Trends in clinical engineering practices

La adecuada implementación y aplicación de herramientas tecnológicas contribuye al mejoramiento de la calidad en la prestación de los servicios de salud, la minimización de los costos de dichos servicios, y el aumento de la accesibilidad al sistema hospitalario. En las últimas décadas los hospitales han venido asignando una considerable porción de sus recursos al cuidado y administración de sus bienes de capital; enfrentan continuamente la necesidad de adquirir nuevas tecnologías biomédicas al tiempo que deben administrar la existente, situación para la que no están bien preparados. Con el fin de orientar eficientemente sus inversiones, los hospitales han venido desarrollando programas de administración de tecnología médica que requieren expertos en el tema y la aplicación de metodologías específicas para un aprovechamiento seguro y eficiente de estas herramientas en el sector salud. Los ingenieros clínicos son quienes pueden liderar estos programas al proveer soluciones tecnológicas basadas en las necesidades prioritarias, cuidadosamente establecidas, y en los objetivos organizacionales específicos. El éxito en la práctica de la ingeniería clínica radica en la habilidad de estos profesionales de transferir los conocimientos del campo de la ingeniería y de las ciencias de la salud al entorno hospitalario para servir de soporte en las aplicaciones médicas. A medida que se dan grandes y rápidos cambios en la complejidad y variedad de las herramientas tecnológicas disponibles y en las formas de evaluar el cuidado que se le brinda a los pacientes, la mejor forma de transferir dichos desarrollos es mediante un completo conocimiento del tema. Esto se puede lograr sólo cuando los objetivos de la profesión han sido claramente definidos y son coherentes con el compromiso y la visión profesional. Tal compromiso debe incluir la promoción del uso seguro y eficaz de la ciencia y la tecnología al servicio del cuidado de los pacientes y la aceptación de la necesidad de demostrar sus capacidades como ingeniero clínico al adquirir el reconocimiento de sus competencias profesionales mediante el programa de certificación profesional nacional.Appropriate deployment of technological tools contributes to improvement in the quality of healthcare delivered, the containment of cost, and better access to healthcare systems. Hospitals have been allocating significant portion of their resources to procuring and managing capital assets; they are continuously faced with demands for new biomedical technology while asked to manage existing inventory for which they are not well prepared. To effectively manage their investments, hospitals are developing medical technology management programs that need expertise and planning methodology for safe and efficient deployment of healthcare technological tools. Clinical engineers are practitioners that can lead such programs and deliver technological solutions based on carefully determined needs and specified set of organization objectives and abilities. The successful practice of clinical engineering is dependent on the ability of these practitioners to transfer knowledge from the engineering and life sciences to the support of clinical applications. As rapid changes in the complexity and variety of technological tools and in the measurement of patient care outcomes taking place, it is best to facilitate transfer of such knowledge having well defined body of knowledge. This can be accomplished only when the goals of the profession are clearly described and uniformly accepted accommodating profession vision and commitment. Such a commitment must include the promotion of safe and effective application of science and technology in patient care and on the acceptance of professional accountability demonstratable by the achievement of competency recognition by national professional certification program

Expertise and the interpretation of computerized physiological data: implications for the design of computerized monitoring in neonatal intensive care

This paper presents the outcomes from a cognitive engineering project addressing the design problems of computerized monitoring in neonatal intensive care. Cognitive engineering is viewed, in this project, as a symbiosis between cognitive science and design practice. A range of methodologies has been used: interviews with neonatal staff, ward observations and experimental techniques. The results of these investigations are reported, focusing specifically on the differences between junior and senior physicians in their interpretation of monitored physiological data. It was found that the senior doctors made better use of the different knowledge sources available than the junior doctors. The senior doctors were able to identify more relevant physiological patterns and generated more and better inferences than did their junior colleagues. Expertise differences are discussed in the context of previous psychological research in medical expertise. Finally, the paper discusses the potential utility of these outcomes to inform the design of computerized decision support in neonatal intensive care

Fifty Years of Innovation in Plastic Surgery

© 2016 The Korean Society of Plastic and Reconstructive Surgeons.Background Innovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years. Methods Patents and publications related to plastic surgery (1960 to 2010) were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored. Results Between 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued. Conclusions The application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active

Contemplative Science: An Insider's Prospectus

This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine

The Prescription Opioid Epidemic: an Evidence-Based Approach

A group of experts, led by researchers at the Johns Hopkins Bloomberg School of Public Health, issued this report aimed at stemming the prescription opioid epidemic, a crisis that kills an average of 44 people a day in the U.S. The report calls for changes to the way medical students and physicians are trained, prescriptions are dispensed and monitored, first responders are equipped to treat overdoses, and those with addiction are identified and treated. The report grew out of discussions that began last year at a town hall co-hosted by the Bloomberg School and the Clinton Health Matters Initiative, an initiative of the Clinton Foundation. The recommendations were developed by professionals from medicine, pharmacy, injury prevention and law. Patient representatives, insurers and drug manufacturers also participated in developing the recommendations. The report breaks its recommendations into seven categories:Prescribing GuidelinesPrescription Drug Monitoring Programs (PDMPs)Pharmacy Benefit Managers (PBMs) and PharmaciesEngineering Strategies (i.e., packaging)Overdose Education and Naloxone Distribution ProgramsAddiction TreatmentCommunity-Based Prevention Strategie

Design Margins: Impact on Building Energy Performance

This paper examines the addition of design margins for building services energy infrastructure during the design process. It argues that care must be taken when applying margins; ensuring cumulative effects do not undermine the ability of systems to be energy efficient. An example of a hospital Trust is provided showing the addition of design margins impacting the energy efficiency of services provided. Tensions are found between delivery of flexibility, adaptability and other change parameters and the need for the system to be bounded, so as to encourage effectiveness

Attitudes Toward Failure in Capstone Design Projects

While working in industry during the 1980s and 1990s, project failures were to be avoided at all costs. For engineers in the medical device industry, these failures could be in the form of: 1) an idea for a new product or feature that eventually failed due to technical infeasibility, regulatory hurdles, lack of market interest, or difficulty in manufacturing; 2) a prototype that did not function as required; or 3) an animal or human clinical study that yielded poor results. They typically resulted in significant project delays, wasted time and money, and lost revenues, and often led to lower raises, fewer promotion opportunities, and damaged reputations