The Men in Blue

The Men in Black take care of extraterrestrial problems, ensure human survival, and wipe memories clean. Less well-known, but far more real, are the “men in blue.” A small group of skilled engineers, they are also known as the clinical engineering team at the EMH Elyria Medical Center in Elyria, Ohio. Their mission is to take care of biomedical equipment, maintain maximum equipment uptime, and provide excellent customer service.

It is a mission that has been made a bit easier since becoming the “men in blue,” a situation that occurred organically but fortuitously. “We used to wear white lab coats, and a lot of people mistook us for doctors, nurses, or other clinical people,” says David Mann, manager of the EMH clinical engineering department. In fact, Mann began to acquire the nickname “Doctor Dave” in response to the frequency of the occurrence.

So the team decided to buy new lab coats in a distinct color that would be unique to them. They landed on navy blue after a department vote. “It was a wise thing to do because our white coats got very dirty,” says John Hojnacki, CBET, CRES, the team’s imaging specialist and a BMET.

The investment was minimal—just a few hundred dollars, according to Mann—but the result was far worth it. “Almost immediately, people started spontaneously calling us the ‘men in blue,’ and we ran with that. It gives us a sense of team identity, and on more a practical end, it made us instantly identifiable out on the floors,” Mann says.

The new moniker seemed an obvious theme for the hospital’s celebration of Healthcare Technology Management Week or, more familiarly, Biomed Week, where another small investment reaps big rewards in terms of awareness and recognition for the department, both within the hospital and the industry. The Association for the Advancement of Medical Instrumentation (AAMI) recognized EMH’s celebration of the week as a model.

But the team’s efforts for the week are not an aberrance; rather, they reflect the general work ethic of the department: simple, Lean, and effective. Teamwork is key, autonomy assumed, and humor doesn’t hurt.

Team Profile

The EMH clinical engineering department is made up of six staff: Mann, the manager; Hojnacki, an imaging specialist; John Mouhanna, senior BMET; and three BMETs, Zachariah Chance, Mark Kundrick, and Allan McHugh. The team organizes the work by department, with a primary technician assigned as the contact point for any service needs. “We strongly emphasize a personal relationship between technicians and their client departments,” Mann says.

There is, of course, some crossover that occurs between departments with specialized equipment. For instance, Kundrick maintains the autoclaves throughout the health system, Hojnacki handles all imaging, and Chance responds to network issues. “Any team of our size must be elastic,” Mann says.

EMH is comprised of the main campus as well as four satellite centers and various physician offices. “We take care of the offices as if they were a hospital satellite,” Kundrick says. No one person is assigned to these areas.

The team tries to take on what responsibilities it can for an inventory that numbers nearly 5,000 devices. They’ve found the elimination of full-service contracts to be a huge money-saver. Mann points to the success seen in imaging.

“We’ve invested pretty heavily in training for John [Hojnacki] over the years, and it has paid off in converting full-service contracts to shared-service contracts or even eliminating them altogether for a savings of well over $100,000 a year,” Mann says.

Such results have helped to secure further funds for training. “As with John [Hojnacki], we’ve been able to demonstrate that when we train people, we get a long-term cost benefit as well as faster response times and more client satisfaction,” Mann says.

The System

To enable the biomeds to perform their best, each member of the team is given a large amount of autonomy. They have the authority to generate purchase order numbers for parts and services for vendors and enter that data directly into the supply services database. “This gets needed parts and outside service requests into the pipeline immediately, so there is no unnecessary downtime while they await sign-offs or processing,” Mann says.

Everyone also has manager’s rights to the database, allowing them to adjust PM schedules or procedures as they see fit. Each team member is expected to act as an advocate for the departments he services and be engaged at every level, participating in capital purchase discussions, contract negotiations, and performance reviews with vendors.

The department works closely with partner groups—IS, facilities, and materials management—through open lines of communication. “So we rarely experience unpleasant surprises because we have been brought in too late on a problem or project,” Mann says.

Projects and process changes are discussed collectively, and creative conflict is encouraged. “And most obviously, while we are certainly proud of our profession and our mission for the hospital, we don’t take ourselves too seriously. This can be a stressful job, and you have to keep a sense of perspective and a sense of humor,” Mann says.

MIB Premiere

That humor is on display during Healthcare Technology Management Week, when the department celebrates its profession. “Biomed week is only 5 years old, but for a long time we thought we ought to do something. There’s a PT week, nurses week, RT week, lab week, facilities engineering—why not us?” Hojnacki says.

