Posted by Patrick Lynch, 12/10/2008 10:38:46 AM

Hospital administration often confuse technical training for Biomeds with the medical conventions that nurses, physicians and technologists often attend.  The difference is that technical training for Biomeds directly affects our ability to be able to perform our jobs in the weeks, months and years to come.  A nurse can still nurse if she misses a nursing convention for a year or two.  But the skills and knowledge to support and service new medical devices does not materialize from the air.  Technical training, whether negotiated at the time of purchase, or paid for from an annual operating budget, is the best value that a hospital can realize.  The benefits begin immediately, and extend far into the future.  The benefits are not just monetary.  Having trained Biomeds on staff who can work with compatability issues, train third shift nurses, and be present almost immediately to work with clinicians who are having problems during a procedure are benefits for the hospital and the patient that relying on an off-site service provider can not come close to providing.  The short-sighted people who decide that that cutting a $5,000 training school is a good idea are obviously NOT consulting the service professionals within the hospital.  Please read the Soapbox inside the back cover of January 24x7 for more details.

Posted by Chris Correll, 12/10/2008 3:22:04 PM

Hi!

First, in order to get the training your “Biomeds” need you must learn to speak the language of our Hospital Administration and Director of CE. Years ago, I had a similar problem when I first took over my department, but then I quickly discovered that administration’s job is to provide the “best” quality of medical care at a low cost to our organization without affecting patient care or patient safety. In fact, this is what every Clinical Engineer and BMET should strive for is lowering costs, but keeping in mind that our first priority to the medical equipment maintenance program is to ensure all medical equipment is serviceable, safe, and properly configured to meet the organization’s medical mission.

Secondly, the best way to accomplish this is build a good rapport with them and begin speaking their language. For example, this is how “we” can save $XX dollars if we send a BMET to a $5,000 training course. Also, for my example let’s use the following figures:  40 ventilators on-hand in your equipment inventory, no trained BMETs, and you have a $20,000 contract with a service provider downtown.  This is how I would attack this problem 1). I’d call the manufacturer to find out the cost of training; let’s say its $5,000 per BMET. 2). I already know I have 40 ventilators in my inventory so that’s $500 per ventilator to be calibrated (wow, that’s expensive). 3). Also, how often are ventilators PMd/Cal’d every 6 months, right?  Now that’s $1,000 per year per device.  3).

Lastly, run the numbers as well as show them a PowerPoint presentation comparing (advantages of training) versus contrast (disadvantages of training).  You said, “It seems that the training is “written off” as a cost savings to the purchase price of the capital equipment or imaging system.” That tells me a couple of things: 1). Your BMETs are able to do the work. How is the work getting done? 2). The equipment package isn’t comparing training to the high cost of contracting the work out. “Our hospital currently has a policy that will not allow any training cost to be purchased as capital equipment since it cannot be depreciated.” I would disagree with that statement due to the fact that training does depreciate at the same rate as does the equipment. I see managements point of view that the BMET could get the training and go elsewhere, but a happy BMET with good opportunities for additional training by his organization will make that BMET sick around.  Finally, you must convince management that to get/keep high quality BMETs on their payroll they need to make sure that BMET feels important in their organization (respected) and see room for advancement (such as the organization providing training).

I’ll close by saying that cutting costs of training is a disadvantage to the organization and a patient safety incident waiting to occur.  That’s why we report those “use error” numbers to the safety or Environment of care committee. So, build a really good rapport, ask those tough “well, why” questions, and speak their language by showing numbers on paper.

I hope this helps!

Regards,

Chris

Posted by Joe M, 12/16/2008 3:47:25 AM

Assure your Material Management/Purchasing department is on board with training requirement when negotiating with the vendor, have them request in RFP documents. This is the time to acquire vendor training at no charge.  Assure you get in writing the training you require and expiration dates of this offer ie you must take training in year 1 or 2.

Posted by Tim Burke, 12/22/2008 4:32:07 AM

Chris Correll's post says it best.  I have 2 other points to add:

1.  It's all about cost effectiveness - not emotional pleas to admin for training money.  There is a cost benefit to all of our actions, including training.  Analyze carefully and thoroughly.  Bottom line, don't waste productive energy on anger or disappointment.  

2.  It's been my experience that few manaufacturers give away training anymore.  I still try to get training rolled in to the capital purchase, even as line item cost.  This is still helpful - not because the cost is not in my budget (it's still hospital money), but because I don't have to wait for a new budget cycle to plan.

Furthermore, even if the cost is free, or hidden, the value of the training should still be a factor when doing a cost benefit analysis.  If free training is the only factor that makes in-house support of a certain item cost effective, it probably is already not justified.  What if an employee leaves and you need to retrain out of your expense budget?  

