In the chapter we describe a model to estimate the number of clinical engineers and biomedical equipment technicians (BMET) that will constitute the Clinical Engineering department staff. The model is based on the activities to be simulated, the characteristics of the healthcare facility, and the experience of human resources. Our model is an important tool to be used to start a Clinical Engineering department or to evaluate the performances of an existing one. It was used by managers of Regione Piemonte to start a regional network of Clinical Engineering departments.
TopBackground
The Italian National Health Service (NHS) follows a model similar to one developed by the British National Health Service since it provides universal health care coverage throughout the Italian State as a single payer. However, the Italian NHS is more decentralized, because it gives political, administrative, and financial responsibility regarding the provision of health care to the twenty regions (Maio and Manzoli, 2002). Each region must organize its services in order to meet the needs of its population, define ways to allocate financial resources to all the Local Health Agencies (LHAs) within its territory, monitor LHAs’ health care services and activities, and assess their performance. In addition, the regions are responsible for selecting and accrediting public and private health services providers and issuing regional guidelines to assure a set of essential healthcare services in accordance with national laws.
The LHAs form the basic elements of the Italian NHS. In addition, in 2000, there were ninety eight public hospitals qualified as “hospital trusts.” Hospital trusts work as independent providers of health services and have the same level of administrative responsibility as LHA. Based on criteria of efficiency and cost–quality, the LHAs might provide care either directly, through their own facilities (directly managed hospitals and territorial services), or by paying for the services delivered by providers accredited by the regions, such as independent public structures (hospital agencies and university-managed hospitals) and private structures (hospitals, nursing homes, and laboratories under contract to the NHS).
Each LHA has three main facilities: one department for preventive health care, one or more directly managed hospitals, and one or more districts. Through the districts, the LHAs provide primary care, ambulatory care, home care, occupational health services, health education, disease prevention, pharmacies, family planning, child health and information services.
Both LHA and hospitals build most of their activities on technology, and require a Clinical engineering department to take care of healthcare technology management.