The department is small but key and sometimes unrecognized. “Like many HTM departments, we are very appreciated by our clients, yet largely anonymous to many other members of the hospital or confused with other, larger departments. ‘Biomed? They’re part of maintenance, right?’ ” Mann says.

Hojnacki estimates that approximately three-quarters of the hospital does not know who clinical engineering is—or didn’t before the “men in blue” campaigns. The first year was small. “We put up a cardboard display with information on it and noticed that, most of the time, people just walked by and glanced at it because there was nothing to draw them in,” Chance says.

The most positive comments were in regard to the “gag” photo of the team in their blue coats wearing dark wraparound sunglasses. “Numerous people in the organization asked for copies,” Mann recalls.

MIB Sequels

So the team decided to expand the theme the following year and again this past May. “It was so popular, we built on it further this year, humorously suggesting that our department was actually some sort of clandestine technical organization with a confidential mission,” Mann says.

The display remained the center of the celebration, but to build interest, the team added a “Take a Day off on Biomed” contest involving a quiz. The information was communicated on a board outside the cafeteria as well as through daily e-mails sent by Mann. Questions included fun facts about the team members as well as educational information about the department.

For instance, team questions included: “Which team member held a top secret clearance in military intelligence?” (Mann); “Which team member is a former drag racer?” (Mouhanna); and “Which team member wrestled a bear?” (Kundrick).

Educational queries asked: “How many work orders does the clinical engineering department average a month?” (893); “For emergency clinical engineering service 24/7, who do you call?” (EMH operator and have the BMET on-call paged); and “How do you unplug a mobile medical device when it needs to be moved?” (Grasp the plug and pull straight out to avoid damage to the cord or prongs).

The respondent with the most correct answers won a day off. Mann donated one of his personal time off days to provide the top prize. Second prize was an autographed 8×10 glossy of the “men in blue”; third was a pair of “Official Men in Blue sunglasses.” Ties were to be decided with a random drawing.

Although the department received only about 100 completed quizzes, anecdotal evidence suggests that far more people actually participated. Mann suggests that next year’s quiz may need to be a little easier. “It’s a lot of fun,” Hojnacki says. Chance concurs, adding, “People are always trying to throw personal questions into conversations to fish out the answers.”

The investment is minimal, although it can be hard to find time to pull the campaign and materials together. Planning starts a couple of months before. The marketing department handles the production, so everything is completed internally. “The first year we put together our own board, but marketing has taken it over the last two times and done a beautiful job,” Hojnacki says.

Through it does require some extra work, the effort is worth it. “Not only do we promote our profession, but we get out useful information such as how to contact us in an emergency, or how to tell if a device is charging. Everyone seems to enjoy it—and there’s nothing wrong with enjoying your job,” Mann says.

In Development

That element of enjoyment is key to the attitude of the EMH clinical engineering team. “I worked in maintenance for 18 years, and the big difference is that maintenance gets on the floor, does its job, and returns to the shop, but biomed needs to talk to the staff and work on the equipment right there with them. I love it,” Kundrick says.

The enthusiasm is shared by his colleagues and carried through to performance. Each biomed is encouraged to develop personal relationships with their client departments and to assume responsibility for their inventory using Lean process improvement as a guiding philosophy. “Uptime is a priority—we’re not going to delay a repair a week to save 10 dollars—but we have always operated with a Lean mentality,” Hojnacki says.

“I spend the hospital’s money as if it were my own,” McHugh says. “I shop around pretty hard for parts and service to make sure we’re not wasting money or parts, or if warranted, I’ll follow up and hold providers accountable.”

The team also applies Lean process improvement to workflow challenges, often sitting down together to work out solutions. “With Lean, we don’t try to achieve perfection immediately. You work toward improvement, making adjustments as you go,” Mann says.

So how will the team adjust for next year, particularly Healthcare Technology Management Week? The “men in blue” may be retired. Recently, the clinical staff has discovered the advantages of color and begun to wear blue warm-up jackets. “So blue has become a common uniform color,” Mann says.

The next campaign is currently confidential (also known as “in development”), but the mission remains the same: to take care of biomedical equipment, maintain maximum equipment uptime, and provide excellent customer service—and while it is not battling aliens, they are doing their part to ensure human survival.

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Renee Diiulio is a contributing writer for 24×7. For more information, contact .