A medical engineering experts said that "if I change the behavior of the patient lawsuit, the hospital is sure to lose, because I know that a large number of loopholes in the management of medical equipment ". On the one hand, medical equipment and equipment in today's hospital has become the lifeline, on the one hand, but the hospital leadership of the equipment and equipment management of habitual indifference, equipment department has become the hospital's lowest level department, its sustainable development is difficult.
How to rationalize the investment and operation of medical devices and equipment, and more importantly, how to ensure the sustainable development of the hospital's equipment department has become a major issue in front of the hospital.
At the end of 2003, some hospitals in Beijing organized a spontaneous meeting of the Department of Instrumentation, at which the directors of the Department of Instrumentation put forward a number of issues related to the development of the Department of Instrumentation in the hospital, many of which, in their view, is the Department of Instrumentation itself is not capable of solving the problem, which should be solved by the hospital directors, and then an idea was born! -- Write an open letter to the hospital deans to reflect the problems faced by the instrumentation department.
A year later, the letter was finally written. The main author of this letter, is a medical equipment from the University of medical equipment professional learning to date, 40 years of learning and working life have not left the medical equipment line of hospital equipment department director.
Device chief to the hospital director of the open letter
Dear Dean:
Hello!
This is a letter that had to be written because many of the dilemmas facing the hospital's instrumentation department today are no longer within the reach of the instrumentation department itself. We have attempted to do this in the form of an open letter, hoping to draw the attention of the deans to the instrumentation department.
In the last decade or so, with the increasing use of medical instruments in hospitals, diagnostic and therapeutic work has grown by leaps and bounds. Whether in the hospital's medical level or economic benefits, medical equipment is increasingly playing a pivotal role. Instrumentation department should be with the hospital on the application of equipment to increase and continue to develop, but in fact, the instrumentation management department not only on the whole did not develop, but also shrink, in many hospitals in the instrumentation department in an embarrassing situation. Reasons for embarrassment:
Of course, the embarrassing situation of the hospital equipment department, we know that not all the dean's reasons, but by combing the reasons for embarrassment, will help you scientifically to solve this problem.
⒈ in the hospital, the medical disciplines have been developed for more than a century, the Chinese people **** and the establishment of the country, in several generations of deans and discipline leaders **** with the efforts of the majority of hospitals have formed a more perfect management model and is in the midst of continuous reform. In contrast, the medical engineering discipline started very late, has not yet formed a more perfect management model.
Peak health administration is the hospital's higher authorities, in the price, statistics, large equipment configuration approval, bidding for consumables and other aspects of the importance of, but not enough attention to the management of equipment, low staffing, insufficient power.
3 hospital director is mostly doctors, more familiar with the medical, the importance of the work of the department of equipment, difficulty, contribution, potential risks and crises of insufficient awareness of inadequate attention. This situation is understandable, but the formation of the results are objective.
Sung articles have been published in publications related to medical devices and equipment, but these publications are rarely read by deans, and it is difficult to play any role.
Carefully compared with other medical disciplines, most of the device department's own personnel's education, management level, technical level, computer level, foreign language level is relatively poor. This is closely related to the recruitment and appointment of staff in the hospital personnel department. Some hospitals even use the instrumentation department as a place to absorb redundant staff and arrange for the relatives and family members of certain people, and it is even more unfortunate that there is no training mechanism for the head of the instrumentation department in the society. These factors seriously reduce the overall quality of the instrumentation department. The low quality of the personnel in the instrumentation department and their insufficient action is one of the major reasons for the embarrassing situation of the instrumentation department. In a few hospitals, the high quality of the instrumentation department, significant work achievements, and the status of the instrumentation department is relatively good, all of which shows that the quality of personnel is crucial.
Select the person in charge of equipment at all levels, and even the equipment department themselves are often not clear what the responsibility of the equipment department. Think that the equipment department as long as the good buy equipment issued equipment, buy equipment to repair equipment, as long as the work seems to run on it. Hospital leaders only buy equipment, repair equipment only think of the equipment department, do not understand the responsibilities of the department of equipment, too low estimate of the difficulty of the medical project.
The development of medical engineering started late, but the speed of development is much faster than other medical disciplines. Neither the content of the teaching in medical engineering colleges nor the improvement of the technical skills of in-service engineers has been able to catch up with the development of technology.
