By admin | November 4, 2008
Hi All,
What an interesting conversation! I wrestled with this while designing the research question for my Masters thesis, which was a study of the effectiveness of clinical engineering (HTM) services in developing world hospitals. I agree completely with all who have suggested that a direct causal relationship between HTM and patient outcomes (morbidity and mortality) [...]
By admin | November 4, 2008
Hello everyone,
I have followed the conversation on the email list
about relating patient outcomes to clinical engineering effectiveness.
You may know already of the model that I tested in 1988/89 on relating
clinical engineering effectiveness and organisational variables. Next,
my student X Cao tested this for developing countries; subsequently,
Shauna Mullally extended the model to include one more important [...]
By admin | November 1, 2008
Dear Jeniffer and Collegues,
From my point of view, HTM activities are not well perceived by everybody (there was previous discussion on this at Infratech) and there are occult points that once revealed or exposed, make HTM to be so obvious that we can think why we haven’t start it before in our institution or workplace.
I [...]
By admin | October 25, 2008
Hi All
I could not agree more with Binseng and others that there are a lot of variables. When we did the study we were very much aware of this fact and in the absence of other studies one starts with what they have and make assumptions on other variables.
The study we did was not for [...]
By admin | October 25, 2008
Dear Jennifer,
Apparently not a quick question.
It has been good to meet you in the past 3 months on-line as you and I
have spoken about other issues in your current part of the world and ours.
I have appreciated with you our colleagues’ various answers so far.
As a practicing clinical engineer, part-time WHO/PAHO consultant, and
former delivery system [...]
By admin | October 24, 2008
Hi all,
Thanks, Jennifer for asking such a tough question.
I agree with Binseng that the impact of HTM on morbidity and mortality
may be almost impossible to prove. The easiest to prove benefits seem to
be primarily financial. They relate to better decisions leading to more
effective use of limited resources.
So perhaps the question becomes: what is the impact [...]
By admin | October 24, 2008
Dear All:
This discussion reminds me of the distinction between effectiveness and efficacy often within the context of healthcare technology assessment (HTA). In the study of drugs, efficacy is measured when patients are carefully controlled while effectiveness is for patients under “normal” conditions in the field.
As we all know, medical devices are even harder to study [...]
By admin | October 23, 2008
Ronald
I am currently out of town, and for quite some time. I will try and dig
up the info. This is at least 12 years ago. Thanks.
Tidi
By admin | October 23, 2008
Perhaps one way to approach this is to understand that a number of
deaths and accidents in hospitals are due to malfunctioning
technologies, inappropriate technologies, absent technologies, or errors
in the use of technology. Regardless of what the number of deaths and
accidents for any particular location is, there is a need to proactively
try to reduce the risks by [...]
By admin | October 23, 2008
This is very well stated, Björn, in particular the notion that HTM is is
a necessary but not sufficient condition for positive health outcomes,
which places HTM in the right context. As you and others suggest, it
also means that ‘impact’ is hard to measure and relate to a single
cause, such as HTM, because of the multiple factors [...]
By admin | October 23, 2008
Hi Jennifer,
This a very fundamental question to which it would agreeable to have an
answer. I agree with Andrei Issakov that the casual pathway between HTM
and health outcomes is not straightforward.
Without wanting to open a debate on the limits of the field of HTM most
of the factors affecting the health outcomes are actually likely to be
outside [...]
By admin | October 23, 2008
I only can agree that this is a very important question. Answers would
certainly be a big help to our efforts in convincing on political and
administrative levels with regard to the requirement of HTM .
Mladen and Tidi:
We would be very much interested to learn how you linked the indicators
of morbidity and mortality with the impact and [...]
By admin | October 23, 2008
Excellent question, Jennifer.
I’ve heard the same question asked regarding Joint Commission (US) or
JCI (international) accreditation: is there evidence that accreditation
leads to reduced morbidity and mortality? I have not heard the answers
though and for the costs and efforts required to receive accreditation,
I would think we would want evidence that it is worth it.
Ismael
By admin | October 22, 2008
Dear Jennifer
I agree this is an important question. The approach we have taken is a 2-step process, i.e. linking HTM to Quality of Care (characterised as being safe, timely, patient-centered, equitable, effective and efficient – IOM, 2001) and then Quality of Care to morbidity and mortality. Also, if healthcare technologies are [...]
By admin | October 22, 2008
In echoing the importance of this I would like to say that the points that Mladen is raising are very important. The Xray project is very interesting. Few years ago, its been quite a few years , we did a preliminary study in Botswana on the impact of Xray facilities [...]
