Biomedical Engineering Reference
In-Depth Information
degree in an engineering discipline. They must be well
versed in the design, modification, and testing of medical
instrumentation
engineering has changed enormously. Yet, it is appropri-
ate to use the clich´, ''The more things change, the more
they stay the same.'' Today, hospital-based clinical engi-
neers still have the following as their primary concerns:
patient safety and good hospital equipment management.
However, these basic concerns are being supplemented
by new areas of responsibility, making the clinical engi-
neer not only the chief technology officer but also an
integral part of the hospital management team.
In large part, these demands are due to the economic
pressures that hospitals face. State-of-the-art, highly
complex instruments, such as MRI systems, surgical
lasers, and other sophisticated devices, are now used as
a matter of course in patient care. Because of the high
cost and complexity of such instrumentation, the in-
stitution needs to plan carefullydat both a technical and
a managerial leveldfor the assessment, acquisition, and
use of this new technology.
With these needs in mind, hospital administrators
have begun to turn to their clinical engineering staffs for
assistance in operational areas. Clinical engineers now
provide assistance in the application and management of
many other technologies that support patient care (e.g.,
computer support, telecommunications, facilities oper-
ations, and strategic planning).
skills that fall predominantly in the
field of engineering practice. Only with an engineering
background can clinical engineers assume their proper
role working with other health professionals to use
available technological resources effectively and to im-
prove health care delivery.
By clearly linking clinical engineering to the engi-
neering profession, a number of important objectives are
achieved. First, it enables hospital administrators to
identify qualified individuals to serve as clinical engineers
within their institutions and to understand better the
wide range of functions that clinical engineers can
perform, while making it clear that technicians cannot
assume this role. Second, from this foundation, it is
possible for the profession of clinical engineering to
continue to mature. It has been pointed out that pro-
fessional activities exist if ''a cluster of roles in which the
incumbents perform certain functions valued in the
society in general'' can be identified (
Parsons, 1954
;
Courter, 1980
;
Goodman, 1989
). Clearly, this goal has
been achieved for the clinical engineer.
One can determine the status of professionalization by
noting the occurrence of six crucial events: (1) the first
training school; (2) the first university school; (3) the first
local professional association; (4) the first national
professional association; (5) the first state license law;
and (6) the first formal code of ethics (
Wilensky, 1964
;
Goodman, 1989
).
Now let us consider the present status of pro-
fessionalism of clinical engineering. Consider the fol-
lowing: (1) there is continued discussion about the
educational needs of existing, as well as beginning, pro-
fessionals; (2) there is a professional society, the Ameri-
can College of Clinical Engineering, which is effective in
establishing the knowledge base on which the profession
is to develop; (3) there exists a credentials process that
reflects the needs of this new profession; and (4) there is
a code of ethics, which the American College of Clinical
Engineering has developed for use by all in the profession.
This process toward professionalization will certainly
continue in the years ahead as this new professional so-
ciety continues to seek to define and control certification
activities, to define the educational process that is re-
quired for these new professionals, and to promote the
status of clinical engineering to hospital administrators
and society as a whole.
d
Computer support
The use of personal computers (PCs) has grown enor-
mously in the past decade. PCs are now commonplace in
every facet of hospital operations, including data analysis
for research, use as a teaching tool, and many adminis-
trative tasks. PCs are also increasingly used as integral
parts of local area networks (LANs) and hospital in-
formation systems.
Because of their technical training and experience
with computerized patient record systems and inventory
and equipment management programs, many clinical
engineers have extended their scope of activities to in-
clude personal computer support. In the process, the
hospital has accrued several benefits from this in-
volvement of clinical engineering in computer servicing.
The first is time: Whenever computers are used in direct
clinical applications or in administrative work, downtime
is expensive. In-house servicing can provide faster and
often more dependable repairs than an outside group can.
Second, with in-house service, there is no need to send
a computer out for service, thus reducing the possibility
that computer equipment will be damaged or lost.
Finally, in-house service reduces costs by permitting the
hospital to avoid expensive service contracts for com-
puters and peripheral equipment.
With all of these benefits, it might seem that every
clinical
Future of clinical engineering
From its early daysdwhen electrical safety testing and
basic preventive maintenance were
the primary
concernsdto the present,
the practice of clinical
engineering department
should carry out