Sorting out the responsibilities of the department of instruments:
Dear Dean, I don't know how you look at the responsibilities of the department of instruments, but I think that the responsibilities of the department of instruments is technical management, logistics management and maintenance management, and conditions of the hospital should also include scientific research and teaching, so the department of instruments in the hospital should be a parallel with the medical department and the nursing department of the technical management department. After clarifying the responsibilities of the instrumentation department, I think you will have a new understanding of the importance of the instrumentation department.
The instrumentation department is responsible for the entire logistics management of consumables and low-value consumables, of which the main links are planning, purchasing, acceptance, storage, issuance, accounts, statistics, measurement, and adverse event reporting. When making plans, the monthly consumption, reasonable inventory, and expiration date control of each variety should be considered. When purchasing, we should consider whether the purchasing channels and procedures are in accordance with the policies of the governmental administration, and whether the differences between similar products and the purchasing price are reasonable. Treasury management should consider fire, water, mold, insects, anti-freeze, anti-temperature, anti-theft, anti-deterioration, how to acceptance, how to record. Treasury should be with the incoming organic cooperation to ensure effective control of expiration date products. Should take into account the logistics procedures whether the process is simple and rigorous, whether the accounts can be done without error, how the accounts on the basis of accurate and often changes in a variety of statistics and reports must be, whether the computer management software is safe and closely matched with logistics management. This requires not only an understanding of the application, structure, and material of the items in the medical treatment, but also knowledge of logistics management, which requires a broader knowledge of the instrumentation department.
Participates in equipment planning and purchasing decisions, executes purchasing procedures, and is responsible for total logistics management. Medical equipment is a high-tech product involving multi-disciplinary knowledge. Purchasing, management, maintenance and scrapping of instruments and equipment not only require basic knowledge of electromechanical engineering, medicine, foreign languages and computers, but also include business negotiation (bidding, competitive negotiation), contract signing, foreign trade formalities, transportation and packaging, operating environment, file management, measurement management, operation management, efficiency management, national policies and laws and other aspects of knowledge.
Equipment maintenance management process, with the advanced medical equipment in the hospital, "unrepairable" increase, equipment department engineers of the specific maintenance is decreasing, maintenance management tasks are increasing, such as the manufacturers of maintenance of judgment and supervision; whether the equipment has the value of the repair; to determine the maintenance program; select which one warranty option, etc.
The whole process of managing the safe and effective application of medical devices. The weight of this task is very heavy, the technical content is very large, not only the performance of the medical equipment itself is safe and effective, but also includes resource allocation and clinical application. The difficulty of this system management and the need to invest in a relatively large number of manpower, this work must be completed with the clinical staff with *** with.
Rights and responsibilities, treatment of unreasonable:
At present, most hospitals exist in the logistics department and the instrumentation department task division is not clear, unreasonable situation, and caused by the division of labor is not clear, the root cause of unreasonable - forgive us - is the hospital leadership mismanagement. -is poor management by hospital-level leaders. This kind of bad management, to the instrumentation department's work has increased the difficulty, frustrated the enthusiasm of the engineering staff.
With the development of the hospital, the cross and interpenetration of departmental functions is also increasing. Many medical engineers not only repair medical instruments and equipment, but also responsible for the hospital's refrigeration equipment, gas supply, welding, pliers and other simple labor, such as repairing the viewing lamp, snake skin lamp, instrument carts, wheelchairs and so on. Some nurses push wheelchairs with flat tires to the equipment department for engineers to pump up the tires. The use of senior technical personnel as ordinary workers is a stifling of talent. Many engineers who have jumped ship mention this when they talk about their reasons for jumping ship.
Engineers graduated from the biomedical engineering department of major universities, the entrance score is higher than the clinical specialty, but after graduation in the device department, income treatment, academic exchange opportunities are worse than the clinical, especially in hospitals, the evaluation of titles by the Personnel Department and the Medical Department is responsible for the medical department does not have medical engineering personnel, resulting in the promotion of titles encountered a lot of unfair treatment, and some of the bonus in the distribution process, the engineer's bonus is even more than the bonus. Distribution process, the engineer's bonus is even lower than the logistics workers, seriously dampen the enthusiasm of the engineering staff.
