L–R: Mark Shelton, BS, CBET, Mike Scalf, imaging tech, and Mark Sheffield, CBET, take care of business in the cath lab.

Collaborating to complete a complicated repair or install a new piece of equipment—or 100 pieces—is nothing new for professional biomeds. Coming together to help decide who the new boss will be, on the other hand, is not quite as common. Yet, that is exactly what happened at North Mississippi Medical Center (NMMC) in Tupelo, Miss, where the resident techs lobbied successfully for the vacant management position to be filled from within the department.

“It just didn’t feel like anybody coming in from the outside could have made a substantial improvement in what we do,” says Shane Smith, CBET, biomedical services clinical division supervisor. “Beyond that, there was also some worry about what you’re getting from the outside. Everyone has been here so long that we knew the people who wanted the job, we knew what kind of people they were and how they were going to treat people if selected for the position.”

That exact attitude was held by a consensus and, as a team, details hammered out through discussions were drawn up, delivered to management, and well received.

“In our meetings, we decided that we had more than enough experience and leadership ability among our own peers that there was no point in recruiting someone from another facility,” says Mark Shelton, BS, CBET. “Beyond that, we all felt we would much rather have one of the other guys in the shop be our manager than a stranger. And it has worked out really well.”

As hospital management reviewed the qualifications of the half-dozen internal applicants, a panel of techs was recruited to help interview candidates and weigh in with their opinions. Each candidate presented their thoughts on how to run the department, both to upper management and to their peers.

L-R: Mark Sheffield, CBET, and Mike Dozier, CBET, work on a circuit board from a cath lab table controller box.

Of course, no matter how well-intentioned or how well techs get along working shoulder to shoulder, rubbing elbows for the top spot sets the scene for ill-will and animosity. Somewhere else, maybe. Definitely not at NMMC.

As Shelton jokes, “I like to say that we had the election. Ultimately, it was our department head’s decision, but we all had some input in it, and that makes a difference.”

Still, moving from peer to superior is a delicate transition, one rife with potential discord.

“To be effective as a leader and in management, there is a little bit of a line that you need to not cross; then all of a sudden you are faced with the possibility that, at some point in time, this guy who I have been golfing with is now my boss,” Shelton says. “Can you draw that imaginary line and respect that now he may have to critique you and what you do?” He adds that retaining a positive demeanor was never a challenge for the team. He also references the importance of communication in helping keep competition for the top spot friendly. “At that point, the question was, can you be a professional biomed and back whoever is chosen? The good thing about it was, we kept talking among ourselves and it never got negative.”

PROVEN SUCCESS

Better still: it actually worked. “I haven’t experienced any animosity at all,” says Smith, who assumed the role of department manager about 2 years ago. “Had there been a lot of that, then I wouldn’t have wanted any part of it. Instead, I’ve gotten nothing but support from my coworkers.”

That contention is evidenced through the facility’s biennial employee opinion surveys. “When I first took over the job, we had just done one, so I actually just had my first, full-blown, 2-year employee opinion survey a few months ago—and I got a 93% positive response.”

L-R: Mark Sheffield, CBET, Mike Dozier, CBET, and Mark Shelton, BS, CBET, check the waveforms on flat panel monitors physicians use during procedures.

Accolades have come from external sources as well. In 2006, the hospital was the Baldridge Winner for Healthcare, an award presented to leaders in excellence within their given industry.

He attributes his success to the bond among the techs, who have forged and maintained a tightly knit group within a facility that employs more than 6,000 individuals.

“We are family,” Smith says. “We know what each other’s spouses do, what our children do, and a lot of times we mingle in the community together. This is just a great family atmosphere here,” he says. Most days, visitors to the department’s library will find the bulk of the team sharing their lunch hour—and the gang often includes the department’s clerk, Sharon Birmingham.

