Chris Hayhurst is a freelance reporter and writer. More information can be found at www.chrishayhurst.com.

Chris Hayhurst is a freelance reporter and writer. More information can be found at www.chrishayhurst.com.

Healthcare technology management (HTM) optimization has become increasingly important for nearly every healthcare facility. At a time when the vast majority of organizations are striving to cut costs while improving care, having a streamlined and productive HTM department often proves critical to ensuring long-term success. For GE Healthcare's Services segment, the application of Six Sigma techniques, including Lean management and 5S, is central to achieving a high degree of organization within individual HTM departments.

Some healthcare facilities and systems choose to outsource part or all of their work to organizations such GE Healthcare. The idea behind such a move is that the resources and economies of scale they provide are, on balance, worth the investment.

Knowing that, Donna Marie Dyer, senior director of healthcare technology management at GE Healthcare; Scott Derryberry, CBET, a manager of clinical engineering; and others at GE Healthcare are constantly thinking of innovative ways to bring additional value to their HTM teams. Whether they're leveraging the power of a new computerized maintenance management system, looking for insights through data analytics, or personally meeting with facility leadership to discuss asset acquisitions and major service decisions, they're always trying to improve their HTM departments.

“It's an ongoing and ever-changing process,” Dyer said. “It's knowing exactly how that particular facility is performing, then using that information to make the key decisions that will lead it to do better in the future.”

To ensure consistency across its operations, the GE Healthcare's HTM team oversees its many sites from strategically located regional offices. Dyer, who started her career as a biomedical technician with GE Healthcare in the mid-1990s, oversees GE Healthcare's HTM Program and its application across their 700 sites. Based in the city of Murfreesboro, TN, just a few miles southeast of Nashville, Derryberry heads up the team's Middle Tennessee Region. In that role, he's responsible for about 20 sites that have contracted with GE Healthcare to optimize their HTM programs according to their unique needs.

Challenge

About 10 years ago, Derryberry recalled, he was visiting one of the shops within his region when he suddenly had a realization. Similar to many HTM departments he oversaw, this one had all of the latest tools and technologies and was run by a highly qualified team of BMETs. However, also like the others, it was cluttered and disorganized, crowded with supplies and equipment that no one seemed to own.

“It's not like people couldn't do their work; they could, and they did, and they were doing a great job,” said Derryberry. “But when you stepped in there and took a look around, things seemed cluttered. It made you wonder if there might be a better way.”

Further investigation revealed that the BMETs were spending an “inordinate amount of time,” according to Derryberry, looking for the things they needed to perform their work. At some sites, he recalled, it was exceedingly difficult to determine which work orders had priority. Again, he said, no evidence indicated that quality was compromised, but it was clear to him that their system needed to change.

“At the very least, when you have a cluttered shop, it can impact the perception of the work performed within,” said Derryberry.

One of the biggest issues, he realized, was that many BMETs were extremely reluctant to get rid of anything. “It's almost as if we're hoarders by nature, like, ‘I may need this thing one day, so I can't throw it out or give it away because as soon as I do I'm going to wish I had it.’”

BMETs tend to like to tinker, added Derryberry—to take a part from one piece of equipment and use it to fix a fault with another. But stashing old devices and parts of devices on the off chance they might prove useful down the line can lead to serious problems. “Most of these facilities don't have a lot of space, so things start to pile up pretty quickly,” he said.

Although he was cognizant of every department's workflow being different, Derryberry still believed that most could benefit from a one-time cleanout and the introduction of new processes. The only major question remaining was how they would go about it.

“You can't just walk into a shop and tell everyone they're doing everything wrong,” said Derryberry. “In a lot of these places, you've got people there who have been on site for many, many years. You have to get their buy-in or you're going to hit a roadblock, and if that happens, you're not going anywhere.”

Solution

When he was growing up, Derryberry's house included a large garage that his father had organized with painstaking precision. “Everything was segmented; it didn't make sense to me at first,” he said.

Designated shelves for equipment awaiting parts. Each device is labeled with the service record number, the status, and the name of the technician assigned. The shelves, which are labeled to indicate the length of time the device has been present, provide technicians a clear visual indication of the age of pending repairs.

Designated shelves for equipment awaiting parts. Each device is labeled with the service record number, the status, and the name of the technician assigned. The shelves, which are labeled to indicate the length of time the device has been present, provide technicians a clear visual indication of the age of pending repairs.

At a Glance

SUBJECT

Healthcare Technology Management, U.S. and Canada Services, GE Healthcare

LOCATION

Headquartered in Chicago, IL, GE Healthcare works with hospitals worldwide.

SIZE

The company's healthcare technology management division currently provides clinical engineering services to more than 700 facilities in the United States and abroad.

STAFF

More than 1,700 biomedical equipment technicians are employed in the U.S. service network.

He remembered his father telling him at one point, “‘Son, if you put stuff up where the stuff belongs, the stuff will be there next time you need the stuff.’” Derryberry filed away his father's advice and went on to start his career with GE.

Years later, Derryberry was working with GE Healthcare when the company began adopting Six Sigma techniques to improve its business processes. As part of that initiative, he said, he received training in Lean management, and he eventually earned his Six Sigma Green Belt certification.