And subordinate the apparatus department to the logistics management, the position of the hospital apparatus department is lower than the logistics, lower than the medical service also makes the apparatus department can not exercise the management responsibility.
Labor value can not be realized:
Equipment maintenance is one of the main tasks of the equipment department, equipment departments have the most say on whether the equipment should be repaired, but the reality is that hospitals often do not have a budget for maintenance funds, and the dean in charge of the maintenance of the value of the dean does not understand.
Respected dean, it is like buying a private car, improve the efficiency of life, improve the quality of life, but also need to spend money to maintain the car ah. But many times like do not understand the car also need to spend money, a mention of spending money dean you upset, instrumentation department in order to make the faulty equipment into operation in a timely manner when applying for maintenance costs often experience the "begging" feeling, seriously frustrated engineers work enthusiasm. So, many times when the use of the department to apply for maintenance, the equipment department let the use of the department director to apply for funds, equipment department to carry out maintenance, which is also our helplessness.
Procurement of equipment, especially imported large equipment procedures are very complex, to obtain the configuration of the health management department of the license, mechanical and electrical import department of the import certificate, the customs side of the tax-exempt certificate, signed a sufficiently protective foreign trade contract, the process has a lot of difficult to do. The tendering process is full of confrontations and is becoming more and more sophisticated. The four parties involved in the tender have been caught in the swamp of control and counter-control, the tender has long gone to the policy makers of the original intention of the opposite, responsible and fair bidding is a very difficult thing. And you as a senior leader often think these things are easy to do.
Large-scale equipment acquisition process and the arrival of the installation period will occur during the user and the manufacturer of all kinds of contradictions. To resolve these conflicts and the legacy of a very difficult to level of the task, and you tend to think that the buyer is God, everything is very good solution, in fact, things are far from it.
Configuration and price negotiation is a through the specialized knowledge and the art of scientific negotiation of the hard process. Manufacturers of sales staff after many sales training, expectations control training, make full use of resources within the hospital and even outside the hospital resources, research and analysis, develop strategies but also product experts to cooperate. Manufacturers in the negotiation meeting to show the pain of the forced price cuts are often pre-arranged performances. In this case, the hospital equipment department should also have a set of scientific negotiation methods and strategies, through the negotiation table through the project all the way through the psychological competition in order to get a reasonable low price.
However, regardless of the degree of price negotiation of the department of equipment, as the dean of you have to negotiate in the department of equipment on the basis of price reductions, if the department of equipment to the end of the price negotiations, the dean of you will be in an impasse, it is difficult to end. In either case, the deans are under the misapprehension that the device department's negotiations will never be successful. This also frustrates the device department and even puts the moral character of the device department in jeopardy. Rationally, we also know that the solution to this phenomenon is communication, however communication is extremely difficult.
Deeper talent crisis:
The equipment department in the hospital should be a technical management organization, the person in charge of not only the overall management of the hospital's equipment, equipment, but also the management of the department's internal work, and even directly undertake a lot of specific work, such as purchasing, maintenance and so on. Instrumentation department also bear the Ministry of Health (Office, Bureau), all levels of Drug Administration, Quality and Technical Supervision of the tasks set out, but also at all levels of mechanical and electrical import and export management departments, customs, foreign trade dealings. Not only requires broad knowledge also requires specialization in certain areas, with the rapid development of the level of science and technology of medical instruments, but also to maintain a constant update of knowledge.
Things are done by people, objective work on the quality of the person in charge of the instrument department is obviously very high. There is no mechanism for training medical engineering discipline leaders, and indeed such well-rounded people are hard to come by. What is more regrettable is that the existing discipline leader motivation is frustrated or environmental conditions prevent the ability to play.
I know that in your mind, Dean, you think it is possible to hire doctors at a cost but not medical engineering management personnel at a cost. Yet with that in mind, a talent crisis is looming in the medical device sector.
The old generation of the head of the device department is older, has retired or is about to retire, the device department in the hospital within the embarrassing situation so that the medical engineering graduates of outstanding college students work 3 years after the job, this has been the major hospitals of the same law ****. Can jump ship to jump ship, can not jump ship to stay, this talent filtration led to the instrumentation department of the quality of the new force to improve the limitations, all of which formed the instrumentation department of the potential personnel crisis.