hospitals, and only a few had evaluated them. The rest of the evening was dedicated to discussing issues related to the future of clinical engineering departments in hospitals, and what the role of the BMET will be. Increased use of technology, cost containment, and lack of nursing knowledge of the devices they use will shape the future role of the BMET. BMETs will need to know more about physiology, and understand the devices they are working with from a systems perspective. The system includes the patient, the devices, and the operator. BMETs and CEs will need to expand their roles past the role of "MR. or Mrs. Fixit." The days of component level repair are rapidly fading, and electronics are becoming disposable. Other areas that we can branch out to all relate to being a liaison between the non technical oriented staffs and the technology that abounds in the hospital. Ira Tackel stated the overall theme of the future career paths and the future of clinical engineering by stating that you must adapt, migrate, or die. Continuously looking at the roles of BMETs and CEs in the same light will bring us closer to extinction.

January

James Schlosser of Trust Video Education presented a talk on troubleshooting OR video systems. His presentation started with a review of basic terminology. He then presented a slide show that illustrated examples of OR video problems, from bent scopes to carts that were a forest of cables and wires. He discussed troubleshooting issues and went over ideas that would prevent many problems from occurring. Most of the problems could be avoided by keeping the connectors and camera free of moisture, and by keeping a supply of electrical connectors and light cable adapters in the OR. A handout was distributed, which included a Troubleshooting Guide. The sheet lists five problems and their most probable causes. For more information contact James Schlosser, Trust Video Education, P.O. Box 320, Richwood, NJ, 08074. Phone 1-800-883-3669.

February

SpaceLabs Medical hosted a meeting at the Airport Raddison. Wayne Morse started the presentation by talking about the history of SpaceLabs Medical. He then discussed the realignment of the sales organization, some different maintenance agreements, and their national dispatch center and customer service. Wayne then talked about SpaceLabs Medical's series of books on clinical topics. These books are very well written and are a good resource in understanding some clinical issues. Titles that are already available include; Cardiac Output, Blood Pressure, ECG, Respiration, Advanced ECG, Implementation of an Early Defibrillation Program, and Medical Technology Assessment. Future titles will include EEG/EMG, Ambulatory ECG (Holter), and Ambulatory Blood Pressure. SpaceLabs Medical also handed out 2 sets of the books, and several articles of SpaceLabs emblazoned clothing. The meeting concluded with a brief overview of the SpaceLabs PCMS monitoring product line, and people had a chance to touch the equipment and ask questions.

The Exit Poll

What did you think of the last three meetings? Send your comments to Alan Barbell at ECRI, 5200 Butler Pike, Plymouth Meeting, PA 19462. Fax me at 215-834-1275, or send me E-mail on ECRINet.

Just the Fax, Please

IVAC Corporation has come up with a unique way to provide service bulletins. Recently, they have introduced a free service bulletin fax service. It makes sense to think that if a manufacturer can provide bulletins/updates at a lower cost, they will be more timely and frequent. To signup, fax IVAC at (619) 458 7507 with your name, title, institution, telephone number and address, along with your fax number and a list of your IVAC product model numbers.

More Fax to Consider

PAMIA is taking steps to initiate an idea, our Treasurer, Shrikant Chaudhary, came up with a long ago; to obtain the ability to quickly fax the PAMIA membership as a whole. The fax boards available for PC's today make this idea feasible. The advantages to having this capability are worthwhile. PAMIA event cancellations/updates could be made easily. Imagine making eighty some phone calls as an alternative! Another use could be meeting announcement reminders. Does anyone have any other ideas? If so, contact someone on the PAMIA board or post your idea on ECRINet.

PAMIA PHEEDBACK!!!

In each issue of the PAMIA Newsletter, objective topics are presented, offering the PAMIA Membership the opportunity to reply with opinions. Feedback ranging from simple votes to editorials are encouraged. Anonymous replies are acceptable. Topics for future "PAMIA PHEEDBACK" is appreciated.

Last Issue's Topic:

Are burnout and the feeling of professional stagnation prevalent among Biomedical Equipment Technicians?

Replies:

My answer: Yes. There is very little growth for technicians in most Biomedical/Clinical Engineering departments. Unless the department has a comprehensive equipment management/repair program, coordinates in services and is involved in research activities, the biomedical technician will be confined to day after day of tedious PM's and repairs. Since PM's are always due and equipment is always breaking, the technician hardly ever feels a true sense of accomplishment. There is a new generation of technicians who have attained Bachelor and even Master's degrees. These people possess technical, communication, business, and other skills that could be valuable assets to any department. A progressive department takes advantage of these skills to improve it's operations.