Birmingham’s responsibilities include completing and organizing the team’s paperwork, managing billing, and ordering parts and supplies, along with “putting up with a bunch of guys,” laughs Imaging Tech Mike Scalf. “This is a pretty rare facility and a rare environment; it’s a family-type environment, and she is part of that. We just would not function without her.”

Troubleshooters in action, L-R: Mark Sheffield, CBET, Chris Wray, CBET, and Mark Shelton, BS, CBET.

IN FOR THE LONG HAUL

Appreciating existing staff and looking at them to fill open positions is good for morale and contributes to a smooth handover of responsibility. Talk to an NMMC tech and you are undoubtedly in conversation with a professional who boasts more than a decade in the industry.

Crunching the numbers, the team’s 15 biomeds, which is comprised of nine clinical techs, four radiology techs, one in the lab, and Smith, have six certifications and a combined 266 years of experience—the vast majority of which was accrued at the hospital.

Such commitment and longevity proves to be an elusive goal for many organizations. At NMMC, however, the secret to keeping techs around seems to be keeping them happy. “Something that is very important here is the opportunity they provide for personal advancement,” Scalf says, referring to the managerial search as an example. “It’s very important to the satisfaction of the employees that they have the ability to move up in their chosen field. People have goals and aspirations, and to keep them, you have to allow them the chance to climb the ladder.”

Beyond filling management or lead roles, preparing for upward mobility at NMMC translates to on-the-job training and responsibility. Each tech has a specific service line they cover, working with others to guarantee coverage around the clock.

NMMC’s team of biomeds also work closely with the techs who make up the communication side of the department. The communication professionals are tasked with maintaining all of the communication systems throughout the organization, including all phone and paging systems, cable installations, V-Tell, and wireless networking.

Most of the biomedical services techs split their time among the 650-bed main hospital, five satellite hospitals (each with 75 to 100 beds), 35 medical clinics, a breast care center, an outpatient rehab center, five wellness facilities, a behavioral health center, and the associated women’s health center, along with numerous private physician’s offices. “This particular job is very satisfying in that there is enough travel and enough diversity during the course of the day to keep the job challenging,” Scalf says. “You are needed during the day to take care of your customers, yet you still get to go home to your family every night.”

That family factor is a recurring theme for Smith, who understands that professional opportunities are just part of the equation. His philosophy is that for his team, their lives outside the hospital come first.

“I want them to be able to spend time with their families,” Smith says. “I want them to be able to go home if someone is sick or if there is a band practice or a concert, sports, whatever the case may be. The flexibility that allows them to be able to spend time with their family is one reason why people enjoy working here.”

That inclusive nature is not reserved just for in-house biomeds. The family atmosphere travels out to the clinics, where the assigned biomed will make a point to talk with the staff on-site, asking if there are any unmet needs or unresolved issues.

“When we go out and work on stuff, most of the time we will stay for a few minutes and talk with the client about what they have on their minds,” Smith says. “The guys who go off-site have a relationship with their point of contact there; they have an idea about how many children he or she has, if their child plays a sport, that type of thing. And I encourage that: I look at it in reverse order of how a CFO would look at it. I will focus on our relationships with each other and, by extension, with our families, because the caring attitude the technicians have is not only toward one another, but it carries through to customers we serve and the patients that we serve because in the end, that is who the equipment is used on. And that is very important to us as individuals within the department.”

NEGOTIATING IMPROVEMENT

Of course, all the concerned questions and flexible schedules in the world won’t hold a team together if the hands-on experience and overall know-how is not there. In addition to in-house cross training, NMMC biomeds benefit from OEM-administered training for virtually every new acquisition.

“What we try to do is include, in the purchase agreement, the things that are vitally important to us as a facility. That list includes having the vendor pay for the training courses for our biomeds,” Smith says, who notes this practice has been in place during his 2 decades with the organization. “We will pay to get our techs there and get them home, but the vendor needs to cover, at least, costs for the training portion.”

