Stellar care for the most fragile patients
Founded nearly 126 years ago, Children’s Hospital of Wisconsin ranks among the oldest hospitals in the Midwest, and it boasts a Time Magazine-lauded neonatal intensive care unit. Below, Children’s Hospital of Wisconsin’s clinical engineering manager, Ann Rovito, discusses what sets the facility apart and how the hospital has been able to stay ahead of the looming HTM staffing crisis.
24×7 Magazine: Can you please tell us a little bit about your department and the equipment you maintain?
Ann Rovito: Our department employs a wide range of technical knowledge specialties and levels of experience. We have six biomedical specialists, three BMETs, two senior BMETs, three imaging specialists, one senior clinical engineer, two part-time clinical engineering aides, one administrative assistant, one manager, and one director. We report directly to the vice president of diagnostic and surgical services.
Clinical engineering is responsible for all equipment that performs diagnostic functions, monitors, or provides therapy to our patients. The range is wide—from small, handheld devices to surgical robots to pulse oximeters and biplane imaging systems. We are also responsible for temperature monitoring for vaccines, tissue, blood, and breast milk.
The levels of service we provide vary, ranging from full maintenance and repair responsibilities to oversight of performance of vendors for equipment fully covered by a service agreement. We are responsible for a territory that covers a great deal of Southeast Wisconsin, including the Milwaukee hospital plus a growing number of outlying clinics, physician offices, and urgent care facilities. We also consult and advise on the management of equipment in an NICU and peds unit in our Fox Valley location, approximately 1.5 hours north of Milwaukee.
24×7: What would you say are the biggest challenges your team faces on a daily basis?
Rovito: Our most pressing challenges are related to the evolution and growth of our hospital and system. Physical space is a challenge since we are unable to expand our walls in any direction to provide the much-needed room for additional staff and the increase in equipment we are servicing.
Associated with growth are managing additional responsibilities that come with expansion projects, both in planning new spaces and providing support once the doors are open to patients. This applies to expansion within the hospital and new outlying clinics—most recently, full-service clinics (imaging, specialty services, urgent care, and standard clinic space) at the outer edges of the community that bring the point of care closer to home for many.
24×7: Maintaining a strong pipeline of talent is a challenge for any biomed department—especially given the widespread graying of the field. So how does your team attract and retain department members?
Rovito: Our pipeline of talent is steady despite the waning numbers of students in BMET programs overall. We have a strong relationship with our local technical college from which we host an intern every school year. The majority of our staff are graduates from that program, including the three most recent hires in the past five years. A current instructor in the program is a former employee of Children’s, and his predecessor was employed here as well.
The attraction begins with the reputation of the hospital. Working for a department that assists with caring for children is a source of pride. There is a strong commitment to ensuring the clinicians and providers not only have the equipment they need, but also that it’s maintained and working properly. This sense of pride has grown from the grassroots level of the department and is reinforced in staff members’ peer-to-peer relationships. The strength of team and collaboration is functionally exceptionally high. That is something evident during recruitment interviews and experienced by interns who are new to Children’s.
Of the 17 technical staff, 10 have been CE employees for longer than 10 years and eight have been with us for more than 15 years. The culture of collaboration and providing quality, personal service is at the crux of our ability to have such a high retention rate. While our responsibilities and workload are high, we do our best to offer flexible schedules with strong considerations for family responsibilities and the need for personal time away from work. Our team is very supportive of each other both professionally and personally.
Our team members are often recognized by the clinical staff for the added value and high-quality service that we provide. The clinical engineering staff is considered to be an important part of the teams that we support to provide the best and safest care.
24×7: Can you please discuss a time when your team directly impacted patient care?
Rovito: A team member was approached by clinical staff to come up with a solution for a small patient who was in the ICU and on a ventilator. She was ambulatory-capable but the restriction of having the ventilator connections—specifically the gas hoses—limited her “walks” to within her room. His immediate resolution—to at least get her out of the room—was to make very long hoses (approximately 50 feet).
Knowing this wasn’t enough, he worked on a couple of designs—by trial and error—and came up with a mobile system on a reliable, sturdy cart, complete with UPS and portable gas supply, that enabled this patient to not just leave her room but walk (run!) around the unit, enjoying her newfound freedom while still connected to her ventilator. The clinical staff caring for her said this mobility likely had a direct positive impact on her healing. This team member received one of the highest recognition awards from the president and CEO of the hospital, presented in front of 400 leaders at an all-system leadership meeting.
24×7: How is your department working with IT to keep devices secure and thwart cyberattacks?
Rovito: Clinical engineering has partnered with IT to collaborate in the evaluation and eventual purchase of an application that monitors medical device network traffic. IT currently leads in monitoring and managing the alerts and notifies us when a risk is identified. We then work with the vendor, when needed, to apply security patches or take other measures as defined by the manufacturers.
24×7: What else should 24×7 Magazine readers know about your department?
Rovito: We are a committed, talented, and diverse group of individuals who, together, prioritize strength, knowledge, and integrity. We understand how our roles and duties fit within the mission and day-to-day functions of the hospital. We take pride in what we do, how we do it, and why we are important, even though many of our efforts are performed and accomplished behind the scenes.
Working at a pediatric institution, we understand the situational importance of a functioning CT scanner for a trauma patient, as well as the need for a child-sized plastic shopping cart in PT whose handle must be modified so a specific patient can grasp it properly. We are fortunate to partner closely with our clinical teams in incident investigations, technical support, equipment specification and evaluation, training and regulatory reporting, and more.
Our daily challenges are numerous, but the satisfaction and pride we take in providing and upholding a safe environment for our patients and families, directly through the work we do, is more than enough to bring us back every day.