Healthcare Technology Management (HTM)
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Item Management of Maintenance(VSO, 1995) Skeet, Muriel; Fear, DavidThe breakdown of a piece of equipment is inconvenient to us and can put our patients’ lives at risk. The result is frustration and stress. Sometimes a breakdown is inevitable or a repair is delayed because a spare part is not available or an expert is required to identify and repair the fault.Item How to Operate Your Healthcare Technology Effectively and Safely(Ziken International, 2005)nfection and hazard control committees are required in the health service at district level and at facility level (depending on the size of the facility). They need access to international data on hazards. Feedback is available on hazards from international sources, in the form of international ‘Alert’ reports (see Annex 2). The central level of your health service provider organization will need to subscribe to the sources of this literature, and make it accessible to health facilities. With guidance from government, your health service provider needs to take overall responsibility for safety issues within its facilities, from a management and legal viewpoint (Section 2.1), since the health service provider is the body that people will make claims against if there are any adverse incidents.Item How to Plan and Budget for Your Healthcare Technology(Ziken International, 2005)Many health service provider organizations have a General Inventory for their facilities kept by Stores personnel. This covers everything found in each department (including such items as furniture, plastic and glassware, waste bins, notice boards, wall clocks). A record of the contents of each room is kept on a card (often found on the back of the door), and a paper copy is held in the Stores. Items are often painted with their Stores code number. However, the details contained within this General Inventory are generally insufficient to enable equipment or maintenance plans to be made. Also, the data is not easily updated or manipulated on a computer. For this reason, a separate record is required, which is known as the Equipment Inventory. This covers technical details and is restricted to items of equipment – in other words, those items which require maintenance throughout their lives.Item How to Procure and Commission Your Healthcare Technology(Ziken International, 2005)This Guide is intended as a practical tool to assist in the procurement of both equipment and equipment-related supplies (in other words, consumables, accessories, spare parts and maintenance materials). The activities in this Guide are aimed at anyone involved in the procurement of healthcare technology. This includes: ◆ staff directly responsible for, or involved with, procuring and commissioning equipment (whichever agency they belong to – your health service provider, a government agency, an external support agency, a partner) ◆ health service decision makers ◆ external support agency decision makers ◆ decision makers of partners such as NGOs, faith organizations, and the private sector.Item How to Organize a System of Healthcare Technology Management(Ziken International, 2005)In order to deliver quality health services, it is essential to undertake effective healthcare technology management. There are various framework requirements to help you do this. These include legislation, regulations, standards, and policies. These framework requirements create the boundary conditions within which you undertake healthcare technology management. They include central or national guiding principles, policy issues, and high-level assumptions that can impede or assist you in your work. It is very difficult to function effectively if these framework requirements do not exist, and you should lobby your organization to develop them. Depending on how autonomous your health facilities are, you may be able to develop these framework requirements at facility, region/district, or central level.Item HTM Guide 1: How to Organise HTM(EWH, 2012) Worm, AnnaThis presentation accompanies the book: How to Organize: How to Manage Vol 1, Lenel et. al., (Ziken International: 2005).Item HTM Guide 2: How to plan and budget your Healthcare Technology(EWH, 2012) Worm, AnnaThis presentation accompanies the book: How to Organize: How to Manage Vol 2, Lenel et. al., (Ziken International: 2005).Item Entrepreneurship(EWH, 2012) Worm, AnnaThis is a powerpoint covering the basics of entrepreneurship.Item HTM Guide 6: How to Organise HTM(EWH, 2012) Worm, AnnaHow to Manage Finances: How to Manage Vol 6 Lenel et. al., (Ziken International: 2005).Item Procurement Procedures(EWH, 2012)Procurement is the process of acquiring goods, supplies and services. It includes Equipment, spare parts & supplies for program activities, Equipment, office furniture & supplies for project offices, Drugs and medicines, and Consulting services by individuals or organizations.Item HTM Guide 3(EWH, 2012) Worm, AnnaThis presentation covers Guide 3: How Procure and Commission: How to Manage Vol 3, Lenel et. al., (Ziken International: 2005) and Guide 6: How to Manage Finances: How to Manage Vol 6 Lenel et. al., (Ziken International: 2005).Item Heuristic analysis(HumanEra @ UHN & IFMBE Clinical Engineering Division, 2015) Andrea Cassano-Piché, et. alWhen a technology is poorly designed, it can lead people to make mistakes while interacting with it. In healthcare, this can be especially serious given the complexity of technology and what we need it to do. Many technologies in healthcare provide support life saving and supporting functions for complex patients with changing medical status. When this technology is poorly designed, it can be responsible for errors leading to patient safety events. Identifying technology designs, or aspects of design, that violate best practices for designing Human-tech[9] systems is a potentially life-saving undertaking. Heuristic analysis is one method by which technology design can be evaluated to determine whether users will find it challenging to operate.Item The Need for Human Factors in Health Technology Management(HumanEra @ UHN & IFMBE Clinical Engineering Division, 2015) Andrea Cassano-Piché, et. alAll people, no matter how careful, have the potential to make mistakes. Healthcare professionals enter the field out of a desire to help others, but because all humans have certain known strengths and limitations, people can often find themselves in situations where the systems in which they work lead them to make mistakes. In 1999, the Institute of Medicine’s publication To Err is Human [1] revealed that approximately 44,000 to 98,000 