Biomedical Engineering Reference
In-Depth Information
Clinical engineers were hired in increasing numbers
to help these facilities to use existing technology and
to incorporate new technology.
Having entered the hospital environment, routine elec-
trical safety inspections exposed the clinical engineer to
all types of patient equipment that were not being prop-
erly maintained. It soon became obvious that electrical
safety failures represented only a small part of the overall
problem posed by the presence of medical equipment in
the clinical environment. This equipment was neither
totally understood nor properlymaintained. Simple visual
inspections often revealed broken knobs, frayed wires,
and even evidence of liquid spills. Investigating further,
it was found that many devices did not perform in ac-
cordance with manufacturers' specifications and were
not maintained in accordance with manufacturers' rec-
ommendations. In short, electrical safety problems were
only the tip of the iceberg. By the mid-1970s, complete
performance inspections before and after use became
the norm, and sensible inspection procedures were de-
veloped ( Newhouse et al., 1989 ). Clinical engineering
departments became the logical support center for all
medical technologies. As a result, clinical engineers as-
sumed additional responsibilities, including the manage-
ment of high-technology instruments and systems used in
hospitals, the training of medical personnel in equipment
use and safety, and the design, selection, and use of
technology to deliver safe and effective health care.
In the process, hospitals and major medical centers
formally established clinical engineering departments to
address these new technical responsibilities and to train
and supervise biomedical engineering technicians to carry
out these tasks. Hospitals that established centralized
clinical engineering departments to meet these respon-
sibilities used clinical engineers to provide the hospital
administration with an objective opinion of equipment
function, purchase, application, overall systemanalysis, and
preventive maintenance policies. With the in-house avail-
ability of such talent and expertise, the hospital was in a far
better position to make more effective use of its techno-
logical resources ( Jacobs, 1975 ; Bronzino, 1977; 1986;
1992 ). It is also important to note that competent clinical
engineers, as part of the health care system, also created
a more unified and predictable market for biomedical
equipment. By providing health care professionals with
needed assurance of safety, reliability, and efficiency in
using new and innovative equipment, clinical engineers
identified poor quality and ineffective equipment much
more readily. These activities, in turn, led to a faster, more
appropriate utilization of new medical equipment and
provided a natural incentive for greater industrial involve-
ment
For the purpose of certification, the Board of Examiners
for Clinical Engineering Certification considers a clinical
engineer to be:
''an engineer whose professional focus is on
patient-device interfacing; one who applies
engineering principles in managing medical
systems and devices in the patient setting,
( ICC, 1991 ).
The Journal of Clinical Engineering has defined the dis-
tinction between a biomedical engineer and a clinical
engineer by suggesting that the biomedical engineer:
''applies a wide spectrum of engineering level knowledge
and principles to the understanding, modification or
control of human or animal biological systems ( Pacela,
1991 ).
Finally, in the topic ''Management of Medical Technol-
ogy,'' a clinical engineer was defined as:
''an engineer who has graduated from an accredited
academic program in engineering or who is licensed as
a professional engineer or engineer-in-training and is
engaged in the application of scientific and technologi-
cal knowledge developed through engineering education
and subsequent professional experience within the
health care environment in support of clinical activities
( Bronzino, 1992 ).
It is important to emphasize that one of the major
features of these definitions is the clinical environment
(i.e., that portion of the health care system in which
patient care is delivered). Clinical activities include
direct patient care, research, teaching, and manage-
ment activities that are intended to enhance patient
care.
Engineers were first encouraged to enter the clinical
scene during the late 1960s in response to concerns about
patient safety as well as the rapid proliferation of clinical
equipment, especially in academic medical centers. In
the process, a new engineering disciplinedclinical engi-
neeringdevolved to provide the technological support
that was necessary to meet these new needs. During the
1970s, a major expansion of clinical engineering occurred,
primarily due to the following events ( Bronzino and
Hayes, 1988 ; Bronzino, 1992 ):
The Veterans' Administration (VA), convinced that
clinical engineers were vital to the overall operation
of the VA hospital system, divided the country into
biomedical engineering districts, with a chief
biomedical engineer overseeing all engineering
activities in the hospitals in a district.
Throughout the United States, clinical engineering
departments were established in most large medical
centers and hospitals and in some smaller clinical
facilities with at least 300 beds.
a step that is anessential prerequisite towidespread
use of any technology ( Newhouse et al., 1989 ; Bronzino,
1992 ). Thus, the presence of clinical engineers not only
d
Search WWH ::




Custom Search