Having access to an authoritative information source for a piece of equipment is important not just for the new purchases. “A heart monitor, for instance, performs like a heart monitor from 20 years ago; it still does the same thing, but the insides of the equipment have changed, even if the function of it hasn’t,” says Mark Sheffield, CBET, a senior technician at NMMC. Heart monitors, among other systems, have transitioned from requiring manual calibration to being virtually self-calibrating. “And as a result, it’s important to stay on top of how things work, because we basically fix everything that breaks, and if you’re doing that, then factory training is very important.”

In fact, staying up-to-date in this fashion has allowed NMMC to release the vast majority of its contracts, assigning responsibility for ongoing maintenance and repair to the in-house team.

Less than 1% of the facility’s 16,000 pieces of equipment are maintained with a service agreement; items are left under contract only when it is financially advantageous to do so. These items include some chemistry equipment along with glass protection policies for the tubes in many of the imaging systems. The end result of in-house maintenance is an estimated annual savings of about $5.5 million.

“Bringing contracts in-house is a lot of risk for the hospital, and there has to be a lot of confidence in the biomed staff for management to agree to it, because one thing the department doesn’t want is to have something break and have an in-house guy say, ‘I have no clue’ or ‘I’ll get around to it when I can,’ ” Shelton says. “The clinical staff is used to having someone who can take care of their problems on the spot.”

Once the trust is there, taking machines off contracts not only saves money, but it also helps the biomeds maintain a respected, professional presence in the hospital.

“This has been a big, long-term investment for the hospital,” Scalf says. He has been an imaging tech with NMMC for more than 15 years, and working on the hospital network’s multiple imaging systems has earned him the trust of his customers. “We have a very good relationship with radiology, and they are very supportive. But it doesn’t happen overnight; it takes years to build that kind of relationship.”

SAYING NO TO “NO”

Successfully completing beneficial negotiations, like those with radiology or the ones that land the techs OEM training, are a direct result of the strong ongoing relationship between the biomed and acquisitions teams.

The last several years have seen an increased focus on relationships across the entire industry: between professional members of biomedical/clinical engineering departments, between the techs and their customers, as well as with other departments. At NMMC, the importance of solid relationships also extends to the vendors.

Some of the sales representatives who visit the hospital have been doing so for decades, according to Smith. As a result, they know exactly what the team at NMMC is looking for and do their best to accommodate it.

“We really have some good relationships with vendors, not just with the departments in the hospital that we work with,” Sheffield says. “To be successful, you have to maintain good relationships and you have to treat people the way you want to be treated.”

Following the Golden Rule at times mandates that the biomedical/clinical engineering team go out of their way to help other employees at the hospital, even those who are not technically customers.

“If someone comes into the shop with a problem that no particular group in the hospital is responsible for taking care of, I will always help them,” Sheffield says.

In days past, such dedication led him to do a little bit of everything: from splicing dictation tapes back together to fixing the check printer for accounting. Today, the variety of tasks is still broad and still includes simple jobs such as repairing a hospital worker’s eyeglasses.

“It’s just one of those things that we do,” Sheffield says. “We try to help folks any way we can. And we never say no just because we’ve never worked on something before. We will always at least make an effort. It’s just something that is part of our work ethic here.”

That outlook is held by every member of the biomed team. “It’s extremely important—after all, we are a service group,” Scalf says. “We realize that we are competing, even though we have a very strong customer base here at the hospital. We constantly are in competition with ourselves and others, and as soon as you start saying no—that opens the door for somebody else to come in and start offering their services.”

That sentiment is music to Smith’s ears. “We really don’t know how to say no around here,” he says with a chuckle. “But not saying no has gotten us invited into more areas of the hospital than anything else we could have done. And it has been an important part of our growth, because once people see that you are willing to do anything for them, the rest of it just falls into place.”

Dana Hinesly is a contributing writer for 24×7. For more information, contact .