Since imaging departments are profit centers, minimizing equipment downtime directly corresponds to the profitability of the medical facility. Depending on the facility, for every 15 minutes of downtime, CT scanning equipment can lose the facility as much as $2,500, and MRI equipment up to $3,500. One of the most effective ways a biomed department can reduce this risk is by implementing an in-house first-call support system.
In a first-call system, an in-house imaging biomed is designated as the first person the hospital staff contacts when there is a problem. By responding quickly, the imaging engineer can begin the diagnostic work needed to determine whether a field service engineer must make an on-site visit to fix the equipment or if it can be repaired with in-house expertise. Implemented effectively, a first-call solution will both minimize imaging system downtime and reduce service contract costs.
A first-call system benefits biomed imaging professionals as well as their facilities. Troubleshooting and resolving issues on their own, without having to bring in an outside technician, increases their value within the medical facility. According to biomeds surveyed for this article, they were able to resolve anywhere from 50% to 80% of the problems they were called for without having an outside resource come on-site. Since imaging departments are profit centers, imaging engineers who can keep that equipment up and running are having a positive outcome on the profits of the facility.
If the OEM is needed on-site, first call can help by defining the problem so OEM engineers know the details before their arrival. They will therefore more likely know what parts are required to fix the issue, which further decreases the on-site repair time and costs.
Most importantly, patients benefit from the services offered by first-call support. Because first-call response helps quickly determine whether the equipment is administering the proper dose, patient safety is more quickly ensured. In addition, when system downtime is decreased, patients are less inconvenienced by lengthy waits while the machine is being repaired or, worse yet, by having to reschedule their appointments.
When a user or department staff recognizes an issue, the first step is to report the problem via a phone call or through an automated system. The responding imaging engineer will need to conduct tests using a multifunction x-ray meter to provide enough information to determine whether the issue is caused by operator error or equipment malfunction. Collecting as much relevant information in as few exposures as possible will accelerate the diagnostic process.
The severity of the issue is determined at this point as well. Once the test results are certain, the issue is either resolved in-house, perhaps with OEM or vendor support given over the phone, or is escalated to an on-site visit.
A key question for the imaging engineer is whether the system in question can remain in clinical use or must be taken offline. The imaging engineer will need to determine the answer by asking questions such as the following:
- Is this an image quality issue?
- If so, can the radiologist accomplish the task of diagnosis with the quality of the images being produced?
- Can a system parameter adjustment be performed?
- Does it seem to be a mechanical issue?
- Is the system administering a patient dose that is as low as reasonably achievable?
- Is the system mechanically safe to operate?
The system should also be checked to ensure it is performing within its specified functionality with respect to kV, mA/mAs, time, dose, and dose rate.
If the technician determines that the system must be taken offline, the main goal shifts to minimizing the cost of repair and maximizing system uptime. The sooner the repairs begin, the faster the system will be up and running with less impact on service costs and imaging center revenue.
If vendors or OEM service providers are required to resolve the problem, a phone call—or better yet, a videoconference call—will help them understand the problem. If a second or third call is necessary, it will ideally involve the same support person so there is continuity.
Ideally, a first-call contract with a service provider or OEM will be flexible enough to accommodate the needs and budget of the medical facility. If the contract must be with one OEM, there may be room to negotiate contract requirements. If there are multiple vendors in the running for a contract, it may be possible to leverage contract rates to keep pricing competitive.
Five Keys to First-Call Success
By taking the following considerations into account, a biomed department can maximize the success of its first-call program:
1) Training. A well-trained and enthusiastic staff is essential to a first-call program. Biomeds should be excited to work on specific equipment and have training from a reputable training facility or the OEM. Going through training builds confidence and enables the engineer to identify and resolve problems quickly and efficiently. Sufficient funds for training of all individuals doing first call should be allotted in the department budget.
2) Preparation. Having the proper documentation and the latest schematics for the systems the first-call technician is supporting will help ensure rapid diagnosis of problems. Having service keys to gain access to system event logs will provide further insights. The in-house biomed may never have 100% of the documents or privileges the OEM engineer has, but taking the initiative to request these documents or abilities could affect the outcome of a first-call support session.
3) Tools of the Trade. First-call responders need to have the right tools to meet the challenge. While there are various options available, x-ray test meters that are fast to set up and that take initial measurements quickly will be most productive. If a technician must spend 10 to 20 minutes getting ready to take measurements, that is valuable time lost.
4) The Human Element. The technical side of executing first-call is clearly important, but there are other aspects that need to be considered. Having good communication skills to be able to articulate the problem and work with the staff is important. By establishing a good relationship with the people they support, first-call biomeds will gain the trust and respect of their customers.
5) Public Relations. Success stories involving first-call situations should be shared with all the imaging department stakeholders, including upper management and even the finance department. HTM managers should take the time to document how their team got the imaging system back up in a timely manner and to estimate the money that the facility saved as a result. The visibility the biomed imaging department will receive will go a long way toward consideration of new tools and support needed to continue to deliver these results.
Saving time and money while improving the end user experience has become a top goal for many medical facilities. Properly implemented, first-call support is a cost-effective strategy for decreasing support costs, increasing system uptime, and improving experiences for patients.
Sally Chambers is sales and marketing manager for Unfors RaySafe, Hopkinton, Mass.