Specialisms | Clinical Engineering

Clinical Engineering

Clinical Engineering is effectively all engineering in healthcare. It is very broad and has 4 sub-specialisms which you can train in as part of the STP.

If you’re interested in managing medical devices in a hospital…

…then you can specialise in Device Risk Management and Governance (DRMG). Every hospital has tens of thousands of medical devices, all of which need to be purchased, set up, safety tested, fixed, checked for compliance, and decommissioned. It’s also critical that staff are trained on how to use devices. Clinical Engineers are involved in every step of the medical device lifecycle.

To give you an idea of the kind of projects you can work on, during my rotation I worked with the hospital’s procurement team to review bids to supply the hospital with new neonatal incubators and organised a demo day in which clinicians and technicians could review and feedback on the prospective models. I also led training with new nursing staff on how to use infusion pumps.

Device risk management in the future

We live in a fast changing  technological landscape. Clinical Engineers have a huge opportunity to bring advances to hospital through medical devices. Some projects I am aware of include:

• Setting up an RFID network so tagged medical equipment can be quickly located in a hospital
• Managing the set up and installation of new vital signs monitors which automatically load results onto a patient’s electronic medical record so they can be accessed by any clinician at any time
• Developing an app alongside a team of physiotherapists which demonstrates exercises patients need to complete at home

Clinical Engineers working in this field will be at the forefront as innovation ripples through healthcare .

If you’re interested in taking, processing and analysing interesting clinical measurements…

… then you can specialise in Clinical Measurements and ICT. Clinical Engineers are well placed to take measurements as we have a good understanding of the principles of pressure, flows and biomechanics which are fundamental to clinical measurements. If you understand the physics which underpins a measurement then the results can be correctly interpreted. Correct clinical measurements are vital for targeting medical interventions. One project I was involved with during my rotation was a data analysis project to which improved the cardiac measurements used by paediatric heart surgeons.

A role working within clinical measurements requires a range of skills. As the Clinical Engineer works directly with patients to acquire the measurement it is critical they have a good patient manner, are able to take a clinical history and explain the measurement they’re doing. They also need to have excellent knowledge of the equipment and software which is being used to acquire measurements to ensure the equipment is set up correctly, calibrated and artefacts are recognised. The Clinical Engineer needs to have data skills to be able to design a database, assess data quality, and be able to clearly present complex data. Finally a Clinical Engineer has to be able to horizon scan to keep up to date with the latest innovations within their field.  If a new measurement could be taken to better inform diagnosis or if an existing measurement can be improved – it’s our job to deliver the change.

Clinical Engineers working in this field have a big impact on the patient’s journey towards diagnosis and bring innovation into clinical practice.

If you’re interested in prescribing technology to help those with disabilities…

… then you can specialise in Rehabilitation Engineering. Rehab engineering is a very broad area so different departments specialise in different technologies. The technologies include designing and prescribing bespoke wheelchairs, using Functional Electrical Stimulation to help those with motor neuron lesions to walk, using technology to aid someone’s communication, and innovative ways to access your computer or environment for those with impaired hand function.

A typical day as a Clinical Engineer would involve seeing patients in a clinic or in their home environment and assessing their needs. The assessments vary but require the clinician to consider what the client’s goals are alongside their whole clinical picture. Following an assessment the Clinical Engineer would review potential interventions, decide on the best option, document the assessment and clinical decision in a report and then arrange for the device to be prescribed. After report writing a Clinical Engineer may have other projects they work on in parallel, for example adapting assistive devices to meet a client’s needs, researching the latest assistive technology innovations and assessing outcomes to ensure the prescriptions are beneficial to clients.

Clinical Engineers working in this field therefore need to have a good patient manner, a keen eye for new technology which can be used to support their patients as well as the ability to fully manage a suite of assistive devices.

If you’re interested in designing medical devices…

… then you can specialise in Medical Device Design. Although this is technically a specialism offered within the STP there are very few centres which allow you to specialise in device design. However there is a clinical need for this skill set and there are Trusts which have departments, staffed by Clinical Engineers, which are dedicated to working on device design projects (for example look at the Clinical Engineering Innovation team at Cambridge University Hospitals).

Being involved in designing medical devices is relevant to all of the other 3 specialisms, as making adaptations and improvements to current devices to fulfil a clinical need will always be required.

Clinical Engineers working in this field need to be able to manage many different stakeholders, and take innovative concepts through to final products while ensuring the product is delivered on time, in budget and in line with medical device regulations.

If you’re interested in finding out more about Clinical Engineering and the STP feel free to reach out to me on Twitter @beadeere