preventable deaths take place each year in the United States, making it the 8th leading cause of death. A similar study in Canada showed even worse outcomes on a per capita basis, with between 9,000 and 24,000 preventable deaths occurring each year [2]. Other studies in the United Kingdom [3], New Zealand [4], and Australia [5] found that 8.7%, 12.9% and 16.6% of hospital admissions, respectively, were associated with an adverse event. In 2013, fourteen years after To Err is Human was published, an updated review of the literature provided higher estimates still, with between 210,000 and 400,000 preventable adverse events occurring in the United States annually[6]. Errors leading to adverse events and preventable patient deaths remain a serious, global issue.Item Human Factors Informed Procurement and Implementation Process(HumanEra @ UHN & IFMBE Clinical Engineering Division, 2015) Andrea Cassano-Piché, et. alThe human factors informed procurement and implementation process (HFPIP) is a framework that can be followed to support the human factors informed selection of medical technologies in hospital organizations. This framework builds on the traditional procurement process by incorporating human factors methods and standards to help inform a decision, and proactively mitigate residual risk as identified through human factors evaluations. This framework was developed iteratively based on the experience gained during several hospital procurement activities.Item Task Analysis(HumanEra @ UHN & IFMBE Clinical Engineering Division, 2015) Andrea Cassano-Piché, et. alOnce data have been collected in the field, you will need a way to make sense of the data, and to share it in a meaningful way with others. Completing a task analysis can be extremely helpful in accomplishing both of these goals. Taking the time to package your data into a task analysis format is an effective way of systematically identifying any assumptions being held, or any gaps in your own understanding.Item Interviews, Focus Groups, and Surveys(HumanEra @ UHN & IFMBE Clinical Engineering Division, 2015) Andrea Cassano-Piché, et. alData collection through observation yields rich information about how people do things, but this insight only provides part of the story. It is also important to understand why a system has been set up, or things are being done, in a particular way. Understanding why from the subject’s perspective helps to prevent you, the observer, from introducing bias by assigning your own assumptions to something you have observed. It is also important to help you learn about people’s mental models, preferences, and knowledge, in the context of technology use. Sometimes observations do result in an understanding of why the system functions as it does; namely, if you have the time and freedom to talk with, and ask questions of the people you are shadowing. However, in reality this is usually difficult because those being observed are busy, with little time to answer questions at length. This is why it is a good idea to plan to collect data in a number of ways, from multiple subjects, including using methods like interviews, focus groups, and surveys.Item Managing the Lifecycle of Medical Equipment(Tropical Health and Education Trust., 2015)This short article provides a brief overview of major concepts in Healthcare Technology Management such as: the equipment lifecycle, planning, budgeting and financing, assessment and selection, logistics, installation and commissioning, skill development, safety, repair, and decomissioning and disposal.Item Usability Testing(HumanEra @ UHN & IFMBE Clinical Engineering Division, 2015) Andrea Cassano-Piché, et. alWhen a technology or system change is evaluated in isolation, the effect of external factors like the environment of use, interfacing technologies and equipment, and team dynamics of multiple care providers are unknown. Putting that same technology in a simulated environment and in the hands of real end users, however, can reveal what problems or unanticipated consequences to expect when the technology or system change is implemented. Whereas during a vendor demonstration of a new technology the technology is shown as a stand-alone device and observers must independently consider as many ‘what- ifs’ as they can think of in the moment, to identify how the technology will fit with its environment and work processes, usability testing allows people to think, and work through tasks and any associated difficulties in a systematic way, without the assistance of highly trained product specialists and within a safe environment.Item Observation for HTM(HumanEra @ UHN & IFMBE Clinical Engineering Division, 2015) Andrea Cassano-Piché, et. alWhen people with similar training and experience are presented with a particular situation, it is not uncommon to find that they take fairly different approaches to managing the situation. This is not necessarily because one person has a better approach or more information than another, but because there are many factors that influence how people perform their work. In healthcare, we believe people inherently want to do their work safely and effectively, and that when their performance is unsafe or ineffective, there are factors, which they may or may not be aware of, that influence their performance. These factors come from a combination of internal and external sources that can vary over time. Examples of external factors that can impact work include equipment design, the physical layout of a workspace, expected workflow and work practices, organizational policies, team dynamics, and organizational culture. Internal factors, or natural human limitations (Chapter 3), that can affect our work include our ability to remember multiple units of information, or to pay attention to many things that are happening at the same time. People also vary in terms of their skill level and ability to perform certain tasks based on factors like age, level of training, and experience.Item Human Factors Informed Root Cause Analysis(HumanEra @ UHN & IFMBE Clinical Engineering Division., 2015) Andrea Cassano-Piché, et. alRoot Cause Analysis (RCA) is a retrospective incident investigation framework, initially developed as a quality management engineering tool, that is now widely used in many industries to support the improved safety of systems following an accident or incident. In healthcare, regulators such as The Joint Commission have mandated immediate investigation and response following a sentinel event, which is “an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof” [44]. RCA is a means by which this type of investigation and response can be accomplished.