PEER REVIEW
Medical Director
the processes of medical professionals and clinical physicists. It is important that technical and medical healthcare colleagues continue to seek each other out proactively. Regardless of the high time pressure and sometimes pressing circumstances in a crisis situation, they must continue to coordinate together and ensure that protocols are followed. Specifically in abnormal situations, close coordination is required in order to ensure considered choices are made by the people responsible. In a crisis situation, it is important that healthcare personnel are made aware of the whole range of risks involved in changing the use of medical equipment, for example, outside an ICU area. When medical technicians or technical specialists have to discover ‘by chance’ that more of the same existing equipment is purchased for additional applications, this introduces potential risks to patient safety and business continuity. If technology is to embrace healthcare, the duty to inform and a proactive approach are essential. Technical specialists are still not consulted often enough when starting protocoled treatments in: l A different space within the hospital than the originally conceived environment for which the equipment was evaluated.
l The use of new equipment that does not enter the hospital through the regular procurement route.
l The use/acquisition of more items of existing/already available equipment that is deployed in a different department/space within the hospital.
l The use/purchase of more items of existing/already available equipment for a different treatment method.
Protocols The Technology & Real Estate department of a hospital uses fixed protocols, as do the medical staff. The Safe Application of Medical Technology Covenant in specialist medical care runs through well-oiled procedures when it comes to the use of
POLICY COVENANT
Treating Physician
Clinical Physicist
Medical
Instruments Service
NVTG:
Technical Service
Figure 4.
equipment. It is unwise to create additional or new protocols, but current protocols can be revised or expanded to include check questions if a situation changes or can be maintained after an ‘interim’ solution.
Recommendations Business continuity and patient safety are crucial in a healthcare organisation. This leads to the following: l CONTROL The NVTG working group states that opportunities should be grasped to proactively ensure that the input of technical knowledge from facilities management is included. By setting up a technical expert team or reserving one or two seats for mechanical and electrical technical experts in the CPT. As a result, local preconditions of the existing technical installation infrastructure are not overlooked in the context of changed medical treatment methods and therapy – with the corresponding changed use and application of medical equipment that has become necessary during a pandemic or other crisis situation.
l KNOWLEDGE TRANSFER Awareness – among medical and technical staff – makes a big difference: education and attention to incidents play a major role in this. NVTG wants to contribute to this by positioning itself as a platform for knowledge sharing and a connector to meet members of other professional associations.
OPERATIONAL CHECK GO/NO GO
Utilise this knowledge even better!
l PRACTICAL Medical equipment suppliers are keen to be challenged to increase their influence with better identification of technical boundary preconditions that are relevant. For example, a manual can refer to a clear checklist for spatial and technical preconditions. A warning in the form of stickers on equipment is also an option.
l CHECK, CHECK, CHECK The NVTG working group suggests that the Dutch Covenant for Safe Application of Medical Technology should also include a focus on the incorporation of additional check questions when more of the same medical equipment is suddenly deployed within the same spaces of a healthcare environment.
l CALL TO MEET Expansion and intensification of knowledge sharing within the various fields is desirable. What can we do ourselves to create a stage for sharing knowledge about the mutual interfaces and to facilitate meetings between medical representatives and technical specialists? For example, would there be a need for a conference for administrators and directors, medical specialists, clinical physicists and specialists of technical infrastructure to meet each other?
Medical Director
Executive Board/Crisis Policy team
Definitive actions
Real estate check
Treating Physician
Clinical Physicist
Medical
Instruments Service
Risk assessment
Impact analysis
Measures NVTG:
Technical Service
Figure 5. 42
Utilise this knowledge even better!
Existing work protocols are effective and safe, but the work process could use further optimisation for non-standard crisis situations when it comes to communication, the interfaces between medical treatments (healthcare), the deployment of the necessary medical equipment (medical technology) and the available structural engineering infrastructure (general technology). Who is the person responsible and how are they best assisted in this process? A group of experts – comprising, for example, specialists in healthcare real estate, technology, infrastructure and healthcare – safeguards all relevant knowledge to ensure carefully considered choices are made in terms of (technical) risk assessments. In a crisis situation, an integral approach is crucial: is all knowledge available in the hospital shared quickly and sufficiently to ensure carefully considered decisions are made? We see potential for improvement if (structural engineering) technical specialists share their knowledge in the process of considering whether or not medical equipment (as well as Dutch Standard NEN1010 risk classification, fire safety and climate requirements for the spaces in which the equipment is operated, etc.) suffices for the intended treatment the equipment is to be used for. Ideally the team should remain small to promote decisiveness and the taking of appropriate risk-levelling measures.
IFHE IFHE DIGEST 2023
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