Central to the Lean philosophy is a methodology known as 5S. The pillars of 5S come from five Japanese terms that loosely translate as “sort,” “set in order,” “shine,” “standardize,” and “sustain.” Quality improvement efforts by Lean practitioners involve implementing the 5S pillars to build workplace environments that are clean, well organized, and safe.

A peg board denoting test equipment that is in use. Technicians place a tag with their initials over the tag for the test device. This allows other technicians to see that the device is in use, as well as provides contact information if a device is needed right away.

A peg board denoting test equipment that is in use. Technicians place a tag with their initials over the tag for the test device. This allows other technicians to see that the device is in use, as well as provides contact information if a device is needed right away.

Derryberry characterized 5S as “having the right resource in the right quantity in the right place, every time,” which ultimately leads to more efficient use of time and money. Harkening back to his father's immaculate garage, he said that “5S is all about getting things segmented and separating the needed from the unneeded.”

As he considered possible improvements for the HTM departments in his region, Derryberry drew on his Lean training and decided he'd incorporate 5S. He began by speaking with individual site leaders and visiting their departments to see how they were run. Then, with the leaders' support, he met with staff and explained how Lean thinking could benefit their work.

After everyone was on the same page, the process began by thoroughly cleaning and reorganizing individual HTM departments. Expired and unused equipment, as well as dated parts, manuals, and supplies, were removed. Spaces were marked around fire extinguishers, eye-wash stations, and egresses in order to prevent carts and supplies from being placed in those areas. A dedicated area was established for test equipment, and each device was assigned to a specific (and labeled) place on a shelf; this allowed BMETs too easily see whether equipment was available for use.

Other shelves were labeled for incoming repairs, and a process was established for opening service reports and moving devices to a specific area while they awaited repair. Dedicated service bays were established where devices that required certain test equipment and supplies (e.g., infusion pumps) could be easily evaluated and serviced without the need to set up for each service event. Cleaners and chemicals were labeled with unique numbers, and corresponding safety data sheets were denoted with the same numbers for quick access, should they be needed.

Flammable chemicals were placed in specially-designed storage cabinets, and unused batteries were stored on shelves, with new batteries placed behind the current stock to drive a “first-in/first-out” usage pattern. The terminals of used batteries were taped off and placed in a labeled container for recycling.

Many other changes were implemented as well, but regardless of whether they were incremental or wholesale, Derryberry was always sure to listen to site leaders and staff. “This was a total team effort; it wasn't just me telling them what to do. Implementing change at this scale is impossible if you try to force it or do it alone,” he said.

Results

The resistance he typically experienced during his initial visits to each site invariably gave way to appreciation once changes had been agreed upon and implemented, Derryberry said.

Today, he added, most of these sites have incorporated Lean and 5S so thoroughly that staff no longer see the approach as “different,” or even think about it as they go about their work. “They're so used to it, and it makes so much sense, that no one has said they want to go back to how things were.”

Dyer pointed out that the improvements coming out of this initiative haven't been limited to GE Healthcare's HTM departments. Sites are operating more efficiently and tracking their service metrics far more accurately, she said, and work environments are substantially safer thanks to the lack of clutter and better organization.

“But we've also seen this steady shift in culture, where everyone is raising the bar, and that's led to changes in how HTM is perceived by the people outside of their departments,” she said.

For example, Dyer noted, some HTM departments have received positive reports about their transformations from the clinical staff with whom they work. “They have more confidence that the devices that they're using are being handled in a systematic, high-quality manner—that when they take a piece of equipment to the HTM department, there's a process that happens there; it's not a black hole,” she explained.

Conclusion and Next Steps

In the years since Derryberry first introduced the principles of Lean to the HTM departments he oversees, other leaders at GE Healthcare have followed suit in their regions. Today, Dyer said, the systematic Lean “culture” is essential to the way many of their departments do business. Further, when the company starts a new HTM site at a facility, Lean thinking almost always plays into its design.

“We haven't gotten there with everyone yet, but we're working on it, and we're making great progress,” she said. “It's definitely part of our long-term goal: to help all of our shops become more Lean.”

The way he sees it, Derryberry said, his job now—at least when it comes to Lean—mostly involves focusing on the last of the five Ss. “Sustaining is really the hardest part, and that entails not just maintaining what we've done, but looking at ways to continually improve.”

Dyer pointed out that the improvements coming out of this initiative haven't been limited to GE Healthcare's HTM departments. Sites are operating more efficiently and tracking their service metrics far more accurately, she said, and work environments are substantially safer thanks to the lack of clutter and better organization.

Even the best-organized HTM shop can be tweaked here and there to bolster performance, he added. And any workflow can be revised to help a team become more efficient.

Sometimes, Derryberry said, the real challenge with Lean is not deciding on the changes you need to make to go from “cluttered and disorganized” to a space where everything is in its place. Rather, it involves admitting that the changes that you've tried—that you truly believed would lead to real gains—aren't as great as they first seemed.

With Lean and 5S, “it's a never-ending, constantly evolving process; there's always that chance you'll need to dismantle what you've done in order to make things better,” explained Derryberry. His recommendation to anyone hoping to bring the Lean approach to their own organization is simple: “Keep an open mind because you never know what you may find.”