Healthcare Technology Management (HTM)
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Item Entrepreneurship(EWH, 2012) Worm, AnnaThis is a powerpoint covering the basics of entrepreneurship.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 How to Manage the Finances of Your Healthcare Technology Management Teams(Ziken International, 2018)The operational budget refers to the planned engineering activities (operations) that the HTM Team carries out for its customers. In other words it allocates funds against the activities in the operational plan (Section 4). It is a recurrent budget – all capital needs are contained in a separate capital budget. The quality and usefulness of an operational budget for healthcare technology management depends to a large degree upon the professional skills and experience of the people who prepare it. Some might argue that budgeting takes a lot of time, increases paperwork, and contributes to inflexible working practices. However, experience shows that the time and effort invested in preparing a realistic budget pays off during the course of the yearItem 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 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 How to Organize the Maintenance of Your Healthcare Technology(Ziken International, 2018)The system introduced in this Guide provides a solid approach to managing maintenance. However, we recognize that there are other ways of organizing the maintenance services which may be more appropriate for your administrative system. The important thing is to implement a well-functioning system. 11 1.2 Introduction to this specific guide As you read through the recommendations in this Guide, you may find it useful to refer to advice in other Guides in the Series, as indicated in the text. Additional useful reference materials and contacts are given in Annex 2.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 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 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 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 Human Factors Informed Failure Mode and Effects Analysis Andrea Cassano-Piché, et. al(HumanEra @ UHN & IFMBE Clinical Engineering Division., 2015)Failure Mode and Effects Analysis (FMEA) is an engineering method for proactively assessing vulnerabilities in a system before the risks cause harm. It was first used in the late 1940’s by the US Armed Forces to analyze various flight control systems (Amzen, 1996), as pilot error was leading to crashes and deaths. Since, FMEA has been adapted and used in several industries including military, aerospace, automotive, plastics, food service, and more recently, in healthcare. FMEA has been promoted by several national healthcare quality and safety organizations in Canada and the United States including: the Veterans Health Administration [37], the Institute for Safe Medication Practices [38], the Institute for Safe Medication Practices Canada [39], and the Institute for Healthcare Improvement [40]. Carrying out an FMEA is a means for hospitals to satisfy accreditation standards in the US and Canada including The Joint Commission’s patient safety standard LD.5.2 in the Leadership chapter of the Hospital Accreditation Manual [41] and Accreditation Canada’s Required Operating Practice that hospitals conduct at least one proactive risk assessment of a high-risk process each year.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 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.Item Identifying Issues and Investigating Incidents Case Study(HumanEra @ UHN & IFMBE Clinical Engineering Division, 2015) Andrea Cassano-Piché, et. alBiomedical technology professionals are often the first people to identify issues with a technology. Sometimes they identify them proactively, during regular inspections, and sometimes they find them retrospectively, when they are contacted by front line staff for assistance. In both of these scenarios, biomedical technology professionals are well positioned to apply human factors methods to identify human factors issues. This chapter will use case studies to showcase two human factors informed methods that can be used to help identify human factors issues with technology either retrospectively (HFRCA), or prospectively (HFFMEA).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 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 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 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.