Many departments lack a proper hierarchial structure that encourages growth and promotes advancement. Usually there is a director and technicians with very few, if any, positions in between. Even for the technicians, there is many times no definite ranking according to skills and motivation. In most cases, the amount of time one has been working in the hospital is the sole criterion for ranking. Education, communication and organizational skills are consequently overlooked.

The days of "the guys in the basement that fix stuff" are slowly fading away. There is still a lot of work to be done before many of our departments reach a truly professional status. It is up to us to accelerate the process.

Ismael Cordero, Albert Einstein Medical Center.

Regardless of the profession, anyone who wants to advance their skills and/or responsibilities and cannot see any means to do so will naturally become frustrated. Managers should recognize such individuals and provide them with additional responsibilities, even to the point of delegating some of their own duties. Another way to get off the treadmill is to experiment with different ways of performing the "tedious tasks". As anyone who is familiar several in house and/or third party biomed departments would know, the function can be performed many different ways. Anything undertaken on a long term basis, whether work or play, should be evaluated periodically in pursuit of potential improvement and to keep up with developing opportunities. Like the old saying says, "You snooze, you lose".

PAMIA President Lou Schonder, CITECH.

This issue's topic:

Do you think that a standard dress code for biomedical/clinical engineers/technicians in hospitals would improve their professional recognition?

(Topic submitted by Thomas J. Gilroy, Jr., Lankenau Hospital)

Replies are targeted for publication in Issue #9, May/June 1993.

The success of "PAMIA PHEEDBACK!!!" depends upon you! It's very easy to place as little as a simple vote to reply. DO IT TODAY!!! Put it off, and you'll forget. Anonymous replies can be accepted. Do your part. Keep PAMIA Pheedback alive. Our forum to poll opinion in our area can be a very valuable tool, if we use it!!!

To respond to PAMIA PHEEDBACK, follow instructions under "How to make PAMIA Newsletter contributions".

Image is Everything?

The following is an excerpt from ECRINet. As you can see the question of this months PAMIA PHEEDBACK is pertinent, and being discussed by clinical engineers. So what do you think PAMIA? Msg#:25279 *PAMIA* 12 17 92 16:18:52 From: ALAN BARBELL To: ALL Subj: PERCEPTIONS OF CLINICAL ENGINEERS

There was some talk during the PAMIA roundtable at Thomas Jefferson University Hospital about the importance of selling your services, and the importance of looking professional. Take a look at these messages that were left on the Healthcare Technology Bulletin Board (Conference area #1 on ECRINet): Msg#:25267 *HCT* 12 17 92 09:51:34 From: DON WHITESIDE To: DWIGHT HILL (Rcvd) Subj: LAB COATS

You had commented that you do not see the value of lab coats; let me share our experience. We added lab coats almost ten years ago to our dress code for 2 reasons: first and foremost appearance, and second, for protection to personal clothing. I agree that a lab coat offers limited protection to clothing, and most OSHA bloodborne pathogen policies do not recognize a lab coat as personal protection (although I believe the word labcoat appears in the regs).

Interestingly, after the staff started wearing the coats, we received many compliments and even comments that our quality had been better as of late. We have always had comments of good quality, and had done nothing other than add the labcoats. Some people people believe that high quality work alone will do the job, but a little PR helps sort of advertising.

As service providers, the service we provide is somewhat intangible and customers often look to outward, physical items to evaluate when assessing quality. Show them a neat, professional looking staff member and it will help them decide the quality was good. Of course, if the staff does a lousy job of serving the customer the lab coat alone won't do anything. After all, if you personally received bad service somewhere the ads on TV won't convince you otherwise.

Msg#:25273 *HCT* 12 17 92 15:12:55 From: MICHAEL SNISKY To: DON WHITESIDE Subj: REPLY TO MSG# 25267 (LAB COATS)

Don,

I have noticed the same reaction from staff. I once worked for a hospital where Clinical Engineering was a division of the Maintenance Department. The Biomeds wore the same dark green work clothes as the rest of the maintenance staff. Docs rarely gave us the time of day, and the nurses didn't always have the greatest faith in us. Once I was working on a monitor in the ICU, and the patient kept asking me if I knew what I was doing, that a guy dressed just like me was working on the toilet earlier in the day...

We changed to nice street clothes. Our image improved a bit. When we began wearing lab coats, docs would actually stop and talk to us. Nursing treated us with much more respect. And the biomeds felt more professional.

