By Steven Ford

When I was a trainee in MR school long ago, we made up a game that made fun of the many specialized, arcane words that are part of that technology. You’d pick various real words from lists and string them all together, and it sort of sounded authoritative, even though it made no sense.

“We traced the problem to your lattice relaxation module, which was controlled by the exciter-receiver Kelvin regulator. We’ll recalibrate the T1 eddy effects dicom link.”

High tech imaging can be intimidating, and that makes it a challenge for the managers of an imaging department to evaluate the quality of service they’re receiving.

Good news: You don’t need to take a physics class to be an effective manager. Some straightforward, practical steps can go a long way.

How to avoid common pitfalls
• Obtain and retain documentation
FDA regulations require your service provider to give you service records that contain information such as the reason for service, the date and time, the actions performed, and parts that were replaced. Your institution is also required to keep copies of those records. If you don’t presently have complete copies of those records, ask for them from your service provider, who will send them to you at no cost. If those records cannot be promptly or accurately produced, this is a grade-one red flag.

• Obtain the data sheet from planned maintenance when completed
When a CT, MR, or X-Ray system has a PM completed, it isn’t just a good-faith once-over by the field engineer. It’s a specific set of tests, processes, checks, and calibrations that’s specified by the manufacturer at the time that the device was FDA approved. That documentation, which includes the performance specifications and the method for how it’s tested, is a specific sequence of actions. Your service engineer can provide you with two different types of documents; a service report stating, for example, “I performed the PM and everything is fine”, or a longer and very detailed document, sometimes over a dozen pages, that spells out the details of every test that was done. You should ask for the longer document, which is often stored on the MRI or CT computer itself, if you know where to look. Save those data sheet documents, even if you don’t analyze them immediately, and get the old ones, too.

• Have a good look at the PM data sheet
You may not understand the meaning of, for example, the RF transmitter output curve. That’s OK; almost all of these data sheets are laid out in a sensible form that clearly states, name of the test, minimum specifications, test results on your machine, and PASS/FAIL. I once testified in court about a data sheet that was written in Japanese, but it was obviously failing specifications.

• If need be, ask your field engineer to explain something to you
From time to time, he may have, in good faith, missed something or had to repair something more urgent. If that’s the case, make a plan to correct any issues.

• Look at the obvious stuff
Walk around the equipment. Are the air filters clean, or do they look like cat fur? Look for software calibration backups on CD or other format that are recent. Many medical devices have a software reload process that can literally take days, so you should have timely backups. Is the keyboard greasy or full of food? Both the techs and the service people should take pride in the appearance of the equipment; for sure your patients notice.

Finally, follow these general guidelines

DO THESE THINGS:
Have a dialog with your service engineer. You get better service from people who know you and like you.

Ask questions. Nobody expects you to master the technical gibberish.

Expect excellence.

Accommodate complex tasks. Sometimes, a scheduled repair will take far longer than anticipated because a tedious and unexpected problem arose.

Trust and listen to your technologists. They often know what the equipment is really capable of and have an accurate idea of the quality of service you’re receiving.

Assign someone to clean the equipment on a regular schedule. Mister Clean Magic Erasers are surprisingly effective in cleaning handprint-caused dirt on plastic equipment covers and coils.

Ask your service provider to create a bootable software clone hard drive for your computers. This takes less than an hour and can save you many hours of downtime. Every hard drive will fail at some point. You can buy an SSD hard drive for most medical imaging computers for about $100. Your IT support person may be able to do this for you.

DON’T DO THESE THINGS:
Assume that a large and respected corporation won’t ever compromise their standards when individuals are under pressure.

Fail to make sure your employer is doing what they need to do. The air conditioning, water chiller, and electrical power have to work properly for your CT or MR to work properly.

Worry too much if a PM date is missed by a week or two. It’s more important that the PMS are done thoroughly than that the item is checked off.

Be afraid to insist that the paperwork is submitted accurately and fully and on time.

Assume there is no alternative to OEM provided service. There are competitors out there, many who are at least as capable as the OEM. The OEM knows this, too.

About the author: Steven Ford, EE, MBA, has over 30 years' experience in medical equipment installation and maintenance, having started the MR service department for two companies. He has authored over 100 technical papers and has served as an expert witness.

Parts And Service Homepage