How to promote medical instrument maintenance engineer?

China urgently needs to establish a medical device maintenance system 2008-09-0120: 49: 21China urgently needs to establish a medical device maintenance system.

A medical engineering expert said, "If I change my behavior into a patient's lawsuit, the hospital will definitely lose because I know many loopholes in medical equipment management." On the one hand, medical instruments and equipment have become the lifeline of the hospital today, on the other hand, hospital leaders have habitually ignored the management of instruments and equipment, and the instrument department has become the lowest department in the hospital, which makes sustainable development difficult.

How to invest and operate medical instruments and equipment more reasonably, and more importantly, how to ensure the sustainable development of hospital equipment department, has become a major issue before the hospital.

At the end of 2003, the equipment departments of some hospitals in Beijing spontaneously organized a meeting. At the meeting, the director of the equipment department raised many questions related to the development of the hospital equipment department. Many of them, in their view, are not solved by the equipment department itself, but should be solved by the hospital president, so they came up with an idea to write an open letter to the hospital president to reflect the problems faced by the equipment department.

Today, a year later, this letter is finally written. The main author of this letter is a director of hospital equipment department who has been studying medical equipment specialty since university and has never left the medical equipment business for 40 years.

Open letter from equipment supervisor to hospital director

Dear Dean:

Hello!

This is a letter that I have to write, because many difficulties faced by the hospital equipment department today are not solved by the equipment department itself. We tried to draw the attention of the deans to the equipment department in the form of an open letter.

In recent ten years, with the increasing application of medical instruments in hospitals, diagnosis and treatment have developed rapidly. Medical equipment plays an increasingly important role in the medical level and economic benefits of hospitals. Equipment department should develop continuously with the increase of hospital equipment application, but in fact, equipment management department has not developed as a whole, but has shrunk, and equipment department is in an embarrassing position in many hospitals. Reasons for the embarrassing situation:

Of course, we know that the embarrassing situation of the hospital equipment department is not entirely due to the dean, but sorting out the embarrassing reasons will help you solve this problem scientifically.

1. In the hospital, the medical discipline has developed for more than one hundred years. After the founding of the People's Republic of China, with the joint efforts of several generations of deans and academic leaders, most hospitals have formed a relatively perfect management model and are in constant reform. In contrast, medical engineering started very late and has not yet formed a relatively perfect management model.

The health administrative department is the superior organ of the hospital, which attaches great importance to the work of price, statistics, large-scale equipment configuration approval, consumables bidding, etc., but it pays insufficient attention to equipment management, low staffing and insufficient strength.

3. Most hospital directors are doctors, who are familiar with medical treatment and pay insufficient attention to the importance, difficulty, contribution, potential risks and crises of equipment department. This situation is understandable, but the result is objective.

4. Some vociferous articles have also been published in medical equipment-related journals, but the directors of these journals rarely read them, so it is difficult to play any role.

5. Compared with other medical disciplines, most equipment departments are relatively poor in academic qualifications, management level, technical level, computer level and foreign language level. This is closely related to the recruitment and appointment of personnel in hospital personnel department. Some hospitals even use the equipment department as a place to digest redundant personnel and arrange relatives and relatives of some people. What is more regrettable is that there is no training mechanism for the heads of equipment departments in society. These factors have seriously reduced the overall quality of the instrument department. The low quality of equipment department personnel is one of the important reasons for the embarrassing situation of equipment department. The equipment department of a few hospitals has high quality, remarkable work performance and relatively good status, which shows that the quality of personnel is very important.

6. People in charge of equipment at all levels, even the equipment department itself, often don't know what the responsibility of the equipment department is. I believe that the equipment department only needs to do a good job of buying, distributing and repairing equipment, as long as it seems to be working. Hospital leaders only think of the equipment department when purchasing and maintaining equipment, but don't understand the responsibilities of the equipment department, thus underestimating the difficulty of medical engineering.

The development of medical engineering started late, but it developed much faster than other medical disciplines. Neither the teaching content of medical colleges nor the improvement of the technical level of on-the-job engineers can keep up with the development of technology.

