MGH - Department of Radiology - Radiology Engineering

MAINTENANCE
LEASING
PLANT MAINTENANCE AND SAFETY
EQUIPMENT

MAINTENANCE

What are the most common reasons for placing service calls?
Since our equipment portfolio is 89% digitally based versus traditional film, the majority of our service calls are related to network based problems.

Does an in-house staff or outside contractor maintain your Radiology imaging equipment? If so, how many FTEs?
MGH has a contractual agreement with General Electric to service the majority of our equipment portfolio. There is 1 GE Account Manager and 3 GE engineers on site.

What is the total amount of Imaging Devices in Radiology Engineering Department's (RED's) portfolio?
We currently have 138 Imaging devices.

What are Radiology Engineering's hours of service?
Service varies by modality. MRI and CT scanners are covered 8:00 to 11:00 pm M-F,
X-Ray, Fluoroscopy and Mammography systems are covered 8:00 am – 5:00 pm M-F,
Ultrasound units are covered 8:00 am – 9:00 pm M-F,
Angio units are covered 8:00am to 5:00 pm M-F, and hard down coverage on the weekends.

Does RED's schedule Preventive Maintenance inspections during hours?
Most PM’s are scheduled at the end of the business day in the respective areas during coverage times.

What metrics does RED's use to track uptime/down time, and calls for equipment?
We track uptime, number of service calls per system, budget control variances, and repair history.

LEASING

What is the minimum cost for a piece of equipment to put on an Operating Bonds?
Radiology has made a policy to add a capital piece of equipment on lease if it has a useful life of over 5 years and is valued at more than $50,000.

What is the difference between Operating leases and Capital leases?
A capital lease is a” lease that meets one or more of the following criteria, meaning it is classified as a purchase by the lessee the lease term is greater than 75% of the property's estimated economic life; the lease contains an option to purchase the property for less than fair market value ownership of the property is transferred to the lessee at the end of the lease term; or the present value of the lease payments exceeds 90% of the fair market value of the property.

An operating lease is a lease for which the lessee acquires the property for only a small portion of its useful life. An operating lease is commonly used to acquire equipment on a short-term basis. Any lease that is not a capital lease is an operating lease”.

Does RED's have an asset management program?
The department of Radiology rolled out the first Asset Management program in 1999. It was collaboration between MGH, BWH and GE.

What are your specifics of RED's Asset Management Program?
See above.

Does RED lease or purchase equipment?
Since 1999 RED leases the majority of its budgeted equipment.

PLANT MAINTENANCE AND SAFETY

What are RED's guidelines for the removal and installation of equipment?
Radiology Engineering crafted an installation checklist with guidelines for the contractors.

What are RED's guidelines for Fire and Safety Inspection?
We conduct quarterly drills in each area and shift. If construction is occurring in an area, we schedule drills twice a quarter in that area. RED's has designed a department wide checklist (download pdf) to assist in the drills.

How frequently does RED's physically inspect the department?
RED's implemented a committee (Radiology Surveillance Rounds) that conducts monthly surveys of the areas within the department. The data is tabulated and distributed to the Operation Managers and committee members for resolution on issues.

Does RED's conduct Fire, Electrical, and Disaster safety training?
Yes. Fire, Electric and Disaster Safety Training are tested through an online tutorial.

EQUIPMENT

How much equipment does RED's have and what types?
Currently RED's has 288 pieces of equipment in our portfolio. The equipment ranges from MRI’s to alternators, to PACS equipment.

What does a collimator do?
A collimator is a device made of a highly absorbing material such as lead, which selects X - or gamma rays along a particular direction. In an x-ray tube and computed tomography, CT collimators are placed so as to ensure that only a limited region is irradiated, but in CT they are also placed in front of the detector bank to eliminate stray radiation. In Nuclear Imaging, they serve to suppress scatter but also to select a ray orientation.

What is DR and CR imaging?
Digital (or computerized) imaging techniques came to x-ray in the 1980s when analog to digital (A/D) converters and computers were also adapted to conventional fluoroscopic image intensifier/TV systems. Digital benefits of digital technology to all x-ray systems include:

Lower dosage x-rays can often be used to achieve the same high quality picture as with film.
Digital x-ray images can be enhanced and manipulated with computers and sent via a network to other workstations and computer monitors so that many people can share the information and assist in the diagnosis.
Digital images can be archived onto compact optical disks or digital tape drives saving tremendously on storage space and manpower needed for a traditional x-ray film library.
Digital images may be retrieved from an electronic archive for future reference.

Computed radiography (CR) systems are currently the most commont type of digital used in radiology departments.

Experts believe that digital imaging soon will replace film-screen imaging due to several advantages: wider exposure latitude, ability to adjust for low and high exposures, and post processing image enhancement techniques.
CR, like film-screen, is an indirect type of imaging system. The information stored in the CR imaging plate must be processed before viewing can occur. CR uses photostimulable-imaging plates to absorb the radiation exiting the patient. The exposed plates are processed in CR readers, where the absorbed energy is extracted and a digital image is created.

What are CT, MRI, and PET?
CT is computed tomography (CT) is a diagnostic procedure that uses special x-ray equipment to obtain cross-sectional pictures of the body.

Magnetic resonance imaging (MRI) is an imaging technique used primarily in medical settings to produce high quality images of the inside of the human body. MRI is based on the principles of nuclear magnetic resonance (NMR), a spectroscopic technique used by scientists to obtain microscopic chemical and physical information about molecules. The technique is called magnetic resonance.

Positron Emission Tomography, or PET, is a procedure that allows a physician to examine the heart, brain, and other organs. PET images show the chemical functioning of an organ or tissue, unlike X-ray, CT, or MRI which show only body structure.