Clinical engineering development

This background provides a basis for the understanding of the role clinical engineering occupies in health care today. Clinical engineering developed with an early large emphasis on the maintenance, electrical safety, and electronics aspects of medical equipment. Some people, such as Scott S and... 

In the future, it is anticipated that clinical engineering departments will provide assistance in the application and management of many other technologies that support patient care, including computer support (which includes the development ofvirtual instrumentation), telecommunications, and facilities operations. 

Nonetheless, hospital-based clinical engineering departments—if adequately staffed and prepared— are often the best suited to the task of managing the equipment-related risks. To do so, however, also requires a thorough, organizational-wide understanding and awareness of each of the model s major elements and—especially—their interactions. Even if the hospital s risk management department is not famihar with Reason s model, they may be a tremendous resource in the development and dissemination of the overall plan. 

The clinical engineering department must consistently gather and enter data into the database. The database becomes the practical definition of the services and work performed by the department. This standardized database allows rapid, retrospective analysis of the data to determine specific indicators identifying problems and assist in developing solutions for implementation. A minimum database should allow the gathering and storage of the following data ... 

Hertz E. 1990. Developing quality indicators for a clinical engineering department. In Plant, Technology and Safety Management Series Measuring Quality in PTSM. Chicago, Joint Commission on Accreditation of Healthcare Organizations. 

It is important for the clinical engineer to understand fully how standards are developed, how they are used, and most importantly, how they affect the entire spectrum of health-related matters. Standards exist that address systems (protection of the electrical power distribution system from faults), individuals (means to reduce potential electric shock hazards), and protection of the environment (disposal of deleterious waste substances). 

The hierarchy of standards model can aid the clinical engineer in the efficient and proper use of standards. More importantly, it can provide standards developers, users, and the authorities having jurisdiction in these matters with a structure by which standards can be effectively developed, recognized, and used to the mutual benefit of all. 

Perhaps the start of the new field, that was to become clinical engineering can be attributed to the establishment in January 1942 of the U.S. Army Medical Equipment Maintenance Course. This developed into the Army Medical Equipment School in Denver, Colorado, and the Air Force Training Wing at Sheppard Air Force Base in Texas. Thus maintenance of medical equipment became the first of the defined functions of what was to become the clinical engineering field. 

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