Clarify the responsibilities of instrument department;

Dear Dean, I don't know what you think of the responsibilities of the Equipment Department, but I think the responsibilities of the Equipment Department are technical management, logistics management and maintenance management, and scientific research and teaching should also be included in qualified hospitals, so the Equipment Department should be a technical management department parallel to the medical department and nursing department in the hospital. After defining the responsibilities of the equipment department, I think you will have a new understanding of the importance of the equipment department

The equipment department shall be responsible for all logistics management of consumables and low-value consumables, including planning, purchasing, acceptance, storage, distribution, accounting, statistics, measurement and adverse event reporting. When making a plan, we should consider the monthly consumption, reasonable inventory and effective period control of each variety. When purchasing, we should consider whether the purchase channels and procedures are in line with the policies of government management departments, compare the differences of similar products and whether the purchase price is reasonable. Warehouse management should consider fire prevention, waterproof, mildew prevention, insect prevention, antifreeze, anti-high temperature, anti-theft, anti-deterioration, how to check and record. The warehouse should cooperate with the incoming goods organically to ensure that the expired products are effectively controlled. We should consider whether the logistics procedures are concise and rigorous, whether the accounts can be error-free, how to make necessary statistics and frequently changing reports on the basis of accurate accounts, whether the computer management software is safe and whether it is closely coordinated with logistics management. This requires not only the understanding of medical applications, structures and materials, but also the knowledge of logistics management, which requires the equipment department to have a wide range of knowledge.

Participate in equipment planning and purchasing decisions, implement purchasing procedures, and be responsible for all logistics management. Medical equipment is a high-tech product involving multidisciplinary knowledge. The purchase, management, maintenance and scrapping of instruments and equipment need not only the basic knowledge of mechanical and electrical engineering, medicine, foreign languages and computers, but also the knowledge of business negotiation (bidding and competitive negotiation), contract signing, foreign trade procedures, transportation and packaging, operating environment, file management, measurement management, operation management, benefit management, national policies and laws.

In the process of equipment maintenance management, with the increase of "irretrievability" of advanced medical equipment in hospitals, the specific maintenance work of equipment engineers is decreasing day by day, and the tasks of maintenance management are increasing day by day, such as judging and supervising the maintenance situation of manufacturers; Whether the equipment has maintenance value; Determine the maintenance plan; Which warranty method to choose, etc.

Manage the whole process of safe and effective application of medical devices. This task is very heavy and highly technical, which is not only the safety and effectiveness of medical equipment itself, but also the resource allocation and clinical application. The management of this system is difficult and requires a lot of manpower, and this work must be completed with the cooperation of clinical medical staff.

Unreasonable rights, responsibilities and treatment:

At present, in most hospitals, there is an unclear and unreasonable division of tasks between the logistics department and the equipment department, and the fundamental reason for this unclear and unreasonable division of labor-forgive our intrusion-is the poor management of hospital-level leaders. This kind of poor management makes the work of instrument department more difficult, and also discourages the enthusiasm of engineers.

With the development of hospitals, there are more and more overlapping and mutual infiltration of departmental functions. Many medical engineers not only maintain medical instruments and equipment, but also take charge of simple work such as refrigeration equipment, gas supply, electric welding and locksmith in hospitals, such as repairing film lamps, snakeskin lamps, equipment carts, wheelchairs and so on. Some nurses pushed wheelchairs with flat tires to the equipment department and asked engineers to pump up the tires. Treating high-tech talents as ordinary workers is the strangulation of talents. Many engineers after job-hopping mentioned this point when talking about the reasons for job-hopping.

Engineers graduated from biomedical engineering departments of major universities, and their entrance scores were higher than clinical majors. But after graduation, their income and academic exchange opportunities are worse than clinical ones. Especially in hospitals, professional title evaluation is the responsibility of personnel departments and medical departments, and there are no medical engineers in medical departments, which leads to many unfair treatments in professional title promotion. In some cases, the bonus of engineers is lower than that of logistics workers, which seriously dampened the enthusiasm of engineers.

The subordinate relationship of equipment department to logistics management, the status of hospital equipment department is lower than that of logistics and medical department, which also makes equipment department unable to perform management duties.