I read an article once that stated if a Biomedical Technician occasionally gets mistaken for a doctor, then that Biomed is dressing properly. I guess in an ideal world, people would be judged only by their actions/performance, but in reality, I'm finding that image goes a long way. Mike

Why 99.9% Just Won't Do

Let's get real here. Is it truly necessary to go for "zero defects"? Why isn't 99.9% defect free good enough?

Those are questions often posed to quality consultant Jeff Dewar, of Red Bluff, California based QCI International, when he argues for eliminating defects altogether. To make his point, Dewar has come up with some examples of what life would be like if things were done right 99.9% of the time.

We'd have to accept:

1 hour of unsafe drinking water every month 2 unsafe plane landings every day at O'Hare International Airport in Chicago 16,000 pieces of mail lost by the U.S. Postal Service every hour 20,000 incorrect drug prescriptions per year 500 incorrect surgical procedures each week 50 newborn babies dropped at birth by doctors every day 22,000 checks deducted from the wrong bank account each hour 32,000 missed heartbeats per person per year, (1 late PAMIA mailing every 100 years)

Suddenly, the quest for zero defects makes a lot of sense... (Reprint from Inc. Magazine)

A Word From Our March Sponsor...

MEDIQ/PRN Life Support Services, Inc. was pleased to arrange Puritan Bennett's presentation at the March PAMIA Meeting, and to host the meeting at our new Pennsauken, NJ corporate headquarters. Some PAMIA members may remember MEDIQ/PRN's early days over a decade ago as a local company started by a physician at Rolling Hill Hospital to rent a few ventilators to other physicians. Today, MEDIQ/PRN is the largest medical equipment rental company in the U.S. with over 75,000 pieces of equipment rented in 75 offices from coast to coast by a staff of nearly 600 people, including about 120 biomedical technicians. Due to the rapid diffusion of medical devices such as infusion pumps, apnea monitors and portable ventilators through home health care providers, MEDIQ/PRN has become the largest single provider to those companies. In the traditional hospital market, due to capital reimbursement and funding constraints, hospitals are continuing to use rentals as a means to gain access to new technology like full featured Puritan Bennett 7200 ventilators, as well as the usual peak demand and back up role MEDIQ/PRN's fetal monitors, incubators, pulse oximeters and telemetry rentals have served in the past. These factors have all contributed to MEDIQ/PRN's continued 25 30% annual growth rate, which will probably continue through the decade. As a local company, MEDIQ/PRN is proud to continue to increase it's supportive role with PAMIA.

Treasury

Our treasurer Shrikant Chardhary provided the executive committee with the his report for the 1992 year at the February meeting. PAMIA had a very good year. We were able to provide some educational grants for the first time, and we still had a surplus at the end of the year. This will help us ensure the ability to continue to provide the grants, and be able to do more for you in the future.

The following is Shri's analysis of PAMIA's 1992 financial statements.

Analyze Income vs. Expense January to December 1992

Year to Date % of Total Net Income Income Membership Dues $2,271.00 53.9% Meetings $295.00 7.0% Special Events $1,650.00 39.1% Total Income $4,216.00 100.0% Expense Bank Charges $13.00 0.4% Postage $199.59 5.4% Misc. Expenses $120.41 3.2% Meeting Expenses $300.00 8.1% Annual Dinner Exp. $2,530.04 68.1% Educational Grant $550.00 14.8% Total Expense $3,713.04 100.0% Total Net Income $502.96 11.9% Current budget predictions for 1993 will not have as large of a surplus.

How to Submit Articles to the PAMIA Newsletter

Submissions of whole articles or just ideas can be sent to Alan Barbell or Lou Schonder at 5200 Butler Pike, Plymouth Meeting, PA 19462. Fax: 215-834-1275. Or you can send E-mail on ECRINet.

PAMIA

March Meeting

A Ventilation Primer

Tom Keating RRT, of Puritan Bennett, will present a talk that will cover the evolution of the ventilator, physiology of the cardiopulmonary system, and modes of ventilation and their application.

When: March 8, 1993

Where: MEDIQ/PRN One Mediq Plaza Pennsauken, NJ 08110

Schedule: 5:45 pm - 6:30 pm Executive Staff Meeting 6:30 pm - 7:15 pm Dinner - Courtesy /PRN 7:15 pm - 7:30 pm Business Meeting 7:30 pm - 9:00 pm Ventilation Primer

R.S.V.P. by Wednesday March 3rd, to Scott Kreifels at 800-222-4776, or 609-662-3200

Please duplicate and distribute this notice to all members and interested parties in your department/institution. PAMIA NEWSLETTER

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