Posted by Dave Soumis, 12/23/2008 3:23:15 AM

In my opinion, cost based justification is the wrong way to look at it. The bottom line is the fact we technicians cannot provide a high level of repair or have high level of understanding of the equipment without adequate training.

What is the cost of a life, when we do not understand, in depth, the functioning of a piece of equipment and mess something up?
Configure something incorrectly and the equipment produces an incorrect analysis?

Revenue savings shouldn't even be included in the equation, other than the fact it often results from proper training.  Patient safety and correctly functioning equipment should be the focus so the staff can use the equipment with the highest confidence it is working correctly. This philosophy should be used in purchasing test equipment as well. Its a neccessity.

Posted by Yadin David, 12/30/2008 4:08:19 AM

The field that brings and supports safe technological solutions to healthcare, Clinical Engineering, is depndent upon training to maintain practitioners' competency. However, reimbursement and accounting principles has changed the association of access to training during capital acquisition to continuous and on-going commitment. Practitioners, industry and educators need to join togather and find a new way to keep up with technological changes. Perhaps, local chapters meetings (were several potential clients are represented)need to focus even more on technical seminars supported in part by local colleges.
Reality is changing and we need to find new partnerships to sustain the competencies. Any ideas how to get it done?
Yadin David  
Biomedical Engineering Consultants, LLC

Posted by Tracy Henry, 12/30/2008 4:39:51 AM

I have asked a vendor why they are itemizing the training.  Whether it is true or not they said that they are being required by new government regulations to have every item of value detailed.

It's more difficult to budget separately for training but it is looking like that is the option we will have to take more often.  When working up the cost analysis don't forget the non-dollar value added benefits.  I work at a remote rural hospital.  If something goes down it's a trip across the state to get service.  We're lucky if it is next day.  Having someone on-site that can make the repair or order parts today is an added value.  Especially if it is an only device and services have to be canceled while waiting for the repair.

Tracy

Posted by Michael Herz, CBET-R, 1/29/2009 4:07:42 PM

I have worked OEM, In-house and Third-party.  In-house, to save money is simple math.  Look at the cost of the service contract for five years, and then the other options, like training in-house technicians.  When you add the benefit of having 'INSTANT' service by having in-house diagnose, troubleshoot, and repair, there is no question that it makes sense to have in-house staff trained on the equipment they service.  It is called doing a professional job in a professional atmosphere.
Intangible 'time' is hard to show value to the bean counter.
The first year that I worked in-house I documented savings of over $150,000 in parts and labor savings.  This did not include what was not documented including the 'Instant' access to service and the significant increase in equipment uptime, availability.  And this was a very small institution.

Posted by online nursing degree, 9/1/2009 3:30:12 AM

It seems like you are just months away from the completion of your new hospital. With the opening of your new hospital, you should make sure that you're staff and employees are professionally well-equipped too.

Posted by Scot Mackeil cbet, 11/22/2009 7:13:20 AM

This issue of training and travel expenses for biomed's is one of the "secret shames" of our industry. monitoring systems with a 7 digit price tag and no way to find a few hundred dollars to send the biomed guy to school? i bet extensive monies were spent to educate caregivers on 3 shifts around the clock before the systems went live? i bet there were many pages of sign in sheets documenting the caregiver staff was trained? why? because user training is mandated by the JC.

my main point is that much of the behavior of senior administration regarding issues like funding travel and training for biomeds is that it is all driven by what a JC inspector looks at during the survey process. until the JC starts walking into materials management departments, asking to see purchase orders for medical equipment along with receipts and certificates to prove biomed staff went to training on recently purchased systems, this "secret shame" of our industry will only continue to grow and grow.

it is my belief that in order to solve this (and other issues) the biomed industry needs to lobby for the JH to develop and include survey criteria which de-incentivize this particular institutional behavior. hospitals employ people to study the JC accreditation process and create a checklist of all the "things" the organization needs to "do" and "spend money on" and if things like biomed training, staffing, space, service manuals etc... are not on that checklist because they are not being surveyed, it is collectively our fault as an industry. we can gripe all we want but change is not going to happen unless the survey process changes first. the JC survey process is where it all starts and wether we like it or not, it is where it all ends.

IMHO, J Scot Mackeil CBET

ps, kudos to any biomed department managers who have the political and organization skill NOT have their departments be in the situation described above. but wouldn't it be nice not to have to fight for every budget cycle because the biomed education money had to be allocated simply because it was mandated by the JC, case closed?

Posted by phoenix social media, 1/24/2011 8:41:16 PM

I know in my area the biomed industry is booming and I'd be disappointed in any employer that didn't provide some level of ongoing training to its employees. So many job descriptions are morphing into entirely different jobs that ongoing training should be taking up a portion of every employee's week. Employer's that get this will have well trained and efficient employees going into the future.

Posted by comparateur mutuelle, 12/1/2011 5:15:14 AM

very nice!!!!