Labor value cannot be realized:

Equipment maintenance is one of the main tasks of the equipment department, which has the most say on whether the equipment should be maintained, but in fact, hospitals often have no maintenance budget and the director in charge does not understand the value of maintenance.

Dear Dean, it's like buying a private car, which improves the efficiency and quality of life, but also needs to spend money to maintain a car. But many times, just like you don't know that it costs money to keep a car, you get upset when it comes to spending money. In order to put the faulty equipment into operation in time, the equipment department often feels "begging" when applying for maintenance fees, which seriously discourages the enthusiasm of engineers. Therefore, many times the user department applies for maintenance, and the equipment department lets the director of the user department apply for funds himself, and the equipment department carries out maintenance, which is also our helpless move.

The procedures for purchasing equipment, especially for importing large equipment, are very complicated. There are many difficulties in obtaining configuration permission from the health administration department, import certificate from the mechanical and electrical import department, tax exemption certificate from the customs, and signing foreign trade contracts with sufficient guarantees. The bidding process is full of various countermeasures, and the more it develops, the more perfect it becomes. All the people involved in the bidding have fallen into the swamp of control and anti-control, and the bidding has gone to the opposite side of the original intention of the decision makers. Responsible and fair bidding is a very difficult thing. As a superior leader, you often think these things are easy to do.

In the process of purchasing and installing large-scale equipment, conflicts between users and manufacturers often occur. Solving these contradictions and problems is a very arduous and important task, and you often think that the buyer is God and everything is easy to solve, but in fact it is far from it.

Configuration and price negotiation is an arduous process that runs through professional knowledge and the art of scientific negotiation. After many sales trainings, expectation control trainings, making full use of hospital internal resources and even external resources, investigation and analysis, and formulating strategies, the sales staff of manufacturers also need the cooperation of product experts. The forced and painful price reduction shown by manufacturers at the negotiation meeting is often a pre-arranged performance. Under such circumstances, the hospital equipment department should also have a set of scientific negotiation methods and strategies, and it is necessary to obtain a reasonable low price through psychological contest throughout the whole project at the negotiation table.

However, no matter how much the price of the equipment department is negotiated, as the dean, you should reduce the price again on the basis of the negotiation of the equipment department. If the equipment department talks about the price to the end, the dean will be deadlocked and difficult to end. In either case, the deans will mistakenly think that the negotiation of the equipment department will never succeed. This has also dampened the enthusiasm of the equipment department and even affected the moral quality of the equipment department. Theoretically, we also know that the solution to this phenomenon is communication, but communication is extremely difficult.

Deeper talent crisis:

The equipment department should be the technical management organization of the hospital, and its person in charge should not only comprehensively manage the equipment of the hospital, but also manage the internal work of the department, and even directly undertake many specific tasks such as procurement and maintenance. The Equipment Department also undertakes all tasks assigned by the Ministry of Health (department or bureau), the Food and Drug Administration at all levels and the Bureau of Quality and Technical Supervision, and also deals with the mechanical and electrical import and export management departments at all levels, customs and foreign trade. It needs not only extensive knowledge, but also some professional knowledge. With the rapid development of medical instrument technology, we must constantly update our knowledge.

Everything is done by people, and objective work obviously requires a high quality of the person in charge of the equipment department. At present, there is no mechanism to train leaders of medical engineering disciplines. In fact, such comprehensive talents are hard to get. What is more regrettable is that the enthusiasm of the existing academic leaders has been dampened or environmental conditions have hindered their ability to play.

I know that in your mind, Dean, you think you can hire doctors at a cost, but you don't think you can hire medical engineering management talents at a cost. However, under such thinking, the talent crisis in the field of medical devices is gradually approaching.

The head of the equipment department of the older generation is older and has retired or is about to retire. The embarrassing situation of hospital equipment department makes excellent college students who graduated from medical engineering major quit their jobs after three years of work, which is the same rule in all major hospitals. Those who can jump ship, those who can't, stay. This kind of talent filtering limits the quality improvement of the new forces in the equipment department and forms a potential personnel crisis in the equipment department.