Notification Responsibility Accountability

Who’s responsible? The clinician? The technician? The administrator? The manufacturer? JCAHO? The Fed.? The State? The sticker?
Copyright, July 2003.

In practice, a large percentage of medical equipment in a hospital is not inspected on a regularly scheduled basis – not that the general public would assume that this is the case. The same lack of understanding may also be applied to the nursing and medical staff who use technology – they are on their own whether they know it or not.

Determining the operational integrity for equipment not on a maintenance program, is largely the job of the individual user. But that is also how it is for 364 days of an annually inspected device, so what attention should be given equipment classified as insignificant enough to not warrant regular inspection?

Equipment that does not require periodic maintenance inspections can be tagged in such a way that the user is reminded of their responsibility:

1. Because even the least significant bit can cause a system to fail, and

2. Awareness is not permanent – it needs reinforcing.

Stickers, of course, are not the only way to address the responsibility issue, and of course there is no one way to do so. But even as there is no one guardian of patient safety, there also is no clear structure, administrative or bureaucratic, in following the course responsibility should take.

Hazard and product recall notification.

Equipment risk assessment.

Repair and failure analysis.

Maintenance compliance.

Environment of Care safety issues.

Physicians write orders, nurses administer treatment, radiologists take pictures, respiratory therapists and physical therapists provide therapy, pharmacists provide medications – the boundaries and responsibilities of these professions are clearly defined and understood, within their respective departments, and by the institution at large. Each of these practitioners can follow a map identifying function, action, and required documentation, but not so for the clinical engineering practitioner.

The use of technology is the one area of medicine that is not effectively managed, not by the Federal government, state, or accreditation organizations, with the exception of a few isolated specialty areas such as blood bank and radiology.

One reason for this disconnection between theoretical requirements and practical application can be found in the history of this profession, another in the on-going revolution in technology. As I once heard one doctor commenting to another in a busy city hospital: “Around here, you have to go fast enough to keep up, but not so fast you leave it all behind.” The application of technology in a clinical setting is enough to make heads spin, all the more making it necessary to apply some practical administrative guidance.

1 comment to Notification Responsibility Accountability

  • admin

    I’m not sure what my point was with this, but decided to leave it here anyway. Can’t hurt, and using a sticker something like that shown is a good idea – it helps remind users that they are part of the scenery! Probably that was the point.