There have been people who have joked that there is a city in Alabama where the elephant’s tusks are loose, paraphrasing an old Groucho Marx joke. That may not be the most accurate description of Tuscaloosa, which actually got its name from the Choctaw Indian words for warrior “tushka” and black “lusa.” The name describes a legendary Indian chief, who died in 1540, named the Black Warrior. The city is located on a river also named for the great chief.
The city has nearly 100,000 residents and is home to the University of Alabama. One of the health networks providing care to residents is the DCH Health System, which serves patients throughout West Alabama. The DCH Health System includes DCH Regional Medical Center, Northport Medical Center and Fayette Medical Center.
The health system’s 23-member clinical engineering department includes a five-member group of imaging specialists referred to as Imaging Equipment Specialists. The CE department is headed by director Deron Crotts. The imaging group is managed by Alan L. McDuff.
The department services the three hospitals owned by DCH and three other hospitals as a third-party provider via contracted service. The three DCH hospitals have more than $54 million of imaging equipment.
The main facilities include one 600-bed, one 300-bed and one 150-bed hospital and a spine care clinic.
“We service eight CT, seven MRI, eight gamma cameras, two linear accelerators, 68 radiographic units, and 53 ultrasound units,” McDuff says. “We do not have any mobile units. We operate out of the main hospital and cover two outlying hospitals and one clinic, all with the same operational model.”
The imaging group is trained to service a number of imaging modalities and an archiving system.
“We repair and perform PMs on PACS, ultrasound, nuclear medicine, radiographic, fluoroscopic, angiographic fluoroscopic, heart cath fluoroscopic, CT, MRI, and linear accelerators,” McDuff says.
The imaging team was first started 27 years ago when McDuff was hired to work on X-ray equipment.
“I assumed responsibility for three general X-ray rooms in the emergency department. That grew over all those years to a team of five Imaging Equipment Specialists,” he says.
The imaging group is able to stay current on the latest technology by negotiating training into purchase contracts.
“When a department in the hospital begins the purchase process for a new piece of imaging equipment, we are included in the discussion to determine what will be the projected cost of ownership,” McDuff says.
The imaging group takes a strategic and budget-minded approach to training. Shared knowledge and cooperation with OEMs makes this work.
“When we compare the cost of a full-service contract over several years to the one-time cost of training, we will routinely purchase manufacturer training with the purchase. So, if a more advanced platform arrives with the new purchase, we will acquire the expertise to maintain it as well,” he adds.
“In addition, we also utilize a simple process of cross training. If one technician is more proficient with a procedure, he will give a quick in-service for the rest of the team. Also, a lot of on-the-job training with the manufacturer’s assistance, if needed. Having a ‘shared service’ agreement with some of our vendors, makes this a wonderful opportunity to learn and grow at an affordable rate,” McDuff adds.
There are a few types of equipment that the team does not service according to McDuff.
“We do not service ‘laptop’ ultrasound units or ultrasound transducers. We would have to invest in ‘computer’ technicians and specialized equipment. I just can’t see the return versus time/expense,” he says.
Bringing the expertise of the imaging service professionals to the table during the purchasing process offers a lot of upside. After all, when evaluating the lifetime cost of a piece of equipment, and its reliability, it’s good to include those who are in the know.
“Our group is fully involved in the purchase, planning, and construction of all of the imaging equipment we service. The purchase considerations include our team’s vendor comparison, ease of service, dependability, etcetera,” McDuff says.
He says that the planning and construction involvement assures nothing is done or is left out for ease of use or maintenance.
“The ultimate decision on service contracts is up to the directors of radiology, cardiology, etcetera. We do play a major role in analyzing the service offerings to determine cost of ownership and best value for the money spent. We are responsible for maintaining our equipment at optimal quality and dependability, but at the most economical way,” McDuff says.
McDuff says that as a parts purchaser they shop for the best price from many third-party vendors.
“We typically do not use any third-party labor,” McDuff says. “We do provide user training that covers safety, error reporting, and emergency measures pertaining to the equipment. All of the Imaging Equipment Specialists are manufacturer trained on all of the modalities I listed. We go beyond first look on all calls but with our shared-risk model, we can call the vendor for help, either phone or on-site.”
Along with their colleagues in CE, the imaging service team has tackled some special projects along with a disaster preparation project to ensure the continuation of service.
“The PACS network, specifically the wire plant and switch configuration, has been an exclusive CE design and implementation project. We designed a standalone wire plant so the radiology department can operate autonomously, on generator power, if a disaster occurs,” McDuff says.
“This was demonstrated in April 2011 when a tornado destroyed all incoming power and most communication into the hospital. Over 1,000 radiology exams were completed and read in a 12-hour period, without failure,” he adds. “With the advent of digital radiography, the PACS network becomes the master link of all work flow.”
Having a specialized imaging team within this clinical engineering department has been a benefit to the health system and the people of West Alabama. Imaging Equipment Specialists – the name says it all.